Efficacy of Gabexate Mesilate on Disseminated Intravascular Coagulation as a Complication of Infection Developing after Abdominal Surgery

Gabexate Mesilate用於腹部外科後感染引發之瀰漫性血管內凝血之結果

徐潤德(Jun-Te Hsu) ； 陳漢明(Han-Ming Chen) ； 邱德發(De-Fa Chiu) ； 陳日昌(Jih-Chang Chen) ； 黃集仁(Chip-Jin Huang) ； 黃燦龍( Tsann-Long Hwang) ； 詹益銀(Yi-Yin Jan) ； 陳敏夫(Miin-Fu Chen)

《Journal of the Formosan Medical Association》 103卷9期 (2004/09) Pp. 678-684

https://doi.org/10.29828/JFMA.200409.0003

並列摘要

Background and Purpose: Gabexate mesilate (GM) is a promising anticoagulation treatment for disseminated intravascular coagulation (DIC). This study was designed to examine the effect of GM on DIC associated with the development of infection after abdominal surgery in the intensive care unit (ICU).
Methods: From January 1999 to March 2002, 50 consecutive ICU patients suffering DIC associated with the development of infection after abdominal surgery were enrolled in this study. Twenty five of the patients were randomized to receive treatment with GM by central intravenous infusion at 1 mg/kg/hour for 5 days or longer, while the remaining 25 were not treated. Blood clotting tests were performed and cytokine levels including tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6) were examined on days 1,3, and 7 after admission. General blood tests and D-dimer tests were conducted before and after GM administration. The gender, age, mortality, Acute Physiology and Chronic Health Evaluation II (APACHE-II) scores and severity of DIC were compared between the 2 groups.
Results: No significant difference was found between the 2 groups in TNF-αand IL-6 concentration on days 1, 3, and 7. The mortality rate was similar between the 2 groups. However, DIC and APACHE-II scores were significantly lower in the GM-treated patients than in controls.
Conclusion: In this study, GM (1 mg/kg/hour) did not reduce the concentration of TNF-αand IL-6, or alter the mortality rate in patients with DIC resulting from infectious complications after surgery. Nevertheless, APACHE-II scores indicated that GM reduced the DIC severity and improved the clinical condition of patients.

並列關鍵字

APACHE ； Disseminated intravascular coagulation ； Gabexate ； Interleukin-6 ； Multiple organ failure ； TNF-alpha