抗Ⅹa活性检测在抗凝治疗中的临床应用现状与前景  

Status and Prospect of Clinical Application of the Evaluation of Anti⁃Ⅹa Activity in Anticoagulant Therapy

作　　者：邸平[1] 李绵洋[1] DI Ping;LI Mianyang(Department of Laboratory,First Medical Center,General Hospital of Chinese PLA,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心检验科,北京100853

出　　处：《协和医学杂志》2021年第4期456-459,共4页Medical Journal of Peking Union Medical College Hospital

基　　金：国家重点研发计划(2018YFC2000201)。

摘　　要：随着检测技术的进步,临床中各种疾病伴随血栓的检出率越来越高。普通肝素和低分子量肝素是目前临床应用较多的注射用抗凝剂,其中普通肝素的半衰期短、无肾毒性、有拮抗剂;低分子量肝素半衰期较长,需在一些特殊人群如儿童、孕妇、老人中进行监测。口服抗凝剂中,除华法林等传统药物外,靶向活化凝血因子Ⅹa的抗凝药物如利伐沙班亦越来越多地应用于临床。既往采用活化部分凝血活酶时间对普通肝素进行监测,而对低分子量肝素、新型抗Ⅹa类药物监测手段和监测意识不强。随着人们对抗凝治疗认识的不断深入,抗Ⅹa活性检测作为一种新的抗凝监测手段,临床应用越来越广泛,但目前检测结果很难与临床表现相关联,未来仍需大型随机对照试验加以验证。With the progress of detection technology,the incidence rate of thrombosis in various diseases is increasing.Unfractionated heparin(UFH)and low molecular weight heparin(LMWH)are commonly used anticoagulants in the clinic.UFH has a short half⁃life,no nephrotoxicity,and antagonists.LMWH has a long half⁃life,and only needs to be monitored in some special persons,such as children,pregnant women,and the elderly people.At present,among oral anticoagulants,in addition to warfarin and other traditional oral anticoag⁃ulants,there are also many anticoagulants targeting factorⅩa,such as rivaroxaban.More and more attention has been paid to the monitoring of anticoagulant therapy.Activated partial thromboplastin time was used to mo⁃nitor heparin in the past,but LMWH and new anti⁃Ⅹa anticoagulants are not well monitored.With the deepe⁃ning understanding of anticoagulant therapy,anti⁃Ⅹa as a monitoring means can be used to monitor anti⁃Ⅹa drugs,and the scope of use is wider and wider.However,due to the lack of large⁃scale randomized controlled trials,it is difficult to correlate anti⁃Ⅹa activity with clinical manifestations.

关 键 词：抗Ⅹa活性检测 肝素 低分子量肝素 活化部分凝血活酶时间 抗凝 

分 类 号：R446.1[医药卫生—诊断学]