Adcock D M, Gosselin R C
Colorado Coagulation, Laboratory Corporation of America® Holdings, Englewood, CO, USA.
University of California, Davis, Davis, CA, USA.
Int J Lab Hematol. 2017 May;39 Suppl 1:37-40. doi: 10.1111/ijlh.12658.
Prolongation of the activated partial thromboplastin time (APTT) and prothrombin time/international normalized ratio (PT/INR) correlates poorly with plasma concentrations of direct oral anticoagulant agents (DOACS) including direct thrombin and direct Xa inhibitors. It has been repeatedly demonstrated that patients can have normal APTT and PT/INR with a therapeutic plasma concentration of a DOAC. Clinicians can no longer rely on a normal APTT and PT to determine that an anticoagulated patient is safe to undergo an invasive procedure. Laboratory scientists need to play a key and active role in educating clinicians about the limitations of the APTT and PT in patients on DOAC prophylaxis or therapy.
活化部分凝血活酶时间（APTT）以及凝血酶原时间/国际标准化比值（PT/INR）的延长与包括直接凝血酶抑制剂和直接Xa因子抑制剂在内的直接口服抗凝剂（DOAC）的血浆浓度相关性较差。反复证实，患者在DOAC治疗血浆浓度下，APTT和PT/INR可能正常。临床医生不能再依靠正常的APTT和PT来确定接受抗凝治疗的患者进行侵入性操作是否安全。实验室科学家需要在向临床医生传授APTT和PT在接受DOAC预防或治疗患者中的局限性方面发挥关键且积极的作用。
