影响儿童和年轻成年人使用未分离的肝素进行体外循环时凝血时间之间的差异的因素
Taiki Haga1, Yotaro Misaki1, Takaaki Sakaguchi1
1Department of Critical Care Medicine, Osaka City General Hospital, Osaka, Japan.
概括
在未分离肝素 (UFH) 治疗期间,激活凝血时间 (ACT) 和激活部分血栓形成时间 (APTT) 之间的差异可能会发生. 年龄,血小板数和抗血素水平有助于解释儿科患者的这些差异.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 药理学 药理学是指药理学的学科.
- 血液学 血液学 血液学
背景情况:
- 在体外循环过程中监测未分离肝素 (UFH) 是非常重要的.
- 激活凝血时间 (ACT) 和激活部分血栓形成时间 (APTT) 是常见的,但可能有所不同,使抗凝血管理复杂化.
研究的目的:
- 调查导致儿童患者在体外循环过程中ACT和APTT测量之间的差异的因素.
- 确定可能提高抗凝血监测准确度的变量.
主要方法:
- 对在体外循环期间接受UFH的儿科患者进行了回顾性观察性研究.
- 分析了来自23名患者的94个样本,不包括同时测量ACT/APTT或同时服用抗凝剂的样本.
- 使用通用线性模型 (,对数) 开发回归方程,以ACT作为响应变量,包括年龄,血小板数和抗血作为预测因子.
主要成果:
- 与单独APTT相比,将年龄,血小板数和抗血素纳入该模型的解释能力显著提高 (AIC从855降至625,伪R平方从0.01增加到0.42).
- 这些因素被确定为 ACT 和 APTT 之间观察到的变异性的重要贡献者.
结论:
- 一些因素,包括年龄,血小板数和抗血素水平,可以解释UFH儿科患者中ACT和APTT之间的差异.
- 考虑这些变量可能会导致在体外循环期间更精确地调整抗凝治疗.
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