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[急性冠状动脉综合征患者华法林治疗的实验室监测]

[Laboratory control over warfarin therapy in patients with acute coronary syndrome].

作者信息

Baluda M V, Lopukhina M V, Fomina V M, Lopukhin V O

出版信息

Ter Arkh. 2005;77(10):68-71.

Abstract

AIM

To elicit the most sensitive and reliable method of control over administration of indirect anticoagulants.

MATERIAL AND METHODS

Sixty patients with acute coronary syndrome were studied. They received varfarin under the control of international normalized ratio (INR) calculated by the tables in cases of prothrombin time (PT) estimation on a stationary turbidynamic hemocoagulometer from venous and capillary blood by thromboplastins. In parallel, PT was estimated from whole capillary blood on individual portable coagulometer "Coagu Check C" by means of standard test-strip (prothrombin test--PT) on the study day 1, 3, 5, 7, 14 and 21. The results were assessed on the study day 21. All the patients were treated in hospital then outpatiently.

RESULTS

The assessment of PT results implied calculation of variation coefficient (VC) and error (m) by each index obtained with thromboplastins. VS and m were the lowest when INR was made from whole capillary blood on coagulometer "Coagu Check C".

CONCLUSION

An optimal method of control over efficacy of varfarin treatment is calculation of INR from capillary blood on coagulometer "Coagu Check C" as calculation of INR from capillary and venous blood on stationary coagulometer is complicated and reliability depends on thromboplastin used.

摘要

目的

探寻控制间接抗凝剂给药的最灵敏可靠方法。

材料与方法

对60例急性冠脉综合征患者进行研究。他们在通过血栓形成素对静脉血和毛细血管血在静态比浊血液凝固计上进行凝血酶原时间(PT)测定时,依据表格计算的国际标准化比值(INR)控制下接受华法林治疗。同时,在研究的第1、3、5、7、14和21天,借助标准测试条(凝血酶原试验 - PT)在个体便携式凝血计“Coagu Check C”上从全毛细血管血中估算PT。在研究的第21天评估结果。所有患者随后先在医院接受治疗,之后转为门诊治疗。

结果

对PT结果的评估意味着计算每种用血栓形成素获得的指标的变异系数(VC)和误差(m)。当在凝血计“Coagu Check C”上从全毛细血管血计算INR时,VC和m最低。

结论

华法林治疗效果控制的最佳方法是在凝血计“Coagu Check C”上从毛细血管血计算INR,因为在静态凝血计上从毛细血管血和静脉血计算INR很复杂,且可靠性取决于所用的血栓形成素。

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