Simeon L, Nagler M, Wuillemin W A
Abteilung für Hämatologie und Hämatologisches Zentrallabor, Luzerner Kantonsspital, Schweiz.
Universitätsklinik für Hämatologie und Hämatologisches Zentrallabor, Inselspital, Bern, Schweiz.
Dtsch Med Wochenschr. 2014 Jan;139(3):94-9. doi: 10.1055/s-0033-1359920. Epub 2014 Jan 7.
The new oral anticoagulants (NOACs) represent alternative antithrombotic agents for prophylaxis and therapy of thromboembolic diseases. They act either by inhibition of the clotting factor Xa or IIa (thrombin). As a consequence, they influence several coagulation assays (for example prothrombin time, activated partial thromboplastin time). Because of the short half-life of these new agents, these changes show great variations in the course of 24 hours. Furthermore, there are significant differences of laboratory results depending on the used reagents. We explain the influence of apixaban, rivaroxaban (factor Xa inhibitors) and dabigatran (thrombin inhibitor) on the most commonly used coagulation assays. Besides we show that this influence depends on the way of action of the drug as well as on the principle of the coagulation assay. Being aware of this relationships helps to interpret the results of coagulation assays under influence of NOACs correctly.
新型口服抗凝药(NOACs)是用于预防和治疗血栓栓塞性疾病的替代抗栓药物。它们通过抑制凝血因子Xa或IIa(凝血酶)发挥作用。因此,它们会影响多种凝血检测(例如凝血酶原时间、活化部分凝血活酶时间)。由于这些新药的半衰期较短,这些变化在24小时内会有很大差异。此外,根据所使用的试剂,实验室结果存在显著差异。我们解释了阿哌沙班、利伐沙班(因子Xa抑制剂)和达比加群(凝血酶抑制剂)对最常用凝血检测的影响。此外,我们表明这种影响取决于药物的作用方式以及凝血检测的原理。了解这些关系有助于正确解释在NOACs影响下的凝血检测结果。