抗因子Ⅹa活性及APTT测定在深静脉血栓低分子肝素治疗患者中的应用评估  

The application of low-molecular-weight heparin monitoring in patients with deep venous thrombosis

作　　者：潘玉卿[1] 陈正辉[1] 冯曜宇[2] 郭翀[1] 

机构地区：[1]昆明医科大学第一附属医院医学检验科/云南省检验医学重点实验室/云南省实验诊断研究所,昆明650032 [2]昆明医科大学第一附属医院血管外科,昆明650032

出　　处：《检验医学与临床》2017年第10期1448-1450,共3页Laboratory Medicine and Clinic

摘　　要：目的通过测定深静脉血栓(DVT)患者活化部分凝血活酶时间(APTT)和抗因子Ⅹa活性,分析两天指标在检测低分子肝素(LMWH)治疗深静脉血栓患者效果中的意义。方法选择规律使用LMWH的深静脉血栓患者56例,分别检测患者用药前后的APTT和抗因子Ⅹa活性,同时对二者进行应用分析。结果APTT在LMWH使用前为(41.1±8.1)s,使用后为(45.5±7.3)s;抗因子Ⅹa在LMWH使用前为(0.03±0.02)IU/mL,使用后为(0.52±0.07)IU/mL;APTT与抗因子Ⅹa使用后都较使用前升高,且差异有统计学意义(t=-12.199、46.494,P<0.05)。APTT监测与抗因子Ⅹa监测的结果相比较,落在目标剂量范围内(APTT为1.5~2.5倍参考值上限,为64.5~107.5s;抗因子Ⅹa为0.5~1.0IU/mL)的患者,以抗因子Ⅹa法所测得结果比例更高。结论 DVT患者使用LMWH抗凝时,通过检测抗因子Ⅹa活性调整用药剂量比APTT检测更有利于临床对患者使用LMWH效果的监测。临床上经验性使用LMWH后抗因子Ⅹa活性基本在安全范围内,提示临床的经验性用药具有较好的安全性。Objective To evaluate the effect of low-molecular-weight heparin （LMWH） in the treatment of patients with deep venous thrombosis （DVT） by measurement of activated partial thromboplastin time （APTT） and anti-factor Xa activity.Methods A total of 56 patients with DVT which had been treated with LMWH were selected.Levels of APTT and anti-factor Xa were detected and compared before and after the treatment in the two groups.Results APTT values of patients before and after LMWH treatment were （41.1＆#177;8.1）s and （45.5＆#177;7.3）s respectively.And anti-factor Xa before and after the treatment were （0.03＆#177;0.02）IU/mL and （0.52＆#177;0.07）IU/mL,differences were statistically significance （P〈0.05）.Compared with APTT,the rate of patients within the scope of the target dos was significantly higher by the method of anti-factor Xa （APTT：64.5-107.5 s;anti-factor Xa：0.5-1.0 IU/mL） （P〈0.05）.Conclusion Monitoring anti-factor Xa activity has more advantages than APTT in patients with DVT after using LMWH.And anti-factor Xa has good security that is tested by the clinical experience administration.

关 键 词：低分子肝素 深静脉血栓 抗因子Ⅹa 活化部分凝血活酶时间 

分 类 号：R722.12[医药卫生—儿科]