特兰胺酸玻尿酸加滴液矛盾地增加了补体激活:一个PATCH试验二次研究
Nicolle Barmettler1, Elizabeth R Maginot, Ernest E Moore
1From the Division of Acute Care Surgery, Department of Surgery (N.B., E.R.M., F.I.G., C.M.W., T.B.M., A.C., K.S.S., D.H., G.E.V., R.H., C.D.B.), University of Nebraska Medical Center, Omaha, Nebraska; Department of Surgery (E.E.M., J.G.C.), Ernest E Moore Shock Trauma Center, Denver Health; Department of Surgery (H.B.M.), AdventHealth Porter, Denver, Colorado; Department of Cardiology (D.F.D.), Bern Center for Precision Medicine, University Hospital of Bern, Bern, Switzerland; School of Medicine and Psychology (R.G.), Australian National University, Canberra, Australia; Department of Biological Sciences, Hunter College (I.M.B.), New York, New York; The Australian Centre for Blood Diseases (R.L.M.), Monash University; Emergency and Trauma Centre (B.M.), Alfred Health, Melbourne, Australia; Department of Surgery (M.A.S.), Uniformed Services University of Health Sciences, Bethesda, Maryland; Section of Trauma and Acute Care Surgery, Department of Surgery (S.E.R.), University of Chicago Pritzker School of Medicine, Chicago, Illinois; Sauaia Statistical Solutions, L.L.C. (A.S.), Denver, Colorado; and Department of Cellular and Integrative Physiology (C.D.B.), University of Nebraska Medical Center, Omaha, Nebraska.
特兰胺酸 (TXA) 在创伤患者中没有减少早期补充激活. 矛盾的是,TXA在24小时后增加了补充激活,这表明它在炎症反应中起着复杂的作用,并质疑最佳剂量策略.
科学领域:
- 创伤和紧急医疗医学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 特兰胺酸 (TXA) 在多创伤中显示出适度的生存益处,但其影响可能超出血静.
- 等离子体激活补充蛋白,TXA抑制等离子体生成.
- 这项研究研究了TXA对创伤患者补体激活的影响.
研究的目的:
- 确定TXA的使用是否降低了多创伤患者的补体激活.
- 探索TXA,等离子体和外伤后补充通路之间的关系.
主要方法:
- 分析了PATCH试验 (TXA与安慰剂) 中53名多创伤患者的血样本.
- 补充激活标志物 (C3a,C5a,sC5b-9) 和等离子体-抗等离子体水平在ED,8小时和24小时测量.
- 在TXA和安慰剂组之间进行了统计比较.
主要成果:
- 在早期时间点 (ED,8小时) 中,TXA和安慰剂组之间的补充激活或等离子素-抗等离子素水平没有显著差异.
- 在TXA组中,在服用后24小时观察到C3a和C5a水平的显著增加.
- 这些发现表明,TXA可能会在创伤后晚些时候悖论地增强补体激活.
结论:
- 在多创伤患者中,TXA的使用矛盾地增加了24小时后的补充激活.
- 这些结果表明TXA参与创伤后的炎症途径.
- 在创伤中最佳的TXA剂量策略需要进一步调查,因为延迟的炎症效应.
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