Samama M, Conard J, Horellou M H
J Mal Vasc. 1981;6(4):257-61.
Laboratory control of anticoagulant treatments is still unclear, in spite of 25 years experience, better knowledge of the mechanisms of action of the different drugs, and the new techniques available. In general, laboratory control includes a test specific for the action of the drug involved, associated or not with a test that reflects global coagulability. During heparin treatment, the association of recalcification time or activated partial thromboplastin time with heparin levels is recommended. A weekly platelet count can eliminate heparin-induced thrombocytopenia. During oral anticoagulant treatment, the association of thromboplastin time or Owren's thrombotest with activated partial thromboplastin time is indicated. The therapeutic ranges for thromboplastin times are different according to the reagents used and should be specified by the laboratory since present methods of standardization are not yet satisfactory.
尽管已有25年的经验,对不同药物作用机制的了解更加深入,且有了新的可用技术,但抗凝治疗的实验室控制仍不明确。一般来说,实验室控制包括一项针对所涉药物作用的特定检测,该检测可与或不与反映整体凝血能力的检测相关联。在肝素治疗期间,建议将复钙时间或活化部分凝血活酶时间与肝素水平相结合。每周进行一次血小板计数可排除肝素诱导的血小板减少症。在口服抗凝治疗期间,建议将凝血活酶时间或奥伦氏凝血试验与活化部分凝血活酶时间相结合。凝血活酶时间的治疗范围因所用试剂而异,由于目前的标准化方法尚不尽人意,应由实验室具体规定。