与治疗范围中的时间相关的结果对于接受静脉注射未分离氨酸的患者
Mujtaba Mahmud1,2, Maia Klimatcheva3, Angela Tsang4
1Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Nashville, TN, USA.
概括
与aPTT相比,用抗Xa监测未分离氨酸 (UFH) 显著改善治疗范围 (TTR) 的时间,并减少血栓事件. 抗Xa监测提供了更好的抗凝血控制和患者的结果.
科学领域:
- 药理学 药理学 是一个学科.
- 临床医学 临床医学
- 健康 结果 研究 研究 结果
背景情况:
- 治疗范围内的时间 (TTR) 对于未分离氨酸 (UFH) 的有效性和安全性至关重要,但其与结果的关联未得到充分研究.
- 目前对静脉注射UFH的监测方法包括激活的部分血栓形成时间 (aPTT) 和抗Xa测定,新出现的证据支持抗Xa用于更快的治疗抗凝血.
研究的目的:
- 在接受UFH的患者中调查TTR和血栓性/安全性结局之间的相关性.
- 为了比较aPTT与抗Xa监测在实现治疗性抗凝剂和影响临床结果方面的有效性.
主要方法:
- 一个回顾性,单中心的队列研究,涉及4773名患者入院.
- 患者根据使用的实验室监测技术进行了分层分类:aPTT (n=2,939) 或抗Xa (n=1,834).
- 主要结局:新的血栓事件;次要结局:严重出血. 使用线性插值计算TTR.
主要成果:
- 与aPTT队列相比,抗Xa队列的TTR (56.1%) 与aPTT队列 (41.6%) 相比显著更高 (p < .001).
- 在抗Xa队列中发生的血栓事件较少 (4.6%),而不是aPTT队列 (6.5%) (p = .006).
- 在aPTT和anti-Xa监测组 (33.3%与31.6%,p = .204) 之间没有观察到重大出血率的显著差异.
结论:
- 与aPTT监测相比,用抗Xa测定对静脉注射UFH的监测与显著更高的TTR和更少的血栓事件有关.
- 抗Xa监测似乎是通过UFH实现治疗性抗凝剂的优越方法,可能改善患者对血栓形成的安全性.
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