Blood:获得性血友病A(AHA)的出血风险及对止血治疗的反应

2020-04-18 QQY MedSci原创

获得性血友病患者在获得部分缓解前,有很高的复发性出血的风险。 VIII因子的残余活性和临床表现状态与复发性出血风险相关。

获得性血友病A (AHA)是由抗凝血因子VIII (FVIII)的自身抗体引起的,通常伴有意外出血。与先天性血友病相比,患者残余的FVIII活性似乎与既往研究提示的出血风险无关。

出血的风险因素尚未被描述。研究人员使用前瞻性GTH-AH研究的数据来评估出血的风险和止血治疗的效果。在基线和其后的每周检测FVIII的活性。治疗医师对出血事件进行评估。

102位患者,共记录了289次出血事件。59%的患者从第一天起共出现了141次新发出血,1-12周内的平均出血率为0.13次/患者·周,在获得部分缓解前的平均出血率为0.27次/患者·周。

每周检测的FVIII活性与出血率显著相关,但只有达到FVIII≥50%才能消除出血风险。在基线时评估的良好的WHO表现状况(得分为0或更高)与较低的出血率相关。据报道,止血治疗对96%的出血有效。

总之,首次确诊为AHA后出现新出血的风险仍然很高,直到部分缓解为止,每周检测的FVIII活性可能有助于评估出血的个体风险。本研究结果将有助于确定未来预防AHA患者出血的治疗策略。

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    2020-04-20 jeanqiuqiu
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    2020-04-20 zhaohui6731
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