活化重组因子Ⅶ治疗大动脉炎所致大咯血1例并文献复习

Use of recombinant activated factor Ⅶ in the treatment of massive hemoptysis due to Takayasu′s arteritis and literature review

目的探讨活化的重组因子Ⅶ治疗大动脉炎所致大咯血的疗效。方法以反复咯血为主要症状的男性患者1例,8年前诊断为大动脉炎,曾予甲基强的松龙及环磷酰胺治疗,因反复咯血曾行2次支气管动脉栓塞术,术后仍有反复咯血,此次入院后咯血量多,并出现凝血功能异常,常规止血药物治疗效果不佳,遂予活化的重组因子Ⅶ治疗。结果患者经活化的重组因子Ⅶ治疗后,第2天咯血症状消失,凝血功能逐渐改善,完善浅表及深静脉彩超未发现血栓形成。结论活化的重组因子Ⅶ治疗大动脉炎所致的大咯血安全有效。

Objective To explore feasibility and efficacy of recombinant activated factor Ⅶ （rF Ⅶa）in the treatment of massive hemoptysis due to Takayasu＇s arteritis. Methods A male with repeated hemoptysis was diagnosed Takayasu＇s arteritis 8 years ago. He was treated with methylprednisolone and cyclophosphamide, and did 2 times transcatheter embolization of bronchial arterial due to recurrent hemoptysis. After his admission he experienced massive hemoptysis and coagulation abnormalities. We gave him rF Ⅶa after the routine hemostatic drugs ineffective. Results The second day haemoptysis symptom disappeared and blood coagulation function gradually improved after applying of rF Ⅶa. Improved the superficial and deep vascular ultrasound thrombosis was not found. Conclusion It is an effective and safe therapy for massive hemoptysis due to Takayasu＇s arteritis by rF Ⅶa.