Different patterns of heparin resistance:: therapeutic implications
Different patterns of heparin resistance:: therapeutic implications
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DOI：
10.1191/0267659102pf562oa
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发表时间：
2002-01-01
期刊：
影响因子：
1.2
通讯作者：
Brozzi, S
中科院分区：
文献类型：
--
作者：
Ranucci, M;Isgrò, G;Brozzi, S
肝素抵抗（HR）是心脏手术中的常见特征。其病因通常认为是由于术前肝素治疗导致循环抗凝血酶III（AT III）降低。然而，一些论文强调了AT III值正常的患者中存在HR。本文旨在确定AT III非依赖性肝素耐药患者的这一亚组。本前瞻性试验入组了500例连续患者，这些患者计划在体外循环下进行冠状动脉血运重建。在104例（20.8%）患者中确定了HR。其中36例（总人群的7.2%）术前AT III活性大于或等于100%，定义为AT III非依赖性肝素耐药患者。该亚组与AT III依赖性肝素耐药组显著不同，后者受HR严重程度较低的影响，并且包括较少的肝素预治疗患者。与其他肝素抵抗患者不同，这些受试者对旨在达到超正常AT III活性值的AT III补充没有反应。
Heparin resistance (HR) during cardiac operations is a common feature. Its aetiology often recognizes a decrease in circulating antithrombin III (AT III) due to a preoperative heparin treatment. Nevertheless, some papers highlighted the existence of HR in patients with normal values of AT III. This paper was designed in order to identify this subgroup of AT III-independent heparin-resistant patients. Five hundred consecutive patients scheduled for coronary revascularization with cardiopulmonary bypass were enrolled in this prospective trial. HR was identified in 104 (20.8%) patients. Thirty-six of them (7.2% of the total population) had a preoperative AT III activity greater than or equal to100%, and were defined as AT III-independent heparin-resistant patients. This subgroup significantly differs from the AT Ill-dependent heparin-resistant group being affected by a less severe degree of HR and including less patients pretreated with heparin. Unlike the other heparin-resistant patients, these subjects do not respond to AT III supplementation aimed at reaching supranormal AT III activity values.