氨甲环酸可降低外伤性出血的死亡风险
Tranexamic Acid Lowers Risk of death from Traumatic bleeding
This benefit does not vary by baseline risk for death.
Results of the CRASH-2 trial suggest that tranexamic acid reduces mortality without increasing risk of thrombosis in adult patients with traumatic bleeding (JW Emerg Med Jun 15 2010). In a prespecified analysis of CRASH-2 trial data, researchers assessed whether the effect varies according to baseline risk for death. They stratified 13,273 trauma patients who received placebo or tranexamic acid (1 g over 10 minutes, followed by 1 g over 8 hours) within 3 hours of injury into four groups according to baseline mortality risk: <6%, 6–20%, 21–50%, and >50%.
In each risk group, patients receiving tranexamic acid had significantly fewer fatal and nonfatal thrombotic events and fewer all-cause deaths than those receiving placebo (the mortality benefit was statistically significant in all but the lowest-risk group). The tranexamic acid group also had a significant reduction in arterial thrombotic events, but no reduction in venous thrombotic events. The authors estimated that in each of the four risk groups, the percentages of deaths that could be averted by tranexamic acid treatment were 17%, 36%, 30%, and 17%, respectively. They conclude that use of tranexamic acid should not be limited to patients at high risk for death from traumatic hemorrhage.
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