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用甲磺酸加贝酯治疗弥散性血管内凝血。

Treatment of disseminated intravascular coagulation with gabexate mesilate.

作者信息

Tamaki S, Wada H, Hiyoyama K, Shimura M, Minamikawa K, Wakita Y, Nakase T, Ohiwa M, Kaneko T, Iwasaki E

机构信息

Second Department of Internal Medicine, Mie University School of Medicine, Japan.

出版信息

Clin Ther. 1993 Nov-Dec;15(6):1076-84.

PMID:8111805
Abstract

Gabexate mesilate (FOY) was used to treat 215 patients with disseminated intravascular coagulation (DIC) and 146 patients with a predisposition to DIC (pre-DIC). Sixty percent of DIC patients and 48% of pre-DIC patients exhibited pretreatment organ failure, which resolved after FOY treatment in 16% of DIC patients and 17% of pre-DIC patients. Seventy percent of DIC patients and 49% of pre-DIC patients had a pretreatment bleeding tendency that was ameliorated by FOY treatment in 32% of DIC patients and 30% of pre-DIC patients. Comparison of pretreatment and posttreatment hemostatic studies of the DIC patients revealed that platelet count and levels of fibrinogen degradation products (FDP), thrombin-antithrombin-III complex, and FDP-D-dimer decreased significantly; fibrinogen level increased markedly; and prothrombin time was prolonged. DIC scores were significantly lowered in both leukemic and nonleukemic patients from the third day of treatment with FOY. Among leukemic DIC patients, 59% showed complete remission (CR), 21% partial remission (PR), and 7% exacerbation of their condition; 46% of the nonleukemic DIC patients demonstrated CR, 17% PR, and 17% exacerbation. Of the leukemic pre-DIC patients, 59% showed improvement and 7% exacerbation, whereas 55% of the nonleukemic pre-DIC patients showed improvement and 27% exacerbation.

摘要

甲磺酸加贝酯(FOY)用于治疗215例弥散性血管内凝血(DIC)患者和146例有DIC倾向(DIC前期)的患者。60%的DIC患者和48%的DIC前期患者在治疗前出现器官功能衰竭,在FOY治疗后,16%的DIC患者和17%的DIC前期患者的器官功能衰竭得到缓解。70%的DIC患者和49%的DIC前期患者在治疗前有出血倾向,FOY治疗使32%的DIC患者和30%的DIC前期患者的出血倾向得到改善。对DIC患者治疗前和治疗后的止血研究比较显示,血小板计数、纤维蛋白原降解产物(FDP)水平、凝血酶 - 抗凝血酶 - III复合物和FDP - D - 二聚体显著降低;纤维蛋白原水平显著升高;凝血酶原时间延长。从使用FOY治疗的第三天起,白血病和非白血病患者的DIC评分均显著降低。在白血病DIC患者中,59%完全缓解(CR),21%部分缓解(PR),7%病情加重;46%的非白血病DIC患者表现为CR,17%为PR,17%病情加重。在白血病DIC前期患者中,59%病情改善,7%病情加重,而在非白血病DIC前期患者中,55%病情改善,27%病情加重。

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