廉价药物可减少事故死亡人数

A low-cost, easy-to-use drug could save tens of thousands of lives each year, according to a new study. The medicine promotes blood clotting and has been shown prevent many accident victims from bleeding to death.

Tranexamic acid, or TXA, is not new. It's a clotting drug that has been used in limited situations, such as some surgeries, where it reduces bleeding.

If it can reduce bleeding in the operating room, doctors wondered, why not in the emergency room?

To find out, about 20,000 accident victims in 40 countries from Albania to Zambia were randomly assigned to either get the TXA treatment or not.

"We do a trial of a treatment that we hope would reduce bleeding," said study leader Ian Roberts of the London School of Hygiene and Tropical Medicine. "So we would hope to see there would be less deaths due to hemorrhage, and there was: quite highly significant reduction in the risk of dying due to hemorrhage. Fifteen reduction in the chances of dying if you got this drug."

That's the good news. But Roberts and his colleagues worried that a clotting drug might increase heart attacks or strokes.

"But we didn't find that either," Roberts said at a London news conference. "We saw a highly significant reduction in the risk of dying, and a highly significant increase in the patients who left hospital with no symptoms whatsoever. So that's good news, too."

Patients were given two injections of the drug, which is no longer under patent protection and doesn't require special handling. With treatment costing less than $10 a patient, Roberts says it is remarkably cost-effective.

"It's probably one of the cheapest ways to save a life there ever is. So it compares favorably in terms of cost-effectiveness with anti-malarials, anti-retrovirals. The treatment is seriously cheap, and it doesn't get much more cost-effective than this," he said.

Ian Roberts said TXA should be added to the World Health Organization's list of essential medicines.