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首页> 外文期刊>Thrombosis Journal >Circulating activated protein C levels are not increased in septic patients treated with recombinant human soluble thrombomodulin
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Circulating activated protein C levels are not increased in septic patients treated with recombinant human soluble thrombomodulin

机译:用重组人可溶性血栓调节蛋白治疗的脓毒症患者中循环活化蛋白C水平不会增加

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Recombinant human soluble thrombomodulin (rTM) has been used for the treatment of disseminated intravascular coagulation in Japan, and an international phase III clinical trial for rTM is currently in progress. rTM mainly exerts its anticoagulant effects through an activated protein C (APC)-dependent mechanism, but the circulating APC levels after rTM treatment have not been clarified. This prospective observational study investigated plasma APC levels after rTM treatment. Plasma levels of soluble thrombomodulin, thrombin-antithrombin complex (TAT), protein C, and APC were measured in eight septic patients treated with rTM. APC generation in vitro was assessed in the presence or absence of rTM. rTM significantly increased thrombin-mediated APC generation in vitro. In septic patients, soluble thrombomodulin levels were significantly increased during a 30–60-min period of rTM treatment and TAT levels were decreased. However, APC activity was not increased during the treatment period. Plasma APC activity is not increased in septic patients treated with rTM. It is possible that APC acts locally and does not circulate systemically.
机译:重组人可溶性血栓调节蛋白(rTM)在日本已用于治疗弥散性血管内凝血,目前正在进行rTM的国际III期临床试验。 rTM主要通过活化蛋白C(APC)依赖性机制发挥其抗凝作用,但rTM治疗后循环APC的水平尚不清楚。这项前瞻性观察性研究调查了rTM治疗后的血浆APC水平。在八名接受rTM治疗的脓毒症患者中测量了血浆中可溶性血栓调节蛋白,凝血酶-抗凝血酶复合物(TAT),蛋白C和APC的水平。在存在或不存在rTM的情况下评估体外APC的产生。 rTM在体外显着增加了凝血酶介导的APC生成。在败血症患者中,rTM治疗的30-60分钟内可溶性血栓调节蛋白水平显着升高,而TAT水平降低。但是,在治疗期间APC活性并未增加。用rTM治疗的脓毒症患者血浆APC活性并未增加。 APC可能会在本地起作用,而不会系统地流通。

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