Leri Frederick, Voyce Stephen J, Scialla Salvatore, Glavich William, Dzielak Edward, Smego Raymond A, Guzek John
Department of Clinical Pharmacy, Moses Taylor Hospital, Scranton, PA 18510, USA.
J Thromb Thrombolysis. 2009 Oct;28(3):348-53. doi: 10.1007/s11239-009-0320-8. Epub 2009 Mar 13.
We prospectively compared anti-Xa activity in 61 elderly (>65 years) subjects receiving enoxaparin according to standard or adjusted body weight (ABW) dosing. In the ABW dosing group, mean patient age was 76 years, mean weight 80 kg, mean serum creatinine 1.0 mg/dl, and mean CrCl 48 ml/min. ABW dosing resulted in 57% of elderly study subjects achieving anti-Xa activity of 0.5-1.0 IU/ml, and 80% achieving anti-Xa activity of 0.5-1.2 IU/ml. Compared to standard dosing, for all subjects ABW dosing of enoxaparin was associated with a more favorable mean anti-Xa activity (0.98 IU/ml vs. 1.28 IU/ml, P = 0.001), fewer highest-risk (>1.5 IU/ml) supratherapeutic anti-Xa levels (0% vs. 28%, P = 0.001), and more frequent therapeutic levels among women (64% vs. 25%, P = 0.001). ABW dosing of enoxaparin may be beneficial in elderly patients aged 65 and older, and its benefit appears to be more pronounced in female patients.
我们前瞻性地比较了61名年龄大于65岁、接受依诺肝素标准剂量或根据调整体重（ABW）给药的老年受试者的抗Xa活性。在ABW给药组中，患者平均年龄为76岁，平均体重80kg，平均血清肌酐1.0mg/dl，平均肌酐清除率48ml/min。ABW给药使57%的老年研究受试者抗Xa活性达到0.5-1.0IU/ml，80%的受试者抗Xa活性达到0.5-1.2IU/ml。与标准给药相比，对于所有受试者，依诺肝素ABW给药的平均抗Xa活性更有利（0.98IU/ml对1.28IU/ml，P=0.001），超治疗性抗Xa水平处于最高风险（>1.5IU/ml）的情况更少（0%对28%，P=0.001），女性中达到治疗水平的情况更频繁（64%对25%，P=0.001）。依诺肝素ABW给药可能对65岁及以上的老年患者有益，且其益处似乎在女性患者中更为明显。
