Harenberg Job, Merx Kirsten, Hoffmann Ursula, Tolle Alexander R, Huisman Menno V
Forth Department of Medicine, University Hospital, Faculty of Clinical Medicine Mannheim of the Ruprecht-Karls, University of Heidelberg, Mannheim, Germany.
J Thromb Thrombolysis. 2002 Aug;14(1):73-8. doi: 10.1023/a:1022022523146.
Coagulation markers are sensitive tools to assess ongoing thrombus formation. An association between changes in these markers and changes in venographic Marder scores in patients with acute deep vein-thrombosis treated with low-molecular-weight (LMWH) or unfractionated heparin (UFH) has not been reported.
We investigated differences in coagulation parameters before and at the end of a twelve days the treatment of patients with an improvement versus no improvement of the venographic findings at the end of the treatment with LMWH (n = 48) and UFH (n = 41).
Patients with lower values in the Marder score had lower D-dimer levels at day 12 compared to entry treated with UFH and LMWH (p < 0.001). Not improved Marder scores paralleled unchanged D-dimer levels at end of both treatments. Higher values of factor-Xa inhibition and Heptest assay (p < 0.001) were measured at the end of treatment in LMWH- in contrast to UFH-patients. Thrombin inhibition was lower and unchanged at day 12 in patients treated with LMWH and UFH, respectively. Thrombin generation inhibition and release of tissue-factor pathway inhibitor remained unchanged in both groups.
An improved Marder score is associated with a decrease of D-dimer during UFH and LMWH treatment of deep vein-thrombosis.
凝血标志物是评估正在形成的血栓的敏感工具。尚未有关于接受低分子量肝素（LMWH）或普通肝素（UFH）治疗的急性深静脉血栓形成患者的这些标志物变化与静脉造影Marder评分变化之间关联的报道。
我们调查了接受LMWH（n = 48）和UFH（n = 41）治疗的患者在治疗12天前和结束时，根据治疗结束时静脉造影结果改善与否的凝血参数差异。
与接受UFH和LMWH治疗的初始值相比，Marder评分较低的患者在第12天时D - 二聚体水平较低（p < 0.001）。两种治疗结束时，Marder评分未改善与D - 二聚体水平未变化情况平行。与UFH治疗的患者相比，LMWH治疗的患者在治疗结束时测量到更高的Xa因子抑制和Heptest测定值（p < 0.001）。接受LMWH和UFH治疗的患者在第12天时凝血酶抑制分别较低且未变化。两组中凝血酶生成抑制和组织因子途径抑制剂的释放均未变化。
在UFH和LMWH治疗深静脉血栓形成期间，Marder评分改善与D - 二聚体降低相关。
