Hirsh J, Spillert C R, Delle Donne E P, Lazaro E J
Department of Surgery, UMDNJ-New Jersey Medical School, Newark 07103.
J Natl Med Assoc. 1994 Aug;86(8):627-8.
Hirudin, in its recombinant form (r-hirudin), is emerging as an ideal anticoagulant. As with any anticoagulant, the true anticoagulant property of hirudin should be contingent not on clinical criteria nor on anticoagulant levels, but on a functional assay that monitors changes in the rate at which blood clots. The purpose of this study was to determine the recalcification time (RT) of whole blood and of plasma on incubation with hirudin in vitro. Citrated human venous blood (n = 6) and plasma (n = 9) were incubated at 37 degrees C with either saline or 0.2 U/mL final concentration hirudin. The RT was measured instrumentally after neutralization of the citrate with CaCl2. Compared with saline, mean RT +/- SD values (minutes) with hirudin in blood increased from 6.9 +/- 0.8 to 7.6 +/- 0.6 minutes (P = .04) and in plasma from 9.0 +/- 1.4 to 11.2 +/- 1.4 (P = .001). We conclude that hirudin increases the RT values in both blood and plasma. The increased RT value in plasma is greater compared with that in blood. Whether this method can be used to titrate the dosage of hirudin warrants in vivo assessment.
重组水蛭素（r - 水蛭素）正逐渐成为一种理想的抗凝剂。与任何抗凝剂一样，水蛭素的真正抗凝特性不应取决于临床标准或抗凝剂水平，而应取决于监测血液凝固速率变化的功能测定。本研究的目的是确定全血和血浆在体外与水蛭素孵育时的复钙时间（RT）。将枸橼酸化的人静脉血（n = 6）和血浆（n = 9）在37℃下与生理盐水或终浓度为0.2 U/mL的水蛭素孵育。用氯化钙中和枸橼酸盐后，用仪器测量RT。与生理盐水相比，水蛭素存在时血液中的平均RT ± SD值（分钟）从6.9 ± 0.8增加到7.6 ± 0.6分钟（P = 0.04），血浆中的平均RT ± SD值从9.0 ± 1.4增加到11.2 ± 1.4（P = 0.001）。我们得出结论，水蛭素可增加血液和血浆中的RT值。与血液相比，血浆中增加的RT值更大。这种方法是否可用于滴定水蛭素的剂量有待进行体内评估。
