用肝素抑制XI因子降低了模拟儿科体外膜氧化器中的血栓形成
Andrew D Meyer1,2, Catherine R Thorpe3, Tamara Fraker4
1From the Division of Critical Care, Department of Pediatrics, Long School of Medicine, University of Texas Health Science Center, San Antonio, Texas.
概括
使用AB023与肝素一起抑制凝血因子XI (FXI),可以防止体外膜氧化 (ECMO) 电路中的凝血. 这种新的方法提高了设备的寿命和生命支持期间的患者安全.
科学领域:
- 生物医学工程 生物医学工程
- 血液学 血液学 血液学
- 关键护理医学 关键护理医学
背景情况:
- 身体外膜氧化 (ECMO) 对需要循环和气体交换支持的重症患者至关重要.
- 在ECMO期间的全身抗凝剂因血液表面相互作用而受到设备相关血栓形成的挑战.
- 针对凝血因子XI (FXI) 的接触通路激活,为缓解ECMO相关的血栓形成提供了一个潜在的策略.
研究的目的:
- 评估用抗FXI免疫球蛋白G (IgG),AB023抑制FXI的疗效,作为预防ex vivo ECMO电路中血栓形成的肝素辅助剂.
- 为了评估AB023加肝素对电路通透性,凝血因子活性和血栓生成的影响,与单独的肝素相比.
主要方法:
- 在健康志愿者的血液中使用了ex vivo ECMO电路.
- 电路被单独使用未分离的氨酸或与AB023.3结合的氨酸处理.
- 电路通透性,血栓生成时间,血栓峰值和内源性血栓潜力被监测了6小时或直到设备故障.
主要成果:
- 用AB023加肝素治疗的电路在6个小时后在所有情况下 (5/5) 显示持续的通透性,而仅用肝素治疗的电路中60%的电路被堵塞 (3/8).
- 与单独的肝素相比,AB023显著延长了凝块形成的时间 (15.5 vs 3.3 分钟在 3 小时内) 并减少了峰值血栓生成 (123 vs 217 nM).
- 这些发现表明,AB023有效地抑制了FXI的接触通路激活,从而减少了血栓形成.
结论:
- 用AB023抑制FXI可以作为体外生命支持系统中对肝素抗凝的有效补充.
- 这一策略增强了电路通透性,并减少了与ECMO相关的血栓性并发症.
- 针对FXI提供了一个有前途的治疗途径,可以改善ECMO治疗患者的安全性和治疗结果.
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