Smith Mark P, Norris Lucy A, Steer Philip J, Savidge Geoffrey F, Bonnar John
Reference Centre for Haemostatic and Thrombotic Disorders, St Thomas' Hospital, Dublin, Ireland.
Am J Obstet Gynecol. 2004 Feb;190(2):495-501. doi: 10.1016/s0002-9378(03)00953-0.
This study was undertaken to assess the pharmacodynamic profile, safety, and efficacy of tinzaparin during pregnancy.
Fifty-four pregnant women, 12 for treatment of thrombosis and 42 for thromboprophylaxis, received tinzaparin by once daily injection. Four-hour postdose anti-Xa results were analyzed by use of repeated measures statistical methods.
One woman (3.4%) on the 175 anti-Xa U/kg dose and three women (20%) on the 50 anti-Xa U/kg dose required a dose increase during the initial dose titration phase to achieve target anti-Xa activity. No thrombotic events occurred.
The 175 anti-Xa U/kg dose is appropriate for treatment and for high-risk thromboprophylaxis throughout pregnancy. In pregnant women at moderate risk of thrombosis, a higher tinzaparin dose is required than in the nonpregnant state and 75 anti-Xa U/kg appears to be appropriate. The majority of women do not need a dose increase with advancing gestation.
本研究旨在评估妊娠期间替扎肝素的药效学特征、安全性及疗效。
54名孕妇,其中12名用于治疗血栓形成,42名用于血栓预防,每日注射一次替扎肝素。采用重复测量统计方法分析给药后4小时的抗Xa结果。
1名接受175抗Xa U/kg剂量的女性(3.4%)和3名接受50抗Xa U/kg剂量的女性(20%)在初始剂量滴定阶段需要增加剂量以达到目标抗Xa活性。未发生血栓事件。
175抗Xa U/kg剂量适用于整个孕期的治疗及高危血栓预防。对于中度血栓形成风险的孕妇,与非妊娠状态相比需要更高剂量的替扎肝素,75抗Xa U/kg似乎是合适的。大多数女性不会随着孕周增加而需要增加剂量。