Smythe M A, Koerber J M, Westley S J, Nowak S N, Begle R L, Balasubramaniam M, Mattson J C
Department of Pharmaceutical Services, William Beaumont Hospital, Royal Oak, MI, USA.
Am J Clin Pathol. 2001 Jan;115(1):148-55. doi: 10.1309/N7RA-D6XN-9EQX-ABJ9.
The objectives of the present study were to evaluate the relationship between heparin concentration and activated partial thromboplastin time (aPTT) results, define a heparin concentration-derived therapeutic range for each aPTT instrument, compare aPTT- and heparin concentration-guided dosage adjustment decisions, and compare laboratory- and bedside aPTT-guided decisions. In phase 1, 102 blood samples were analyzed for bedside and laboratory aPTTs and heparin concentration (used to establish aPTT therapeutic range). In phase 2, 100 samples were analyzed in the same manner. Correlations for aPTT compared with heparin ranged from 0.36 to 0.82. Dosage adjustment decisions guided by the aPTT agreed with those based on heparin concentration 63% to 80% of the time. Laboratory and bedside aPTT dosage adjustment decisions agreed 59% to 68% of the time. The correlation of aPTT with heparin concentration and agreement between aPTT- and heparin-guided decisions vary with the aPTT instrument. Decisions guided by laboratory aPTT results often disagree with decisions guided by bedside aPTT results.
本研究的目的是评估肝素浓度与活化部分凝血活酶时间（aPTT）结果之间的关系，为每种aPTT仪器确定基于肝素浓度的治疗范围，比较aPTT和肝素浓度指导的剂量调整决策，并比较实验室和床边aPTT指导的决策。在第1阶段，对102份血液样本进行了床边和实验室aPTT以及肝素浓度分析（用于确定aPTT治疗范围）。在第2阶段，以相同方式对100份样本进行了分析。aPTT与肝素的相关性范围为0.36至0.82。aPTT指导的剂量调整决策与基于肝素浓度的决策在63%至80%的时间内一致。实验室和床边aPTT剂量调整决策在59%至68%的时间内一致。aPTT与肝素浓度的相关性以及aPTT和肝素指导决策之间的一致性因aPTT仪器而异。实验室aPTT结果指导的决策通常与床边aPTT结果指导的决策不一致。
