Marlar Richard A, Clement Bernadette, Gausman Jana
Pathology and Laboratory Medicine Service, Oklahoma City VA Health Care System, Oklahoma City, Oklahoma.
College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Semin Thromb Hemost. 2017 Apr;43(3):253-260. doi: 10.1055/s-0036-1581128. Epub 2016 Jun 6.
When administering unfractionated heparin (UFH), therapeutic levels of anticoagulation must be achieved rapidly and maintained consistently in the therapeutic range. The basic assays for monitoring UFH therapy are the activated partial thromboplastin time (APTT) and/or the chromogenic antifactor Xa or antithrombin assays. For many laboratories, the APTT is the preferred standard of practice; however, the APTT is a surrogate marker that only estimates the heparin concentration. Many factors, including patient variation, reagents of the APTT, UFH composition, and concentration can influence the APTT result. This article reviews various methods to determine the heparin therapeutic range and presents recommendations for the laboratory to establish an APTT heparin therapeutic range for all sizes of hospitals.
在使用普通肝素（UFH）时，必须迅速达到抗凝治疗水平并持续维持在治疗范围内。监测UFH治疗的基本检测方法是活化部分凝血活酶时间（APTT）和/或发色抗Xa因子或抗凝血酶检测。对于许多实验室而言，APTT是首选的标准检测方法；然而，APTT只是一个替代指标，仅用于估算肝素浓度。许多因素，包括患者个体差异、APTT试剂、UFH的成分和浓度等，都会影响APTT结果。本文综述了确定肝素治疗范围的各种方法，并为各规模医院的实验室建立APTT肝素治疗范围提供建议。
