Smets K, Vanhaesebrouck P, Voet D, Schelstraete P, Govaert P
Neonatal Intensive Care Unit, University Children's Hospital, Gent, Belgium.
Am J Perinatol. 1996 May;13(4):217-22. doi: 10.1055/s-2007-994367.
Recombinant tissue type plasminogen activator (rt-PA) has been used successfully in neonates for resolution of thrombotic processes, both arterial and venous. We report on 2 neonates with vena cava inferior thrombosis and with biochemical evidence of liver dysfunction in whom rt-PA treatment had to be interrupted because of significant bleeding tendency, without complete resolution of the thrombus. Therapy failure may be due to the age of the thrombus and the systemic way of administration, bypassing the site of the thrombus by collateral circulation. Impaired liver function may result in decreased degradation of rt-PA with prolonged effect and higher risk for bleeding complications. We suggest that lower doses should be administered in these patients.
重组组织型纤溶酶原激活剂（rt-PA）已成功用于新生儿，以解决动脉和静脉血栓形成过程。我们报告了2例患有下腔静脉血栓形成且有肝功能障碍生化证据的新生儿，他们因明显的出血倾向而不得不中断rt-PA治疗，血栓未完全溶解。治疗失败可能是由于血栓形成的时间以及全身给药方式，侧支循环绕过了血栓部位。肝功能受损可能导致rt-PA降解减少，作用时间延长，出血并发症风险增加。我们建议在这些患者中应给予较低剂量。
