Monitoring of hemostatic abnormalities in major orthopedic surgery patients treated with edoxaban by APTT waveform
Monitoring of hemostatic abnormalities in major orthopedic surgery patients treated with edoxaban by APTT waveform
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DOI：
10.1111/ijlh.12727
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发表时间：
2018-02-01
影响因子：
3
通讯作者：
Sudo, A.
中科院分区：
文献类型：
--
作者：
Hasegawa, M.;Wada, H.;Sudo, A.
前言：对骨科大手术患者应用依多沙班预防静脉血栓栓塞症(VTE)患者的活化部分凝血活酶时间(APTT)进行分析。方法：对上述患者的APTT波形图进行分析，监测依多沙班的应用情况。结果：99例患者中，12例出现深静脉血栓形成，25例出现大出血。服用依度沙班后，APTT波形呈双相增加，但有并发症和无并发症患者的APTT波形无明显差异。用药后加速、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，且与抗Xa活性呈中度相关。接受华法林治疗的患者的速度和加速度峰值2的高度低于接受依多沙班治疗的患者，但这些参数的宽度明显长于接受华法林治疗的患者。给药后1/2纤维蛋白形成高度、加速峰1、2的宽度和速度均明显增加。结论：给药后APTT波峰时间明显延长。因此，APTT波形的分析可能有助于预测大出血的风险。
Introduction: 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.Methods: The APTT waveform was analyzed in the above patients to monitor edoxaban administration.Results: 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.Conclusion: 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.