目的 分析反复发作的抗凝血类灭鼠药所致获得性凝血功能障碍的临床特点，探讨其诊治方案。方法 对2009年3月－2010年12月收治的3例抗凝血类灭鼠药所致获得性凝血功能障碍患者的临床表现、实验室检查和治疗转归进行分析，并复习相关文献。 结果 3例患者均以同时出现多部位出血为首发表现，经应用维生素K1、凝血酶原复合物、新鲜冰冻血浆、冷沉淀等治疗，患者病情好转，实验室指标恢复正常。停药（2、5周，3个月）后再次出现多部位出血，再给予维生素K1等治疗，病情可缓解。 结论 维生素K1可作为首选的治疗药物，且对反复发作的患者同样有效。为避免再发性出血，应维持治疗至少3个月。
ObjectTo investigate the pathogenesis of drug-resistant epilepsy by examining the expression of mRNA and protein of Cell Division Cycle 42 GTP-binding protein (Cdc42), Neural Wiskott-Aldrich Syndrome Protein (N-WASP) and Actin-related protein 2/3(Arp2/3) in peripheral blood of patients with drug-resistant epilepsy (DRE).MethodsSeventy two essential epilepsy patients who were attended at outpatients and inpatients in the Department of Neurology of the Affiliated Hospital of Youjiang Medical University for Nationalities were selected from October 2016 to October 2018. According to the 2010 International League Against Epilepsy’s definition of Drug-Resistant Epilepsy, the patients were divided into 2 groups: 32 patients with DRE were defined as DRE group, 40 patients with anti-epilepsy drugs (AEDs) well controlled were defined as the well controlled group. Thirty two healthy persons were selected as control group. The expression of mRNA and protein of Cdc42, N-WASP and Arp2/3 in peripheral blood were measured by quantitative real-time PCR (RT-qPCR) and Western blot(WB). Experimental data were analyzed by ANOVA or rank-sum test.ResultsCompared with well-controlled group and healthy persons group, Cdc42, N-WASP, Arp2/3 in DRE group were significantly increased, the differences were statistically significant (P<0.05). Compared with the control group, Cdc42, N-WASP, Arp2/3 in well-controlled group were significantly increased, with statistically significant differences (P<0.05).ConclusionThe expression of Cdc42, N-WASP, Arp2/3 in peripheral blood of patients with DRE significantly increased, being closely related to the occurrence and development of DRE, and used as indicators in peripheral blood predicting the occurrence of DRE.