Fitch J C, Geary K L, Mirto G P, Byrne D W, Hines R L
Department of Anesthesiology, Yale University School of Medicine, Yale-New Haven Hospital, CT, USA.
J Cardiothorac Vasc Anesth. 1999 Feb;13(1):53-7. doi: 10.1016/s1053-0770(99)90174-x.
To compare the abilities of the heparin management test (HMT) and the activated coagulation time (ACT) to provide a measurement of heparin effect in patients undergoing cardiac or peripheral vascular surgery. These measurements of heparin effect were also compared with measurements of heparin concentrations tested by anti-Xa activity. A secondary objective was to compare the performance of the noncitrated HMT with that of the citrated HMT.
A prospective study.
A single-center study conducted in a university hospital.
After human investigation committee approval and informed consent were obtained, adult patients undergoing cardiac or peripheral vascular surgery were included in this study.
In both surgical groups, blood was sampled for ACT, HMT, and anti-Xa activity. Each HMT was performed on both noncitrated and citrated samples.
As an indicator of heparin effect, the HMT had a strong correlation with the ACT (r = 0.899; p < 0.01). In addition, the HMT had a significantly stronger correlation with anti-Xa activity than the ACT (p < 0.01). The correlation obtained from the noncitrated samples was identical with that obtained from the citrated samples (r = 0.819; p < 0.001 for both groups).
The ability of the HMT and the ACT to measure heparin effect was similar. The HMT performed better than the ACT when using anti-Xa activity as a measure of heparin concentration. Noncitrated HMT results were similar to citrated HMT results, thus supporting the use of fresh whole blood for testing purposes.
比较肝素管理试验（HMT）和活化凝血时间（ACT）在心脏或外周血管手术患者中测量肝素效果的能力。还将这些肝素效果测量值与通过抗Xa活性检测的肝素浓度测量值进行比较。次要目的是比较非枸橼酸化HMT与枸橼酸化HMT的性能。
前瞻性研究。
在一家大学医院进行的单中心研究。
在获得人类研究委员会批准并取得知情同意后，纳入接受心脏或外周血管手术的成年患者。
在两个手术组中，采集血液用于ACT、HMT和抗Xa活性检测。每个HMT分别在非枸橼酸化和枸橼酸化样本上进行。
作为肝素效果的指标，HMT与ACT有很强的相关性（r = 0.899；p < 0.01）。此外，与ACT相比，HMT与抗Xa活性的相关性显著更强（p < 0.01）。从非枸橼酸化样本获得的相关性与从枸橼酸化样本获得的相关性相同（r = 0.819；两组p均< 0.001）。
HMT和ACT测量肝素效果的能力相似。以抗Xa活性作为肝素浓度的测量指标时，HMT比ACT表现更好。非枸橼酸化HMT结果与枸橼酸化HMT结果相似，因此支持使用新鲜全血进行检测。
