直接口服抗凝剂对ROTEM®变量的影响;一个样本大小计算的实验研究
Lotta Sunnersjö1,2, Lukas Lindquist2, Ulf Schött2,3
1Department of Intensive and Perioperative Care, Skåne University Hospital, Malmö, Sweden.
Scandinavian journal of clinical and laboratory investigation
|December 14, 2024
概括
直接口服抗凝剂 (DOAC) 与出血风险有关. 旋转血小板测量 (ROTEM) 在监测这些药物方面表现有前途,凝血时间 (CT) 与DOAC度一起增加,这表明ROTEM可以指示药物水平.
科学领域:
- 药理学 药理学是指药理学的学科.
- 血液学 血液学 血液学
- 临床诊断 临床诊断 临床诊断
背景情况:
- 直接口服抗凝剂 (DOAC) 广泛用于抗凝.
- 随着DOAC血度升高,出血并发症是一个问题.
- 旋转性血小板造影仪 (ROTEM) 是一个评估血液静止的临床试验,可能与DOAC水平相关.
研究的目的:
- 为了研究增加里瓦洛克萨班度对旋转血栓等离子仪 (ROTEM) EXTEM测试凝血时间 (CT) 的影响.
- 检查利瓦洛克萨班,达比加特兰和阿皮克萨班对ROTEM参数 (如CT,凝块形成时间 (CFT) 和α角 (AA)) 的影响.
主要方法:
- 来自12名健康志愿者的血液中添加了不同度 (0-1000μg/L) 的里瓦洛克萨班,达比加特兰和阿皮克萨班.
- 用四种不同的ROTEM测试分析了尖的血液样本.
- 测量了凝血时间 (CT),凝血形成时间 (CFT) 和α角 (AA).
主要成果:
- 凝血时间 (CT) 随着所有三种DOAC度的上升而线性增加.
- 在EXTEM测定中,Rivaroxaban和达比加特兰在200-1000μg/L时和apixaban在500-1000μg/L时观察到CT升高.
- 凝块形成时间 (CFT) 和α角 (AA) 仅在超治疗性DOAC度下显著受到影响,主要是在INTEM试验中. 阿皮克萨班对CT的影响最小.
结论:
- 来自ROTEM的凝血时间 (CT) 测量与直接口服抗凝剂 (DOAC) 度相关.
- 在临床实践中,ROTEM测定,特别是CT,可以作为监测DOAC水平的替代标记.
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