药代动力学指导治疗重型血友病A急性关节出血患者的疗效观察
Pharmacokinetics in the treatment of acute joint bleeding in patients with severe hemophilia A

曾艳.药代动力学指导治疗重型血友病A急性关节出血患者的疗效观察[J].内科急危重症杂志,2019,25(6):475-477

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DOI：10.11768/nkjwzzzz20190610

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作者	单位	E-mail
曾艳	华中科技大学同济医学院附属梨园医院	hanhongy65@163.com

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中文摘要:

目的：研究在药代动力学(PK)指导下的治疗方案对重型血友病A急性关节出血患者的疗效。方法：因1~2个关节发生急性出血而入院治疗的重型血友病A患者40例，以随机数字表法分为A、B组，每组20名。A组以输注凝血因子Ⅷ后个体化测定的PK参数为依据计算用药剂量及频率；B组以公斤体重为依据计算用药剂量及频率。在用药前、用药后3d及7d，对2组患者在关节肿痛程度、关节出血及血肿吸收（B超测定关节积液等级）等方面的情况进行评定。结果：治疗3d时，A组患者的疼痛缓解优于B组（P<0.05）；治疗7d时，患者血肿吸收程度优于B组（P<0.05）。结论：对于重型血友病A急性关节出血患者，以药代动力学为指导的个体化方案的疗效优于以公斤体重为基础的经验性方案。

英文摘要:

Objective: To study the efficacy of treatment regimens under the guidance of pharmacokinetics (PK) for acute joint bleeding in severe hemophilia A. Methods: A total of 40 inpatients with severe hemophilia A, due to acute bleeding of 1-2 joints, were divided into groups A and B by a random number table (n=20 each). The patients in group A were treated based on the individualized PK parameters after infusion of factor Ⅷ, and those in group B were treated based on kilograms of body weight. The bleeding degree, visual analogue scale (VAS) score and hematoma absorption (measured by B-ultrasound) were compared before, and 3 and 7 days after treatment. Results: At 3rd day of treatment, the pain relief in group A was better than that in group B (P<0.05). The degree of hematoma absorption in group A was better than that in group B at 7th day of treatment (P<0.05). Conclusions: For patients with severe hemophilia A acute joint bleeding, the efficacy of individualized regimen guided by PK is superior to that of weight-based empirical regimen.