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[求助]
求一段论文翻译,因本人是学俄语的,应该挺简单的,谢谢
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How important coadministration of antiplatelet agents is in the pathogenesis of some of these hemorrhagic events is unclear in the context of uremic platelet dysfunction. Antiplatelet agents were administered to 7 of our 10 patients and 1 of the 5 cases described. However, their use would not explain the prolonged APTT seen in 7 of our 10 cases. Four of our patients were on the maintenance hemodialysis program; although the onset of bleeding was on nondialysis days in all patients and the quoted APTTs were 48 hours after hemodialysis, the possible contribution of heparin during dialysis treatment remains unclear. Finally, in our case series, 7 of 10 patients had end-stage renal disease (ESRD), but 1 patient had a CrCl of 30 mL/min (0.50 mL/s) and still experienced a major hemorrhagic event (Fig1). Although there was an overlap with warfarin therapy, he had only been administered 2 doses,and his international normalized ratio was 2.4. LMWHs are derived from standard UFH through controlled chemical or enzymatic degradation, resulting in heterogeneous molecules with individual pharmacological properties. Each commercial product is considered by theWorld Health Organization as a distinct and noninterchangeable drug. There are important differences between LMWHs and UFH, but the clinical relevance of their differences in terms of effectiveness or safety remains unclear. Hence, LMWHs have a reduced ability to catalyze the inhibition of thrombin (IIa), whereas they retain the ability to inhibit Xa activity. The reduced binding of LMWH to plasma proteins and cells (including platelets, endothelial cells, and macrophages) contributes to its more predictable dose response and longer plasma half-life. LMWHs are eliminated primarily by the kidney through glomerular filtration in comparison to UFH, in which renal clearance becomes an important route of elimination only at greater concentrations. |
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爱与雨下: 金币+1 2013-01-01 21:31:22
liboygg: 金币+50, 翻译EPI+1, ★有帮助, 条理还是不怎么清楚 2013-01-03 19:35:12
爱与雨下: 金币+1 2013-01-01 21:31:22
liboygg: 金币+50, 翻译EPI+1, ★有帮助, 条理还是不怎么清楚 2013-01-03 19:35:12
| 在尿毒性血小板功能异常下,多种抗血小板药物联用对一些失血事件的病理进程有何重要意义,尚不清楚。抗血小板药物用于所述的10个病人中的7个,以及5个病例中的一个。然而,这些药物的使用不能解释我们在10个病例中的7个中观察到的APTT的延长。我们的4个病人曾在接受维持性血液透析;虽然所有病人渗血的开始是在非透析日,且采用的APTTs值是透析48小时后的值,透析治疗中肝素的可能贡献尚不清楚。最后,在我们的病例系列里,10个病人中的7个患有终末期肾脏病,但是其中1个病人的CrCl值为30 mL/min (0.50 mL/s),仍然经历了大出血事件(图1)。尽管和华法林抗凝治疗存在一定的重叠,该病人仅使用了2剂量,他的国际标准化比率为2.4。LMWHs源自化学降解或酶降解的标准UFH,导致异质分子具有各自的药学特性。每个商业产品都被世界卫生组织认为是独特的不可相互替换的药物。LMWHs 和 UFH有着重要区别,但是就疗效或安全性而言,它们这些区别的临床相关性仍不清楚。因此, LMWHs抑制凝血酶 (IIa)的催化能力降低了,但是仍然保持其抑制Xa活性的能力。LMWH和血浆蛋白及细胞(包括血小板、内皮细胞和巨噬细胞)的结合力降低,其剂量反应具有更好的可预测性,并能延长血浆半衰期。与UFH 相比,LMWHs主要由肾通过肾小球滤过去除,UFH只有在较高浓度时,肾清除才是一条重要的清除途径。 |

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