Marongiu F, Sorano G G, Mameli G, Mamusa A M, Cambuli A B, Conti M, Sanna M P, Farci P, Balestrieri A
Institute of Internal Medicine, University of Cagliari, Italy.
Haemostasis. 1989;19(3):142-6. doi: 10.1159/000215907.
The aim of this work was to investigate whether the thrombin activity is related to the degree of anticoagulation induced by oral anticoagulants. Moreover, we tried to detect an optimal anticoagulation range at which the lowest possible thrombin activity can be reached. We investigated 28 patients (19 women and 9 men, mean age 54 +/- 9 years). Anticoagulation had been induced by acenocoumarol for at least 1 year before the beginning of this study. The degree of anticoagulation was monitored by the thrombotest coagulation method. The therapeutic range was 5-13%. The thrombin activity was measured by means of the fibrinopeptide A radioimmunological assay. In 15, 7, and 6 of the patients, thrombotest and fibrinopeptide A were carried out twice, once, and three times, respectively. Our results show first of all a significant positive relationship between thrombotest and fibrinopeptide A (p less than 0.001). Once this result was obtained, we tried to improve our identification of the behaviour of the thrombin activity in relation to the degree of anticoagulation assessed by thrombotest. For this purpose we employed a third-degree polynomial regression analysis which showed a better fit of the data. Since the curve became steeper from about 10% thrombotest levels, we divided the FPA values on the basis of thrombotest ranges. FPA values for the 14- to 25% thrombotest range were significantly different from those in the thrombotest range of 4-10%. Moreover, FPA levels in the 11 to 13% thrombotest range were significantly different from those in the thrombotest range of 4-10%. Our results suggest that a significant decrease in thrombin activity may be achieved only with a deep anticoagulation.
这项工作的目的是研究凝血酶活性是否与口服抗凝剂诱导的抗凝程度相关。此外，我们试图检测出能达到最低凝血酶活性的最佳抗凝范围。我们研究了28例患者（19名女性和9名男性，平均年龄54±9岁）。在本研究开始前，已使用醋硝香豆素诱导抗凝至少1年。通过凝血酶试验凝血法监测抗凝程度。治疗范围为5%-13%。通过纤维蛋白肽A放射免疫分析法测量凝血酶活性。分别对15例、7例和6例患者进行了2次、1次和3次凝血酶试验及纤维蛋白肽A检测。我们的结果首先显示凝血酶试验与纤维蛋白肽A之间存在显著的正相关（p<0.001）。得到这一结果后，我们试图改进对凝血酶活性与凝血酶试验评估的抗凝程度之间关系的识别。为此，我们采用了三次多项式回归分析，结果显示数据拟合度更好。由于从凝血酶试验水平约10%开始曲线变得更陡，我们根据凝血酶试验范围划分了FPA值。凝血酶试验范围为14%-25%时的FPA值与凝血酶试验范围为4%-10%时的FPA值显著不同。此外，凝血酶试验范围为11%-13%时的FPA水平与凝血酶试验范围为4%-10%时的FPA水平显著不同。我们的结果表明，只有进行深度抗凝才能使凝血酶活性显著降低。
