摘要
目的分析对长期使用抗凝药物进行治疗的脑卒中患者实施Anti-Ⅹa精准监测的效果。方法选择2018年11月至2019年11月在本院实施脑卒中治疗的80例患者为研究样本。全部患者均使用低分子肝素实施治疗,并在用药前后对其分别实施Anti-Ⅹa精准监测及活化部分凝血活酶时间检测。比较用药前后患者Anti-Ⅹa活性水平和部分凝血活酶时间;分析低分子肝素采用Anti-Ⅹa活性监测和部分凝血活酶时间监测情况;分析Anti-Ⅹa活性监测和部分凝血活酶时间监测使用作用。结果用药后患者Anti-Ⅹa活性水平和部分凝血活酶时间均高于用药前(P<0.05)。Anti-Ⅹa活性监测与部分凝血活酶时间监测低分子肝素处于安全治疗范围内患者占比依次是73.75%、5.00%(P<0.05)。使用部分凝血活酶时间监测及Anti-Ⅹa活性监测低分子肝素均低于安全治疗范围者占比为26.25%;部分凝血活酶时间监测低分子肝素低于安全治疗范围但Anti-Ⅹa活性监测低分子肝素在安全治疗范围内者占比为70.00%;部分凝血活酶时间和Anti-Ⅹa活性监测低分子肝素均在安全治疗范围内者占比为3.75%。10例患者抗凝血酶原Ⅲ水平下降,4例患者抗凝血酶原Ⅲ水平及Anti-Ⅹa活性水平均下降。结论脑卒中患者在使用低分子肝素进行抗凝治疗时,通过实施Anti-Ⅹa精准监测,对用药剂量进行合理调整,进而降低出血风险,保障临床用药安全性。
Objective To analyze the effect of anti-Ⅹa precision monitoring in stroke patients treated with long-term use of anticoagulant drugs.Methods Eighty patients who underwent stroke treatment in our hospital between November 2018 and November 2019 were selected as the study sample.All patients were treated with low-molecular-weight heparin.Anti-Ⅹa precise monitoring and activated partial thromboplastin time detection were performed before and after treatment.The anti-Ⅹa activity level and partial thromboplastin time were compared before and after treatment.The low-molecular-weight heparin was analyzed using anti-Ⅹa activity monitoring and partial thromboplastin time monitoring.The use effect of Anti-Ⅹa activity monitoring and partial thromboplastin time monitoring was analyzed.Results The levels of Anti-Ⅹa activity and partial thromboplastin time in patients after treatment were higher than those before treatment(P<0.05).The patients with low-molecular-weight heparin in the safe therapeutic range by Anti-Ⅹa activity monitoring and partial thromboplastin time accounted for 73.75%and 5.00%,respectively(P<0.05).26.25%of the patients using partial thromboplastin time monitoring and anti-Ⅹa activity monitoring had low molecular weight heparin lower than the safe therapeutic range.70.00%of patients had low molecular weight heparin lower than the safe treatment range using partial thromboplastin time monitoring,while their low molecular weight heparin was in the safe treatment range using Anti-Ⅹa activity monitoring.3.75%of the patients had low molecular weight heparin within the safe therapeutic range using both partial thromboplastin time and anti-Ⅹa activity monitoring.AntiprothrombinⅢlevels decreased in 10 patients.AntiprothrombinⅢlevels,as well as anti-Ⅹa activity levels,decreased in 4 patients.Conclusion When stroke patients are treated with low molecular weight heparin for anticoagulant therapy,the dosage is reasonably adjusted by implementing accurate monitoring of Anti-Ⅹa,to reduce the risk of bleeding and ensure the safety of the clinical medication.
作者
彭霜霜
PENG Shuangshuang(Department of Neurology,Taizhou First People's Hospital in Zhejiang Province,Taizhou 318020,China)
出处
《中国现代医生》
2021年第32期105-108,共4页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2020KY1043)。
