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纠正华法林相关的出血:EPAHK研究
原作者: Haney Mallemat,江利冰 译 发布日期:2014-07-10

Title: Reversing Warfarin-Associated Bleeding: The EPAHK Study
题目:纠正华法林相关的出血:EPAHK研究
Author 作者: Haney Mallemat
翻译:江利冰 校对:肖锋

1.A feared complication of patients taking vitamin K antagonists (VKA) is life-threatening bleeding (LTB), including intracranial hemorrhage (ICH).
使用维生素K拮抗剂的患者会发生一种可怕的并发症就是威胁生命的出血(LTB),包括颅内出血(ICH)。

2.Prothrombin complex concentrate (PCC; containing factors 2,7,9,and 10) rapidly reverses VKA-associated bleeding. Despite a rapid reversal of the INR, there is little literature demonstrating a mortality benefit.
凝血酶原复合物(PCC,包含了凝血因子2,7,9和10)可以快速逆转维生素K拮抗剂相关的出血。尽管可以快速逆转国际标准化比值(INR),很少有文献报道可以降低死亡率。

3.The EPAHK study was observational-cohort that examined the 7-day mortality of guideline-concordant administration of PCC and vitamin K (GC-PCC-K) for multiple-types of patients with warfarin-associated bleeding.
EPAHK研究是一个观察性的队列研究,研究了多种类型人群发生华法林相关性出血,使用符合指南推荐的凝血酶原复合物以及维生素K(GC-PCC-K),对7天死亡率的影响。

4.The study demonstrated patients who received GC-PCC-K within 8 hours of presentation had a two-fold decrease in 7-day morality; there was a three-fold reduction when only ICH was considered.
这项研究显示在症状出现后的8h内使用GC-PCC-K可以减少2倍的7天死亡率,如果只是考虑颅内出血的话,可以减少3倍。
 
References 参考文献:
Tazarourte, K. et al. Guideline-concordant administration of prothrombin complex concentrate and vitamin K is associated with decreased mortality in patients with severe bleeding under vitamin K antagonist treatment (EPAHK study). Crit Care. 2014 Apr 24;18(2):R81.