现代国际标准化比率的历史起源 目标 目标
Sheharyar Raza1, Peter Pinkerton2, Jack Hirsh3
1Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada; Canadian Blood Services, Medical Affairs and Innovation, Toronto, Ontario, Canada.
Journal of thrombosis and haemostasis : JTH
|May 25, 2024
概括
血输血对异常的前血时间 (PT) 和国际正常化比率 (INR) 缺乏证据. 历史的INR目标,经常被毫无理由地使用,推动了这种做法,需要重新评估以合理的未来使用.
科学领域:
- 血液学 血液学 血液学
- 临床病理学 临床病理学
- 医学史 医学史 医学史
背景情况:
- 输血栓时间 (PT) 和国际正常化比率 (INR) 评估凝血.
- 对轻度PT/INR异常的血输血是常见的,但缺乏证据.
- 在指南中,INR目标很普遍,推动了大量的血使用.
研究的目的:
- 审查PT和INR目标的历史发展.
- 检查支持INR测试和血输血对出血风险的证据.
- 为PT/INR管理中的当前实践提供历史背景.
主要方法:
- 关于PT,INR标准化和VKA治疗的历史文献综述.
- 在VKA治疗之外,针对出血风险的INR测试的证据综合.
- 对临床指南和血输血实践的分析.
主要成果:
- 研究了INR目标的历史基础,包括VKA的发展.
- 使用INR来预测非VKA患者出血风险的证据有限.
- 轻度INR升高的血输血是常见的,尽管生物可信度低.
结论:
- 目前用于轻度PT/INR异常的血输血实践缺乏可靠的证据.
- 了解PT和INR的历史揭示了误解中的并行.
- 需要对PT/INR目标进行批判性重新评估,以合理化血输血实践.
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