Prophylactic dosing adjustment in pregnancy based upon measurements of anti-factor Xa levels
Prophylactic dosing adjustment in pregnancy based upon measurements of anti-factor Xa levels
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DOI：
10.1080/14767050500275796
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发表时间：
2005-11-01
影响因子：
1.8
通讯作者：
Gaddipati, S
中科院分区：
文献类型：
--
作者：
Gyamfi, C;Cohen, R;Gaddipati, S
Objective.确定监测孕妇服用低分子量肝素（LMWH）时抗Xa因子水平的必要性。对血液学数据库进行了审查，并进行了图表审查，以确定接受LMWH治疗的患者。每月绘制水平。如果LMWH的预防和治疗剂量分别具有< 0.2U/mL和0.6U/mL的抗Xa值，则认为它们是次优的。相关变量包括年龄、产次、血栓形成倾向和抗磷脂抗体综合征。在30例患者中，3例需要治疗剂量的LMWH，27例接受预防性治疗。66%的治疗剂量需要改变剂量，而11%的预防剂量需要改变（p = 0.013）。没有一个变量预示着需要改变。1例血栓栓塞事件发生在服用高剂量低分子量肝素时。没有单一变量可以预测需要改变剂量。接受治疗剂量的患者更有可能需要改变。
Objective. To determine the necessity for monitoring of anti-factor Xa levels in pregnant women taking low molecular weight heparin (LMWH).Study design. A review of a hematological database with chart review was undertaken to identify patients on LMWH. Levels were drawn monthly. They were considered suboptimal if prophylactic and therapeutic doses of LMWH had an anti-Xa value < 0.2U/mL and 0.6U/mL, respectively. Variables of interest included age, parity, thrombophilias, and antiphospholipid antibody syndrome.Results. Of 30 patients, three required therapeutic-dose LMWH and 27 were on prophylaxis. Sixty-six percent on a therapeutic dose required a dose change, whereas 11% on a prophylactic dose were changed (p = 0.013). None of the variables were predictive of a need for change. One thromboembolic event was noted while on prophylactic-dose LMWH.Conclusions. No single variable is predictive of a need for dose change. Patients on a therapeutic dose were more likely to need change.