CAJ | 학술논문

[目的]探讨中小剂量重组Ⅶa 因子（rFⅦa）治疗高血压脑出血患者的安全性和有效性。[方法]采用前瞻性单中心病例对照研究。2011年8月至2013年1月本院共收治高血压脑出血患者168例，根据纳入标准共86例患者入组，其中试验组27例，对照组59例。试验组患者入院后2 h 内予以单次 rFⅦa 20μg/kg静脉推注，记录并比较两组入院时格拉斯哥昏迷评分（GCS）、凝血指标的变化。随访比较内容包括出院时输注血制品量、ICU 入住天数、总费用、30 d 病死率、90 d 格拉斯哥预后评分（GOS）。[结果]治疗后两组患者凝血功能指标均较治疗前有改善。试验组患者其国际标准化比值（INR）降低（0．29±0．23 vs 0．11±0．39）和凝血酶原时间（PT）缩短（3．26±2．53 vs 1．85±4．5）明显优于对照组，且差异均有显著性（P ＜0．05）。至3个月随访时，两组患者 GOS 评分差异无统计学意义（P ＞0．05）。[结论]rFⅦa 治疗脑出血可改善患者凝血功能，但其与预后之间的关系尚需大样本的临床资料进一步研究。
[목적]탐토중소제량중조Ⅶa 인자（rFⅦa）치료고혈압뇌출혈환자적안전성화유효성。[방법]채용전첨성단중심병례대조연구。2011년8월지2013년1월본원공수치고혈압뇌출혈환자168례，근거납입표준공86례환자입조，기중시험조27례，대조조59례。시험조환자입원후2 h 내여이단차 rFⅦa 20μg/kg정맥추주，기록병비교량조입원시격랍사가혼미평분（GCS）、응혈지표적변화。수방비교내용포괄출원시수주혈제품량、ICU 입주천수、총비용、30 d 병사솔、90 d 격랍사가예후평분（GOS）。[결과]치료후량조환자응혈공능지표균교치료전유개선。시험조환자기국제표준화비치（INR）강저（0．29±0．23 vs 0．11±0．39）화응혈매원시간（PT）축단（3．26±2．53 vs 1．85±4．5）명현우우대조조，차차이균유현저성（P ＜0．05）。지3개월수방시，량조환자 GOS 평분차이무통계학의의（P ＞0．05）。[결론]rFⅦa 치료뇌출혈가개선환자응혈공능，단기여예후지간적관계상수대양본적림상자료진일보연구。
[Objective]To explore the safety and value of middle and low dose of recombinant Ⅶa factor (rFⅦa)for the treatment of patients with hypertensive cerebral hemorrhage.[Methods]A prospective single-centre case control study was conducted.A total of 168 patients with hypertensive cerebral hemorrhage from Aug 2011 to Jan 2013 were admitted in our hospital.According to the recruitment criteria,86 patients were enrolled in this study including 27 patients in experiment group and 59 patients in control group.In the experi-ment group,patients were injected with rFⅦa 20 μg/kg within 2 hours after admission.Glasgow coma scale (GCS)and coagulation parameters of two groups at admission were recorded and compared.The amount of blood transfusion,length of stay in ICU,medical expense,mortality on day 30,and GOS on day 90 were fol-lowed up.[Results]Compared with before treatment,coagulation parameters in two groups after treatment were improved.Compared with control group,international normalized ratio(INR)was decreased(0.29±0.23 v.s 0.11 ± 0.39)and prothrombin time(PT)was shortened in the experiment group(3.26±2.53 v.s 1.85± 4.5)which were better than the control group,and there were significant differences(P <0.05).GOS score of patients was evaluated during 3 months of follow up.The prognosis of patients in the experiment group showed slight better,but there was no significant difference.[Conclusion]rFⅦa for the treatment of cerebral hemorrhage can improve the coagulation of patients,but its correlation with the prognosis needs further inves-tigation by large-sample clinical data.