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恶性肿瘤患者的低相对分子质量肝素血栓弹力图R时间监测

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目的 探讨采用血栓弹力图(thromboelastography,TEG)R时间监测低相对分子质量肝素(low molecular weight heparin,LMWH)在恶性肿瘤患者中的临床使用情况,指导临床合理用药.方法 选取恶性肿瘤患者145例,分别于第1次和第2次给予低相对分子质量肝素后4 h肘静脉取血测定TEG R时间和抗Xa活性,比较不同剂量LMWH用药对TEG R时间的影响;比较不同剂量LMWH用药对抗Xa活性的影响;TEG R时间与第一次LMWH给药量间的相关性分析;抗Xa活性与第一次LMWH给药量间的相关性分析;TEG R时间与抗Xa活性间的相关性分析.结果 不同剂量LMWH用药对TER G时间有显著影响(P<0.05);不同剂量LMWH用药对抗Xa活性无显著影响;TER G与第一次LMWH给药量间显著相关(P<0.05);抗Xa活性与第一次LMWH给药量间无显著相关性;TEG R时间与抗Xa活性间无显著相关性.结论 采用TEG R时间比检测抗Xa活性更能灵敏准确的反映恶性肿瘤患者低相对分子质量肝素的临床用药情况.
Thromboelastogram R time monitoring of low molecular weight heparin in malignant tumor
Objective To investigate the clinical use of low molecular weight heparin (LMWH) with thromboelastography (TEG)R time monitoring in malignant tumor patients, and guide clinical rational drug use. Methods 145 patients with malignant tumors were respectively first times and second times with low molecular weight heparin 4 h after venous blood determination of TEG R time and anti Xa activity, compare the effects of different doses of LMWH on TEG R time; the effects of different doses of LMWH against the activity of Xa; the correlation between the doses of LMWH at first time and TEG R time; the correlation between the doses of LMWH at first time and the activity of anti Xa; the correlation between TEG R time and the doses of LMWH at first time. Results Different doses of LMWH treatment had a significant effect on the TER G time (P < 0.05); no significant effect of different doses of LMWH against the activity of Xa; TEG R time with the first LMWH dose significantly correlated (P < 0.05); anti Xa activity and LMWH at the first time had no significant correlation between the dosage; no significant correlation with the anti Xa activity of TEG R time. Conclusion Using TEG R time to detect the clinical application of low molecular weight heparin is more sensitive and accurate compared with anti Xa activity detecting in patients with malignant tumor.

low molecular weight heparinthromboelastogramR timecorrelation analysismalignant tumor

张静

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浙江省义乌市中心医院 检验科,义乌 浙江 322000

低相对分子质量肝素 血栓弹力图(TEG) R时间 相关性分析 恶性肿瘤

2017

中国生化药物杂志
南京生物化学制药研究所,全国生化制药情报中心站,中国生化制药工业协会,中国药品生物制品检定所

中国生化药物杂志

ISSN:1005-1678
年,卷(期):2017.37(1)
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