BEDSIDE MONITORING OF HEPARIN-THERAPY - COMPARISON OF ACTIVATED CLOTTING TIME TO ACTIVATED PARTIAL THROMBOPLASTIN TIME
BEDSIDE MONITORING OF HEPARIN-THERAPY - COMPARISON OF ACTIVATED CLOTTING TIME TO ACTIVATED PARTIAL THROMBOPLASTIN TIME
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DOI：
10.1002/ccd.1810320112
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发表时间：
1994-05-01
期刊：
影响因子：
--
通讯作者：
ROSS, AM
中科院分区：
文献类型：
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作者：
REINER, JS;COYNE, KS;ROSS, AM
肝素抗凝在介入性心脏导管插入术期间和之后使用，以降低急性血栓性冠状动脉闭塞的风险。肝素的半衰期短、维持治疗性抗凝的重要性以及医院实验室处理和检索活化部分凝血活酶时间（aPTT）的固有时间延迟引起了对床旁肝素监测的兴趣。从100例接受静脉肝素治疗的患者的相同血液样本中获得活化凝血时间（ACT）、通过新便携式设备以及医院实验室评估的aPTT和肝素水平（H）。床边测定的aPTT与医院实验室测定的aPTT之间具有良好的相关性（r = 0.89）。ACT与实验室或床旁aPTT均无良好相关性（分别为r = 0.63、0.68）。在亚治疗和治疗范围内，ACT和H之间基本上没有相关性。只有ACT值> 225秒才能预测治疗性或超治疗性aPTT。然而，ACT值< 225秒对于预测抗凝程度没有用处。在维持治疗性抗凝至关重要以及需要确定缺乏抗凝的情况下，床边aPTT测定似乎是一种有用的工具。(C)1994 Wiley-Liss，Inc.
Heparin anticoagulation is utilized during and after interventional cardiac catheterization procedures to reduce the risk of acute thrombotic coronary artery occlusion. The short half-life of heparin, the importance of maintaining therapeutic anticoagulation, and the time delay inherent in the processing and retrieval of the activated partial thromboplastin time (aPTT) by the hospital laboratory has generated interest in point-of-care heparin monitoring. The activated clotting time (ACT), the aPTT as assessed by both a new portable device, as well as the hospital laboratory, and heparin levels (H) were obtained from the same sample of blood in 100 patients receiving intravenous heparin. There was an excellent correlation between the aPTT determined at the bedside and by the hospital laboratory (r = .89). The ACT did not correlate well with either the laboratory or bedside aPTT (r = .63, .68 respectively). In the sub-therapeutic and therapeutic range, there was essentially no correlation between ACT and H. Only ACT values > 225 sec were predictive of therapeutic or supra-therapeutic aPTTs. ACT values < 225 sec, however, were not useful in predicting degree of anticoagulation. In situations in which the maintenance of therapeutic anticoagulation is critical as well as those in which the determination of lack of anticoagulation is required, the bedside determination of aPTT appears to be a useful tool. (C) 1994 Wiley-Liss, Inc.