摘要
近年来,直接口服抗凝药(DOACs)在临床中使用逐渐增加,相比于传统口服抗凝药,其具有个体差异小、血药浓度更容易预测等优点。本文通过检索国内外DOACs实验室检测指标的研究文献,试图探究4种DOACs(达比加群酯、利伐沙班、阿哌沙班和依度沙班)的检测方法,并讨论在紧急情况或围手术期时,DOACs检测的使用以及其对于常规凝血功能检测的影响。服用达比加群的患者可使用活化部分凝血活酶时间、稀释凝血酶时间和蝰蛇毒凝血时间检测,服用直接Ⅹa因子抑制药的患者可用Ⅹa因子活性检测,其中服用利伐沙班的患者也可选择高敏感度的凝血酶原时间检测。
In recent years, the use of direct oral anticoagulants(DOACs） have been gradually accumulated in clinical practice. In specific cases,the DOACs blood concentration of patients are needed to be clearly defined in order to assist in further diagnosis and treatment.Therefore,through the study of literature retrieval of DOACs laboratory test at home and abroad,we intended to explore detection method of four kinds of DOACs(dabigatran,rivaroxaban,apixaban and edoxaban）.Meanwhile we also discussed the use of DOACs detection and its effect on coagulation function detection in emergency or during the perioperative period. Finally,the results turned out that patients with dabigatran can detect the blood concentration by activated partial thromboplastin time,diluted thrombin time and ecarin clotting time. Factor Xa activity assay can be used for patients taking direct a factor Xa inhibitor,and high sensitivity of prothrombin time detection are especially suitable for rivaroxaban patients.
作者
王哲
谢秋芬
向倩
崔一民
WANG Zhe;XIE Qiu -fen;XIANG Qian;CUI Yi -rain(Department of Pharmacy, Peking University First Hospital, Beijing 100039, China;Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Peking University Health Science Center, Beijing 100191, China)
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2018年第10期1253-1256,共4页
The Chinese Journal of Clinical Pharmacology
基金
国家自然科学基金面上基金资助项目(81673509
81573504)
国家重点研发计划精准医疗课题基金资助项目(2016YFSF090494)
北京市自然科学基金资助项目(7171012)
