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2007, Número 1

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Acta Med 2007; 5 (1)


Modelo celular de la hemostasia y utilidad del factor VII recombinante activado en la práctica clínica

Carrillo ER, Antigua BYY, Carrillo CJR

Idioma: Español
Referencias bibliográficas: 84
Paginas: 27-34
Archivo PDF: 83.47 Kb.


RESUMEN

El modelo de hemostasia que tradicionalmente ha sido aceptado consiste en dos vías e incorpora una serie de pasos humorales secuenciales que inducen la producción de trombina. El modelo celular de la hemostasia rompe el paradigma anterior y establece que el complejo factor tisular-factor VII activado (FT-FVIIa) en estrecha interacción con plaquetas activadas modula la secuencia del proceso de coagulación que induce la generación de trombina. Se caracteriza por los pasos secuenciales de iniciación, amplificación y propagación. Con base en el modelo celular de la hemostasia se introdujo en la práctica clínica el empleo del factor VII recombinante activado (FVIIra). El FVIIra es potente agente prohemostático que se ha usado ampliamente en pacientes hemofílicos con anticuerpos inhibidores y en otros problemas complejos de coagulación con resultados positivos en el 90% de los casos. La aplicación del FVIIra en otras indicaciones caracterizadas por presentar hemorragia grave y no controlada es promisoria. El FVIIra es efectivo y tiene un amplio margen de seguridad, reportándose una incidencia de 1 a 2% de complicaciones trombóticas.


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