Bower W A, Humphries J E
Department of Internal Medicine, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
Haemostasis. 1995 May-Jun;25(3):144-8. doi: 10.1159/000217154.
A 34-year-old man with recurrent deep and superficial thromboses was found to have severe protein S deficiency. Treatment with both warfarin and adjusted-dose subcutaneous heparin failed to completely prevent thrombosis. Based on reports of increases in the endogenous anticoagulants (protein C, protein S, antithrombin III and plasminogen) with synthetic androgen therapy, the patient was treated with danazol for 8 weeks. Although the levels of antithrombin III, protein C and plasminogen increased, no change in the levels of total or free protein S or C4b binding protein was observed. Treatment was discontinued at 8 weeks when the patient developed a recurrence of superficial thrombophlebitis. The role of synthetic androgens in the treatment of patients with inherited thrombotic disorders is reviewed and potential reasons for treatment failure in this patient are discussed.
一名34岁反复发生深部和浅部血栓形成的男性被发现存在严重的蛋白S缺乏。华法林和调整剂量的皮下肝素治疗均未能完全预防血栓形成。基于合成雄激素治疗可使内源性抗凝剂（蛋白C、蛋白S、抗凝血酶III和纤溶酶原）增加的报道，该患者接受了达那唑治疗8周。尽管抗凝血酶III、蛋白C和纤溶酶原水平升高，但总蛋白S或游离蛋白S以及C4b结合蛋白水平未观察到变化。8周时患者出现浅部血栓性静脉炎复发，治疗中断。本文综述了合成雄激素在遗传性血栓形成疾病患者治疗中的作用，并讨论了该患者治疗失败的潜在原因。
