[Monitoring for oral anticoagulant therapy].
[Monitoring for oral anticoagulant therapy].
复制标题
[口服抗凝治疗的监测]。
DOI：
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发表时间：
1995
期刊：
影响因子：
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通讯作者：
H. Tsuji
中科院分区：
文献类型：
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作者：
K. Nakagawa;Y. Nakahara;H. Tsuji
华法林已被广泛用于治疗血栓性疾病的口服抗凝治疗。在日本，凝血酶原时间（PT）比值和凝血试验（TT）百分比通常用于监测其抗凝强度。最近，国际标准化比值（INR）被ICSH/ICTH推荐。在缺血性心脏病（有或无介入治疗）、心肌病和瓣膜病患者中评价INR及其联合使用凝血酶-抗凝血酶III复合物（达特）监测口服抗凝治疗的实用性和有用性。凝血活酶敏感性的差异已被证明会导致PT延长和抗凝活性评价的错误，因此仅通过PT比值进行监测被认为是不相关的，建议使用INR。INR与TT水平相当。达特水平保持正常的大多数患者的INR控制在建议的治疗范围以下。结合INR和达特监测，华法林抗凝作用可以在较低的剂量下安全地达到，低于可能导致出血事件的剂量。
Warfarin has been widely used for an oral anticoagulant therapy against thrombotic diseases. For the monitoring of its anticoagulant intensities, prothrombin time (PT) ratio and percentage of thrombotest (TT) are commonly used in Japan. Recently, International Normalized Ratio (INR) was recommended by ICSH/ICTH. Practicality and usefulness of INR and its combined use of thrombin-antithrombin III complex (TAT) for the monitoring of oral anticoagulation therapy were evaluated among patients of ischemic heart disease with or without interventions, and of cardiomyopathies and valvular diseases. Difference in thromboplastin sensitivities have been shown to cause errors in PT elongation and in the evaluation of anticoagulant activity, so that the monitoring only by PT ratio is considered to be irrelevant, and that INR is recommended to be used. INR was comparable to the levels of TT. Majority of the patients, whose TAT levels were kept normal, were controlled below the proposed therapeutic ranges of INR. With the combination of INR and TAT monitoring, anticoagulant effect of warfarin could be achieved safer in lower dose than the levels that might cause bleeding accidents.