在预防性未分离的皮下肝素管理的设置中增加的抗Xa
Tatiana Weinstein1, Diana Altshuler2, Elyse Lafond1
1Division of Pulmonary Critical Care, NYU Langone Health, New York, NY, USA.
Journal of pharmacy practice
|January 18, 2024
概括
接受肝素预防的住院患者可能会出现抗Xa水平升高的情况. 这一病例系列突出显示了5名患有和肝素结合蛋白的患者,在例行预防中导致意外高的治疗度.
科学领域:
- 药理学 药理学是指药理学的学科.
- 内部医学 内部医学
- 血液学 血液学 血液学
背景情况:
- 皮下未分离的肝素和低分子量肝素是入院患者静脉血栓塞栓症预防的标准.
- 预防剂量通常具有较差的生物可用性,无法达到治疗性血清度.
- 肝素结合蛋白在特定条件下可以和.
研究的目的:
- 报告一系列病例中,尽管接受了皮下未分离肝素的预防剂量,但患有抗Xa水平升高的患者.
- 在临床实践中研究和肝素结合蛋白的现象.
主要方法:
- 追溯案例系列分析.
- 在接受预防性皮下未分离肝素的患者中监测抗Xa水平.
- 识别出意外高抗Xa水平的患者.
主要成果:
- 五名患者在预防性未分离肝素治疗期间发现抗Xa水平升高.
- 这些升高的水平表明肝素结合蛋白和.
- 这表明,在某些个体中,通过标准预防剂量达到治疗度的潜力.
结论:
- 接受皮下未分离氨酸预防的患者可能会由于和的氨酸结合蛋白质而表现出超治疗性抗Xa水平.
- 在接受肝素预防的部分患者群体中,可能需要对抗Xa水平进行临床监测.
- 这一发现对优化抗凝策略和预防过度和过度预防都有影响.
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