Christen Y, Minazio P, de Moerloose P
Haemostasis Unit, University Cantonal Hospital, Geneva, Switzerland.
Blood Coagul Fibrinolysis. 1993 Aug;4(4):627-30. doi: 10.1097/00001721-199308000-00014.
The effects of Amanita phalloides poisoning on haemostatic parameters were determined in five members of two families with particular attention to coagulation inhibitors. According to the prothrombin time and factor V level, one patient had severe poisoning, one moderate and the other three had only mild toxicity. The decrease of inhibitors (antithrombin III, proteins C and protein S) was not followed by coagulation activation as assessed by the moderate increase in D-dimers and the absence of a clinically significant coagulopathy. Anti-thrombin III showed little decrease, except in the more severely affected case and protein C paralleled the decrease in factor VII, but to a lesser extent. The decrease in coagulation factors and inhibitors could not be explained by their half-lives alone. Factor V was a better indicator of the recovery of liver synthesis function than other factors. Our observations indicate that monitoring coagulation inhibitors in Amanita poisoning is not more informative than prothrombin time and coagulation factor V, both usually recognized as early prognostic markers of fulminant hepatic failure.
在两个家庭的五名成员中测定了毒鹅膏中毒对止血参数的影响，特别关注凝血抑制剂。根据凝血酶原时间和因子V水平，一名患者为重度中毒，一名为中度中毒，另外三名仅为轻度中毒。通过D - 二聚体适度升高和无临床显著凝血病评估，抑制剂（抗凝血酶III、蛋白C和蛋白S）减少后并未出现凝血激活。抗凝血酶III除在受影响更严重的病例中外几乎没有下降，蛋白C与因子VII的下降平行，但程度较小。凝血因子和抑制剂的减少不能仅用它们的半衰期来解释。因子V比其他因子更能指示肝脏合成功能的恢复。我们的观察表明，在毒鹅膏中毒中监测凝血抑制剂并不比凝血酶原时间和凝血因子V更具信息量，这两者通常都被认为是暴发性肝衰竭的早期预后标志物。
