RECURRENT VENOUS THROMBOSIS DURING WARFARIN TREATMENT RELATED TO ACQUIRED PROTEIN-S DEFICIENCY
RECURRENT VENOUS THROMBOSIS DURING WARFARIN TREATMENT RELATED TO ACQUIRED PROTEIN-S DEFICIENCY
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DOI：
10.1016/0049-3848(92)90048-f
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发表时间：
1992-06-15
影响因子：
7.5
通讯作者：
SORBO, JH
中科院分区：
文献类型：
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作者：
ODEGAARD, OR;LINDAHL, AK;SORBO, JH
在3例游离蛋白S浓度极低而C4b结合蛋白(C4bBP)浓度高的患者以及1例遗传性蛋白S缺乏患者中，观察到华法林未能阻止新的血栓形成过程。我们认为C4bBP的增加会降低游离蛋白S的水平，而华法林治疗会导致游离蛋白S的进一步降低。这四位患者都表明这种降低具有临床意义。在这种情况下，肝素似乎更适合作为抗凝剂，因为单独给予华法林是无效的，甚至可能是有害的。在晚期胰腺癌患者中，游离蛋白S水平低于正常水平，总蛋白S水平和C4bBP水平显著高于正常水平(P<0.05)。
Failure of warfarin to prevent new thrombotic processes was observed in three patients with very low free protein S concentrations and high C4b-binding protein (C4bBP) concentrations, and in one patient with hereditary protein S deficiency. We suggest that an increase in C4bBP reduces the free Protein S level, and warfarin treatment causes an additional decrease of free protein S. The four patients presented indicate that such reductions are of clinical importance. Heparin seems preferable as an anticoagulant in this situation, as warfarin given alone is ineffective, or may even be harmful. In a group of pancreatic cancer patients with advanced disease, subnormal mean free protein S was found, whereas mean total protein S concentration, and mean C4bBP concentrations were significantly higher (p