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[用奎克凝血酶原时间监测口服抗凝剂时的标准化问题:瑞士该问题现状的探究]

[Standardization problems in the monitoring of oral anticoagulants by Quick's thromboplastin time: an attempt to determine the state of the problem in Switzerland].

作者信息

Marti P, Beck E A

出版信息

Schweiz Med Wochenschr. 1983 Oct 29;113(43):1593-7.

PMID:6648436
Abstract

In comparison with British Comparative Thromboplastin, we examined 11 different reagents which are presently available in Switzerland for surveillance of oral anticoagulation. Frozen plasma samples obtained from 50 patients under oral anticoagulation for at least 6 weeks were used for comparison of the various reagents. From our results the following conclusions emerge: Our present results largely concur with those of a similar study which compared the therapeutic range of thromboplastin reagents available in Switzerland 6 years earlier; therefore, we assume that the reagents which were sold at that time and are now available in Switzerland have remained fairly constant. In contrast to this apparent agreement, the therapeutic ranges indicated by the producers of reagents are, at least in part, comparable neither with the therapeutic range established for the British Comparative Reagent nor among themselves. Thus, the intensity of the induced coagulation defect is obviously variable, depending on a given test system. The calculated "therapeutic range" for a given test system traditionally corresponds to an average risk of thrombosis or bleeding; this range is not of necessity identical with a target zone that has to be established either individually or for certain diseases. Once established, a target value defining the intensity of oral anticoagulation can be more conveniently reproduced by use of suitable control plasmas rather than with reference thromboplastins, at any rate by practitioners or non specialised hospital laboratories.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

与英国比较凝血活酶相比,我们检测了瑞士目前可用于监测口服抗凝治疗的11种不同试剂。从50名接受口服抗凝治疗至少6周的患者中获取的冷冻血浆样本用于比较各种试剂。从我们的结果得出以下结论:我们目前的结果在很大程度上与一项类似研究的结果一致,该研究比较了6年前瑞士可用的凝血活酶试剂的治疗范围;因此,我们假定当时销售且现在仍在瑞士可用的试剂保持相当稳定。与这种表面上的一致性形成对比的是,试剂生产商给出的治疗范围,至少部分地,既与为英国比较试剂确定的治疗范围不可比,相互之间也不可比。因此,根据特定的检测系统,诱导的凝血缺陷强度明显可变。传统上,给定检测系统计算出的“治疗范围”对应于血栓形成或出血的平均风险;这个范围不一定与必须单独或针对某些疾病确定的目标区间相同。一旦确定,通过使用合适的对照血浆,而不是参考凝血活酶,定义口服抗凝强度的目标值可以更方便地重现,无论如何对于从业者或非专业医院实验室来说都是如此。(摘要截选于250词)

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