MODS抗凝治疗中凝血因子Ⅹ检测的意义  

Significance of detecting coagulation factor X in anticoagulant therapy of MODS patients.

作　　者：章火祥[1] 陈建国[1] 

机构地区：[1]浙江医院,杭州310013

出　　处：《江西医学检验》2005年第1期9-10,48,共3页Jiangxi Journal of Medical Laboratory Sciences

摘　　要：目的探讨多器官功能障碍综合症(MODS)患者在低分子量肝素抗凝治疗过程中凝血因子Ⅹ和凝血参数监测的意义。方法采用ACL200血凝仪连续监测(0,1h,24h,48h,96h)MODS患者血浆凝血因子Ⅹ活性、凝血酶原时间(PT)、部分凝血活酶时间(APTT)的变化,分别将使用低分子量肝素抗凝后1h,24h,48h,96h血浆凝血因子Ⅹ活性、PT、APTT与用药前比较。结果使用低分子量肝素抗凝治疗后1h,PT、APTT均延长,凝血因子Ⅹ活性明显下降;低分子量肝素维持量(第24h,48h,96h)时,凝血因子Ⅹ活性各测定值之间无显著性差异(P>0.05),但与用药前比较,具有非常显著性差异(P<0.01),而PT、APTT与用药前比较无显著性差异。结论在低分子量肝素抗凝治疗过程中,监测凝血因子Ⅹ和凝血参数非常必要,且监测凝血因子Ⅹ较监测PT、APTT更为有用。检测血浆凝血因子Ⅹ活性是监测MODS患者低分子量肝素抗凝治疗过程中十分有用的方法。Objective To investigate the significance of monitoring coagulation factor Ⅹ and coagulation parameters in multiple organ dysfunction syndrome (MODS) patients with low-molecular-weight heparin anticoagulant therapy. Methods Plasma coagulation factor Ⅹ, prothrombin time (PT) and activated partial thromboplastin time (APTT) were consequently determined(0,1h,24h,48h,96h) from MODS patients by ACL 200 Coagulation Systems. Plasma coagulation Ⅹ, PT and APTT between heparin anticoagulant therapy with 1h, 24h, 48h, 96h and no anticoagulant therapy were compared. Results After heparin anticoagulant therapy 1h, both PT and APTT extended, plasma coagulation factor Ⅹ was significantly decreased; When low-molecular-weight heparin maintenance (24h,48h,96h), there were no significant difference among coagulation factor Ⅹ measurements(P>0.05). Except PT and APTT, the result were very significant difference among compared with no anticoagulant therapy(P<0.01). Conclusions It's essential to monitor plasma coagulation factor Ⅹ and coagulation parameter in low-molecular-weight heparin anticoagulant therapy. Retecting coagulation factor Ⅹ is more important than to detect PT and APTT in monitoring low-molecular-weight heparin anticoagulant therapy for MODS patients.

关 键 词：血浆凝血因子 低分子量肝素 抗凝治疗 MODS APTT 患者 监测 过程 显著性差异 结论 

分 类 号：R446[医药卫生—诊断学] R743[医药卫生—临床医学]