The Severity of Intracranial Hemorrhages Measured by Free Hemoglobin in the Brain Depends on the Anticoagulant Class: Experimental Data.
The Severity of Intracranial Hemorrhages Measured by Free Hemoglobin in the Brain Depends on the Anticoagulant Class: Experimental Data.
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DOI：
10.1155/2017/6516401
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发表时间：
2017
影响因子：
1.5
通讯作者：
Brodsky SV
中科院分区：
文献类型：
--
作者：
Ware KM;Feinstein DL;Rubinstein I;Battula P;Otero J;Hebert L;Wang TF;Ivanova A;Chaudhary S;Hemminger J;Brodsky SV
背景与目的。抗凝治疗广泛用于预防血栓栓塞事件。颅内出血是抗凝治疗的严重并发症，尤其是使用华法林时。直接口服抗凝剂可降低但不能消除颅内出血的风险。本研究的目的是确定在无其他诱因的情况下使用抗凝剂后颅内出血的程度。
方法。用不同种类的抗凝剂（维生素K拮抗剂、肝素、直接凝血酶抑制剂和Xa因子抑制剂）对大鼠进行治疗。通过脑实质中的游离血红蛋白浓度来评估脑出血情况。
结果。维生素K拮抗剂（华法林和溴鼠灵）显著增加了脑中的游离血红蛋白。在直接口服抗凝剂中，凝血酶抑制剂达比加群也显著增加了脑中的游离血红蛋白，而使用Xa因子抑制剂利伐沙班治疗对游离血红蛋白浓度没有显著影响。
结论。我们的数据表明，脑出血的严重程度取决于抗凝剂的种类，且在使用维生素K拮抗剂时更为明显。
Background and Purpose. Anticoagulant therapy is broadly used to prevent thromboembolic events. Intracranial hemorrhages are serious complications of anticoagulation, especially with warfarin. Direct oral anticoagulants reduce but do not eliminate the risk of intracranial hemorrhages. The aim of this study is to determine the degree of intracranial hemorrhage after application of anticoagulants without additional triggers. Methods. Rats were treated with different anticoagulant classes (vitamin K antagonists, heparin, direct thrombin inhibitor, and factor Xa inhibitor). Brain hemorrhages were assessed by the free hemoglobin concentration in the brain parenchyma. Results. Vitamin K antagonists (warfarin and brodifacoum) significantly increased free hemoglobin in the brain. Among direct oral anticoagulants, thrombin inhibitor dabigatran also significantly increased free hemoglobin in the brain, whereas treatment with factor Xa inhibitor rivaroxaban did not have significant effect on the free hemoglobin concentration. Conclusions. Our data indicates that the severity of brain hemorrhages depends on the anticoagulant class and it is more pronounced with vitamin K antagonists.