Application of snake venom hemagglutinin injection

Snake venom hemagglutinin, which contains thrombin and thrombin, has been widely used in clinical hemostasis in recent ten years. Thrombin can promote platelet aggregation at the bleeding site, promote fibrinogen degradation, generate fibrin monomer, and then polymerize into insoluble fibrin, promote thrombosis at the bleeding site; Thrombin activates prothrombin and accelerates the production of thrombin, thereby facilitating the clotting process.

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Snake venom class blood clotting enzyme has low toxicity, work faster (5 ~ 30 minutes after the treatment can produce hemostatic effect), efficacy for a long time (after the work effect sustainable 48 ~ 72 hours) etc, and widely used in clinical need to reduce bleeding or bleeding situations (such as surgery, internal medicine, obstetrics and gynecology, ophthalmology, otolaryngology, mouth cavity hemorrhage and hemorrhagic diseases), It can also be used to prevent bleeding (for example, medication before surgery can avoid or reduce bleeding at the surgical site and after surgery). According to literature reports, the effective rate of snake venom hemagglutinin in surgical incision hemostasis and gastrointestinal bleeding is significantly better than that of phenolsulfonamides, sodium caroxesulfonate, vitamin K and other hemostatic drugs.


Snake venom hemagglutinin injections previously sold in the market mainly include snake venom hemagglutinin injection (trade name: Sulejuan), snake venom hemagglutinin injection (trade name: Bangting), agkistrodon halys hemagglutinin injection (trade name: However, systematic evaluation showed that there was no significant difference in hemostatic efficiency and the incidence of adverse reactions among the three snakes.Snake venom class blood clotting enzyme is a biological preparation, from the chemical structure, belongs to the heterologous protein, and mast cells in vivo or basophilic cell surface molecules, a series of reactions in the cell, vascular active substances, such as histamine release, slow reaction substances, type Ⅰ allergy effects on the body, may also be associated with the enzyme contains impurities. At the same time, both surgical trauma and postoperative pain can lead to acute phase response (APR), such as increased body temperature, increased blood glucose, increased catabolism, negative nitrogen balance and increased plasma acute phase protein (APP) concentration. At this time to give allogenic protein, the body is prone to allergic, or even severe allergic reaction. Zhao Shanshan et al. analyzed literature on case reports of adverse reactions of snake venom hemagglutinase injection, and found that 57 of 69 cases of adverse reactions occurred within 1 hour after injection, and 35 of them occurred within 1 ~ 5 minutes after injection. Acute rapid-onset allergic reaction, if found in time or improper handling, the rapid development of the disease and dangerous, will cause adverse consequences to patients.Therefore, indications should be strictly controlled in clinical use, and the patient's medical history, medication history, allergy history and family history should be carefully inquired before the first use. Prepare medicines and articles needed for emergency treatment before use. The injection speed should be slow, and patients' vital signs and other changes should be closely observed at the beginning of the medication. After careful observation for several minutes, patients can leave to ensure that there are no adverse reactions.

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