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[接受直接口服抗凝剂(DOACs)治疗患者的实验室凝血试验]

[Laboratory coagulation tests in patients treated by direct oral anticoagulants (DOACs)].

作者信息

Sié Pierre

机构信息

CHU de Toulouse, hôpital Rangeuil, laboratoire d'hématologie, TSA 50032, 31059 Toulouse, France.

出版信息

Presse Med. 2015 Jul-Aug;44(7-8):772-8. doi: 10.1016/j.lpm.2015.06.004. Epub 2015 Aug 3.

Abstract

Routine clotting time assays (Prothrombin Time/INR, activated Partial Thromboplastin Time [aPTT]) are prolonged at variable extent by direct oral anticoagulants (DOAC), according to the assay, the reagent and the type of DOAC. These assays are not reliable for monitoring the intensity of treatment and the measurement of the plasma level of the DOAC is usually not required. At high concentrations, DOAC interfere with the routine clotting assays, making them difficult to interpret. In critical situations such as major bleeding or urgent invasive procedure, the measurement of DOAC level and its kinetics are simple and useful to manage the patient.

摘要

根据检测方法、试剂以及直接口服抗凝剂(DOAC)的类型,常规凝血时间检测(凝血酶原时间/国际标准化比值、活化部分凝血活酶时间[aPTT])会被DOAC不同程度地延长。这些检测方法对于监测治疗强度并不可靠,通常也不需要测定DOAC的血浆水平。在高浓度时,DOAC会干扰常规凝血检测,使其难以解读。在诸如大出血或紧急侵入性操作等危急情况下,测定DOAC水平及其动力学对于治疗患者简单且有用。

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