Comparison of Protective Effects of Recombinant Antithrombin Gamma and Plasma-Derived Antithrombin on Sepsis-Induced Disseminated Intravascular Coagulation and Multiple Organ Failure.
Comparison of Protective Effects of Recombinant Antithrombin Gamma and Plasma-Derived Antithrombin on Sepsis-Induced Disseminated Intravascular Coagulation and Multiple Organ Failure.
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DOI：
10.1177/1076029620981630
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发表时间：
2020-01
期刊：
影响因子：
--
通讯作者：
Masuda Y
中科院分区：
文献类型：
--
作者：
Kuroda H;Masuda Y
在日本，新型重组抗凝血酶III浓缩物（rAT-γ）的剂量根据患者体重（BW）进行滴定，而传统血浆衍生抗凝血酶浓缩物（AT）则以固定剂量给药。因此，预计rAT-γ可以产生比AT更好的治疗效果。本研究的目的是比较rAT-γ和AT在临床实践中对脓毒性弥散性血管内凝血（DIC）和多器官衰竭的器官保护作用。本研究在日本的一所大学医院进行。回顾性分析了49例继发于脓毒性DIC的抗凝血酶缺乏症患者，这些患者接受了rAT-γ（n = 26）或AT（n = 23）治疗，以评估补充抗凝血酶浓缩物的剂量、血浆抗凝血酶活性、日本急性医学协会（JAAM）-DIC评分和第0、3和6天的改良序贯性器官衰竭评估（SOFA）评分。每kg BW的rAT-γ AT等效剂量（等于每kg BW的初始rAT-γ剂量除以1.2）显著高于每kg BW的AT剂量（AT 23.4 ± 5.1 vs. rAT 28.9 ± 3.9 IU/kg/天; P < 0.001）。因此，血浆抗凝血酶水平的连续增加在rAT-γ组中发生得更快（P = 0.036）。JAAM DIC和改良SOFA评分显示，rAT组的改善显著大于AT组（JAAM DIC评分：P = 0.042，mSOFA评分：P = 0.005）。这项研究的结果表明，AT补充调整患者体重可能会进一步改善脓毒性DIC和多器官功能衰竭。
In Japan, the dose of the new recombinant antithrombin III concentrate (rAT-gamma) is titrated according to patient body weight (BW), while conventional plasma-derived antithrombin concentrates (AT) are administered as a fixed dose. Therefore, it is anticipated that rAT-gamma could produce better treatment effects than AT. The aim of this study was to compare the organ protective effects of doses of rAT-gamma and AT administered in clinical practice for septic disseminated intravascular coagulation (DIC) and multiple organ failure. This study was performed at a single university hospital in Japan. A total of 49 patients with antithrombin deficiency secondary to septic DIC who were administered either rAT-gamma (n = 26) or AT (n = 23) were retrospectively analyzed to assess the dose of supplemental antithrombin concentrates, plasma antithrombin activity, Japanese Association for Acute Medicine (JAAM)-DIC score, and modified Sequential Organ Failure Assessment (SOFA) score on days 0, 3 and 6. The AT-equivalent dose per kg BW of rAT-gamma (equal to the initial rAT-gamma dose per kg BW divided by 1.2) was significantly higher than the dose per kg BW of AT (AT 23.4 ± 5.1 vs. rAT 28.9 ± 3.9 IU/kg/day; P < 0.001). Consequently, serial increases in plasma antithrombin levels occurred more rapidly in the rAT-gamma group (P = 0.036). JAAM DIC and modified SOFA scores revealed significantly greater improvement in the rAT versus the AT group (JAAM DIC score: P = 0.042, mSOFA score: P = 0.005). The results of this study suggest that AT supplementation adjusted for patient BW might further improve septic DIC and multiple organ failure.
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DOI：
10.1186/s13054-014-0497-x
发表时间：
2014-09-15
期刊：
Critical care (London, England)
影响因子：
--
作者：
Iba T;Saitoh D;Wada H;Asakura H
通讯作者：
Asakura H
影响因子：
4.3
作者：
Yamada T;Kanda Y;Takayama M;Hashimoto A;Sugihara T;Satoh-Kubota A;Suzuki-Takanami E;Yano K;Iida S;Satoh M
通讯作者：
Satoh M
影响因子：
38.9
作者：
Rhodes, Andrew;Evans, Laura E.;Dellinger, R. Phillip
通讯作者：
Dellinger, R. Phillip
影响因子：
3.1
作者：
Aibiki, Mayuki;Fukuoka, Noriyasu;Kikuchi, Satoshi
通讯作者：
Kikuchi, Satoshi
临床综述：抗凝血酶在败血症中作用的分子机制。
DOI：
10.1186/cc4822
发表时间：
2006-02
期刊：
Critical care (London, England)
影响因子：
--
作者：
Wiedermann CJ
通讯作者：
Wiedermann CJ