Hedner U
Novo Nordisk A/S, Health Care Discovery, Gentofte, Denmark.
Blood Coagul Fibrinolysis. 1998 Mar;9 Suppl 1:S147-52.
Haemostasis is initiated by the complex formed by tissue factor (TF) and activated factor VII (FVIIa) present in the blood [1% of the factor VII (FVII) protein]. Recombinant FVIIa (rFVIIa), enzymatically active only after complex formation with TF exposed following tissue damage, has been demonstrated to induce haemostasis in haemophilia patients with life- and limb-threatening bleedings with an efficacy rate of 76-84% in patients having failed on other treatment. rFVIIa has been successfully used in patients with congenital FVII deficiency and has been demonstrated to normalize the prolonged prothrombin time in patients with liver disease and in warfarin-treated individuals. In patients with thrombocytopenia, rFVIIa shortened the prolonged bleeding time in 50% of the patients treated and a haemostatic effect on acute bleeds in eight patients was demonstrated. One patient with Glanzmann's thrombasthenia and three with Type III von Willebrand's disease were successfully treated with rFVIIa. By exploiting the binding capacity of FVIIa to platelets, rFVIIa, may also be used to enhance normal haemostasis in patients without coagulation defects but suffering from bleedings in organs or at sites with limited possibilities for mechanical haemostasis.
止血由血液中组织因子（TF）和活化的凝血因子VII（FVIIa）[占凝血因子VII（FVII）蛋白的1%]形成的复合物启动。重组FVIIa（rFVIIa）仅在与组织损伤后暴露的TF形成复合物后才具有酶活性，已被证明可在患有危及生命和肢体出血的血友病患者中诱导止血，在其他治疗失败的患者中有效率为76 - 84%。rFVIIa已成功用于先天性FVII缺乏症患者，并已证明可使肝病患者和接受华法林治疗的个体延长的凝血酶原时间恢复正常。在血小板减少症患者中，rFVIIa使50%接受治疗的患者延长的出血时间缩短，并证明对8例患者的急性出血有止血作用。1例Glanzmann血小板无力症患者和3例III型血管性血友病患者用rFVIIa成功治疗。通过利用FVIIa与血小板的结合能力，rFVIIa还可用于增强无凝血缺陷但在器官或机械止血可能性有限的部位出血的患者的正常止血功能。
