易栓症

196 5年 ,Egeberg在报道一个挪威家族的血栓形成倾向时使用了易栓症 (Thrombophilia)一词 ,此后这一名词被广泛用于有血栓倾向的患者。易栓症不同于高凝状态和血栓前状态 ,是指患者存在易发生血栓的缺陷 ,这种缺陷可以是遗传的 ,也可继发于某种疾病呈获得性。前者主要的临床特点是有血栓家族史 ,反复的血栓形成 ,年轻时 (<45岁 )发生血栓 ,轻微激惹即可发生血栓 ,患者存在难以治疗的血栓病 ;而获得性易栓症可见于肝病、肾病综合征及红斑狼疮等。1　临床分类1.1　遗传性抗凝血酶 (AT- )缺陷症　于 196 5年Egeberg报道首例 ,临床又分 型…     

Enhancement of study on hemostatic and thrombotic disorders

Hemostasis and thrombosis is a discipline combining various aspects of basic biology and clinical medicine.Hemostatic abnormalities and thrombosis are involved in the pathophysiology of many diseases in clinical medicine. The fundamental and clinical research of the bleeding disorders and thrombotic diseases has been     

抵克力得预防重组人类促红细胞生成素诱发顽固性高血压和血栓症的临床研究

用抵克力得预防重组人类促红细胞生成素(rHuEPO)治疗尿毒症的血栓并发症共17例。并讨论其机理。证实药品改善了血小板聚集功能,能使rHuEPO导致的高血压与血栓症的不良作用得到改善。     

Increased procoagulant activity of red blood cells in the presence of cisplatin

Background Cisplatin based chemotherapy is a well recognized risk factor for coagulation disorders and thrombosis. The pathophysiological mechanisms by which cisplatin promote thrombosis are not well understood. Methods Red blood cells （RBCs） were separated from peripheral blood of patients with breast cancer （n=10） and healthy adults （n=6） and treated with cisplatin. Coagulation time of RBCs was assessed by one step recalcification time and the productions of thrombin, intrinsic and extrinsic factor Xa were measured in the presence or absence of various concentrations of lactadherin. Exposed phosphatidylserine was stained with lactadherin and observed by confocal microscopy and flow cytometry. Results Neither fresh RBCs nor RBCs treated without cisplatin had potent procoagulant activity. Cisplatin treatment increased procoagulant activity of RBCs in a cell number- and concentration-dependent manner. Exposed phosphatidylserine was stained with lactadherin and after cisplatin treatment, strong fluorescence was revealed by confocal microscopy. Lactadherin bound RBCs from patients with breast cancer increased from （1.9＋0.5）% on control RBCs to （68.0±3.5）% on RBCs treated with 10umol/L cisplatin for 24 hours. Conclusions Cisplatin treatment increases procoagulant activity of RBCs, which have a strong association with exposure of phosphatidylserine. The increased procoagulant activity may contribute to the pathogenesis of thrombophilia during cisplatin based chemotherapy in breast cancer patients.     

Tinzaparin可安全有效地预防治疗妊娠期血栓症

Tinzaparin(亭扎肝素,TP)的抗Xa剂量为175U／kg时可有效用于整个妊娠期间的高危血栓症的预防和治疗;对具有中度血栓症风险的妇女而言,Tinzaparin的抗Xa剂量为75U／kg时似乎较为适宜;但大多数妇女勿需随着妊娠的进程而增加Tinzaparin的抗Xa剂量。     

疏血通对血透患者血小板和血液流变学的影响

血液透析（hemodialysis，HD）患者受多种因素影响而易发血栓症，如发生肢体动静脉瘘管（arterio—venous fistula，AW）阻塞、脑梗死等。2003年8月-2007年6月我们应用疏血通注射液治疗81例HD患者，观察其对血小板参数和血液流变学及上肢AVF阻塞防治效果的影响，现报告如下。     

Efficacy of different treatment strategies for hepatocellular carcinoma with portal vein tumor thrombosis

AIM: To evaluate the efficacy of different treatment strategies for hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) and investigate factors influencing prognosis. METHODS: One hundred and seventy-nine HCC patients with macroscopic PVTT were enrolled in this study. They were divided into four groups and underwent different treatments: conservative treatment group (n = 18), chemotherapy group (n = 53), surgical resection group (n = 24) and surgical resection with postoperative chemotherapy group (n = 84). Survival rates of the patients were analyzed by the Kaplan-Meier method. A log-rank analysis was performed to identify group differences. Cox's proportional hazards model was used to analyze variables associated with survival. RESULTS: The mean survival periods of the patients in four groups were 3.6, 7.3,10.1, and 15.1 mo respectively. There were significant differences in the survival rates among the groups. The survival rates at 0.5-, 1-, 2-, and 3-year in surgical resection with postoperative chemotherapy group were 55.8%, 39.3%, 30.4%, and 15.6% respectively, which were significantly higher than those of other groups (p<0.001). Multivariate analysis revealed that the strategy of treatment (P<0.001) and the number of chemotherapy cycles (P = 0.012) were independent survival predictors for patients with HCC and PVTT. CONCLUSION: Surgical resection of HCC and PVTT combined with postoperative chemotherapy or chemoembolization is the most effective therapeutic strategy for the patients who can tolerate operation. Multiple chemotherapeutic courses should be given postoperatively to the patients with good hepatic function reserve.