Tranexamic versus aminocaproic acids in patients with total hip arthroplasty: a retrospective study.
作者: Hui Xie ; Yu-Shen Yang ; Si-Miao Tian ; Ben-Jie Wang ; Wei-Min Fu ; Liang-Liang Cheng ; Nan-Nan Jiang ; Guishan Gu ; De-Wei Zhao
Recently, tranexamic acid (TXA) and epsilon aminocaproic acid (EACA) have been applied in total hip arthroplasty (THA). However, doubts in clinicians' minds about which medicine is more efficient and economical in THA need to be clarified. Therefore, this study compared the efficacy and cost of the intraoperative administration of TXA and EACA per surgery in decreasing perioperative blood transfusion rates in THA.
This study enrolled patients who underwent THA between January 2019 to December 2020. A total of 295 patients were retrospectively divided to receive topical combined with intravenous TXA (n = 94), EACA (n = 97) or control (n = 104). The primary endpoints included transfusions, estimated perioperative blood loss, cost per patient and the drop in the haemoglobin and haematocrit levels.
Patients who received EACA had greater total blood loss, blood transfusion rates, changes in HGB levels and mean cost of blood transfusion per patient (P < 0.05) compared with patients who received TXA. In addition, both TXA and EACA groups had significantly fewer perioperative blood loss, blood transfusion, operation time and changes in haemoglobin and haematocrit levels than the control group (P < 0.05). Cost savings in the TXA and EACA groups were 736.00 RMB and 408.00 RMB per patient, respectively.
The application of perioperative antifibrinolytics notably reduces the need for perioperative blood transfusions. What's more, this study demonstrated that TXA is superior to EACA for decreasing blood loss and transfusion rates while at a lower cost per surgery. These results indicate that TXA may be the optimum antifibrinolytics for THA in Chinese area rather than EACA.
作者: Shenkman, Boris ; Livnat, Tami ; Budnik, Ivan ; Tamarin, Ilia ; Einav, Yulia ; Martinowitz, Uriel
The relationship between tissue-type plasminogen activator (tPA) and urokinase-type plasminogen activator (uPA) function is not fully understood. The aim of this study was to compare in vitro the fibrinolytic activity of tPA and uPA and evaluate their possible interaction. Blood coagulation and fibrinolysis were conducted by rotation thromboelastometry, whereas blood clotting was induced by CaCl2 and tissue factor and fibrinolysis additively by tPA and uPA. Effective concentration 50% of tPA and uPA fibrinolytic activity in blood was found to be 90 and 33 IU/ml relating to the units of activity established by manufacturers in the absence of blood. uPA-induced fibrinolysis in blood was faster compared with tPA used at the same units of activity. In contrast, in a blood-free system containing fibrinogen, plasminogen, and thrombin, fibrinolysis induced by uPA was weaker than by tPA. Treating of blood with tranexamic acid (60 mmol/l) was followed by decreased fibrinolytic potential of both exogenous tPA and uPA, despite uPA by itself is known to be not sensitive to aminocaproic acids. Thus, uPA exerted stronger activity in blood but weaker activity in blood-free system, compared with tPA. Taking into account the intermolecular binding of uPA to tPA, it could be suggested that interaction of exogenous uPA with plasma-containing tPA provided amplification of fibrinolysis due to formation of uPA/tPA complex possessing high affinity to fibrin.
1989-01-01·Vestnik dermatologii i venerologii
[The treatment of psoriatic arthropathy with a combination of mefenamic and aminocaproic acids].
作者: N A Kuliev
Studies of the connective tissue status, lysosomal enzymes and kallikrein-kinin system activities in 30 patients with psoriatic arthropathy have revealed an increased level of the connective tissue matrix and collagen metabolites, elevated activities of proteoglycan-destroying hydrolases and of kallikrein and its precursor. The detected shifts correlated with the severity of the skin and articular processes. Besides the traditional local and fortifying therapy, the patients have been administered mefenamic acid (connective tissue stabilizer) and aminocaproate (tissue protease and kinin system inhibitor). Such treatment has been effective in 76% of the patients. The mean length of treatment has made up 42.3 days. The drugs have had a positive effect on both the skin and articular processes. A tendency to normalization of the biochemical characteristics has been observed. The suggested scheme of therapy is recommended for practice.