Departments of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan.
Departments of Molecular and Laboratory Medicine, Mie University Graduate School of Medicine, Tsu, Japan.
Int J Lab Hematol. 2018 Feb;40(1):49-55. doi: 10.1111/ijlh.12727. Epub 2017 Sep 4.
An analysis of the activated partial thromboplastin time (APTT) in major orthopedic surgery patients receiving edoxaban for the prevention of venous thromboembolism (VTE) was carried out.
The APTT waveform was analyzed in the above patients to monitor edoxaban administration.
Of these 99 patients, 12 exhibited deep vein thrombosis, and 25 had massive bleeding. An increased biphasic pattern of the APTT waveform was observed after the administration of edoxaban, but there were no significant differences between the patients with and without complications. The peak times of acceleration, velocity, and 1/2 fibrin formation were significantly prolonged after the administration of edoxaban, especially in patients with massive bleeding, and were moderately correlated with the anti-Xa activity. While the heights of velocity and acceleration peak 2 were lower in patients receiving warfarin treatment than in those receiving edoxaban, the widths of these parameters were significantly longer. The height of 1/2 fibrin formation and the width of acceleration peaks 1 and 2 and the velocity were significantly increased after the administration of edoxaban.
The peak time of the APTT waveform was significantly prolonged after the administration of edoxaban. The analysis of the APTT waveform may therefore be useful for the prediction of the risk of massive bleeding.
对接受依度沙班预防静脉血栓栓塞症（VTE）的骨科大手术患者的活化部分凝血活酶时间（APTT）进行分析。
对上述患者的 APTT 波形进行分析，以监测依度沙班的给药情况。
在 99 例患者中，12 例出现深静脉血栓形成，25 例发生大出血。依度沙班给药后，观察到 APTT 波形呈双相增加模式，但有并发症和无并发症患者之间无显著差异。依度沙班给药后，加速、速度和 1/2 纤维蛋白形成的峰值时间明显延长，尤其是大出血患者，与抗 Xa 活性呈中度相关。虽然接受华法林治疗的患者的速度和加速度峰值 2 的高度低于接受依度沙班治疗的患者，但这些参数的宽度明显更长。依度沙班给药后，1/2 纤维蛋白形成的高度、加速峰值 1 和 2 的宽度以及速度均显著增加。
依度沙班给药后 APTT 波形的峰值时间显著延长。因此，APTT 波形分析可能有助于预测大出血的风险。
