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Thrombin

神经

关键词神经 临床研究术语 凝血因子

词汇介绍

拓展阅读

解析

thrombin    英 ['θrɒmbɪn]  美 ['θrɑmbɪn] 

释    义   n. [生化] 凝血酶

例    句   The ultimate result is the formation of the thrombin and fibrin clot, and each enzymolysisaccompaniment magnify effective. 最终结果是凝血酶和纤维蛋白凝块的形成,而且每步酶解反应均有放大效应。

概述

凝血酶也称为凝血因子IIa(FIIa),由其无活性前体凝血酶原转化而成,是丝氨酸蛋白酶和维生素K依赖性凝血因子家族的成员,参与凝血过程的各个环节,在凝血级联中起关键作用。在凝血反应中,凝血酶通过正负反馈,发挥着促凝和抗凝双重调节作用,维持机体凝血系统的平衡。近年来发现,凝血酶除了在凝血级联中发挥重要作用外,与炎症及炎症相关的多种疾病也关联密切,累及神经、消化、心血管、运动、呼吸、内分泌等多个系统。结构凝血酶来源于其无活性的酶原形式-凝血酶原,一种在肝脏中合成并分泌到血液中的70KD糖蛋白。在

Fresh frozen plasma transfusion in patients with cirrhosis and coagulopathy: effect on conventional coagulation tests and thrombomodulin-modified thrombin generation复制标题

肝硬化和凝血病患者新鲜冰冻血浆输注: 对常规凝血试验和血栓调节蛋白修饰凝血酶生成的影响

发表时间:2019-09-16

影响因子:18.9

作者: Amanda Bruder Rassi

期刊:J Hepatol

BACKGROUND AND AIMS:The efficacy of fresh frozen plasma (FFP) transfusion in enhancing thrombin generation in patients with cirrhosis and impaired conventional coagulation tests has not been sufficiently explored.METHODS:Fifty-three consecutive patients receiving a standard dose of FFP to treat bleeding and/or before invasive procedures if prothrombin time (PT) ratio-INR was ≥1.5 were prospectively enrolled. Primary endpoint was the amelioration of endogenous thrombin potential (ETP) with thrombomodulin (ETP-TM) after transfusion, which corresponds to the total amount of generated thrombin. PT-INR, aPTT were also assessed before and after transfusion.RESULTS:FFP enhanced ETP-TM by 5.7%, from 973 [731-1258] to 1028 [885-1343] nM x min; p= 0.019). Before transfusion, evidence of normal or high ETP-TM was found in 94% of patients, even in those with bacterial infections. Only 1 (1.9%) patient had ETP-TM values reverting to the normal range after transfusion. Notably, no patients with low ETP-TM had bleeding. The median decrease in ETP-TM was 8.3% and the mean was 12.8% in 18 (34%) after transfusion (from 1225 [1071-1537] to 1124 [812-1370] nM x min; p=<0.0001). Similar responses to FFP transfusion were observed in patients with compensated and acute descompensated cirrhosis, ACLF, infection or shock. FFP significantly ameliorated INR and aPPT values (p < 0.0001), but in a minority of patients the values were reduced to less than the cut-off point of 1.5.

译文

背景与目的:新鲜冰冻血浆(ffp)输注对肝硬化及常规凝血功能受损患者凝血酶生成的影响尚未得到充分的探讨。方法:53名连续接受标准剂量ffp治疗出血和/或在侵入性手术前(如果凝血酶原时间(pt)比值inr≥1.5)的患者被前瞻性纳入研究。主要终点是输注血栓调节蛋白(ETP-TM)后内源性凝血酶电位(ETP)的改善,与凝血酶生成总量相对应。输血前、输血后检测pt-inr、aptt。结果:ffp对etp-tm的增强率为5.7%,由973[731-1258]提高到1028[885-1343]nm x min,p=0.019)。在输血前,94%的患者,即使是那些有细菌感染的患者,也发现ETP-TM正常或高。只有1例(1.9%)患者输血后etp-tm值恢复到正常范围。值得注意的是,低etp-tm患者没有出血。输血后ETP-TM的中位下降率为8.3%,平均下降率为12.8%(34%)(从1225[1071-1537]下降到1124[812-1370]nM x min;P=<0.0001)。在代偿性和急性非代偿性肝硬化、aclf、感染或休克患者中观察到类似的ffp输血反应。ffp能显著改善inr和appt值(p<0.0001),但少数患者的inr和appt值低于1.5的临界值。