血友病甲亲属供脾全脾移植后的凝血像变化  

Changes of coagulation picture in hemophilia A patients with whole-organ transplantation of living relative spleen

作　　者：刘慎微[1] 陈知水[1] 徐慧珍[1] 夏穗生[1] 

机构地区：[1]同济医科大学附属同济医院器官移植研究所,武汉430030

出　　处：《中华器官移植杂志》1997年第3期174-176,共3页Chinese Journal of Organ Transplantation

摘　　要：对3例血友病甲患者行亲属供脾全脾移植后的凝血像进行分析,以了解术后的变化情况。发现部分凝血活酶时间(KPTT)、血栓弹力图中的r值(凝血潜伏期)及K值(全血栓形成期)移植后较移植前明显缩短,其中KPTT值在脾脏移植半年后随着Ⅶ因子(Ⅶ:C)浓度的降低而逐渐延长,基本可间接反应血中Ⅷ:C水平,而r值及K值在术后半年至3年仍处于较术前明显缩短的水平,与Ⅷ:C的再度下降不成正比。全血粘度、血浆粘度及血小板聚积,术前与术后的差异不显著,与Ⅷ:C也无相关性。从而认为,血友病患者行全脾移植后远期的Ⅶ:C水平虽然较手术近期降低,但临床仍无出血的现象可能是移植脾除合成Ⅶ:C外,还可刺激机体产生某种促凝物质,加速血栓形成,而使血友病患者的出血得以改善。并认为Ⅶ:C水平逐渐下降可能与长期免抑制剂的应用有关。The changes of coagulation picture in 3 hemophilia A patients with whole-organ transplantation of living relative spleen were investigated. It was found that the values of KPTT, r (during incubation period) of coagulation, K (during whole thrombosis period) of thromboelas-tograph were obviously decreased as compared with those before transplantation. Among them, KPTT values were gradually increased followed Ⅷ: C level gradual reduction after half a year of spleen transplantation. But r and K values during 0.5 to 3 years after transplantation were still obviously lower than those before transplantation. Although Ⅷ: C level in the far future was lower than that in the near future after the whole-spleen transplantation, the bleeding did not clinically occurred. The reason might be as follows: the transplanted spleen can also stimulate the human body to produce some substances which can accelerate process of coagulation and thrombosis, then the bleeding is improved. It was also considered that the gradual decrease of Ⅷ: C level may be related to long-term use of immunosuppressive durgs.

关 键 词：脾移植 血友病 血液凝固 

分 类 号：R657.6[医药卫生—外科学] R554.105[医药卫生—临床医学]