ESTABLISHING A THERAPEUTIC RANGE FOR HEPARIN-THERAPY

被引：263

作者：

BRILLEDWARDS, P ^{[1
]}

GINSBERG, JS ^{[1
]}

JOHNSTON, M ^{[1
]}

HIRSH, J ^{[1
]}

机构：

[1] HAMILTON CIVIC HOSP, RES CTR, HAMILTON, ON, CANADA

来源：

ANNALS OF INTERNAL MEDICINE | 1993年 / 119卷 / 02期

关键词：

HEPARIN; PARTIAL THROMBOPLASTIN TIME; THROMBOEMBOLISM; DOSE-RESPONSE RELATIONSHIP; DRUG; ANTICOAGULANTS;

D O I：

10.7326/0003-4819-119-2-199307150-00002

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective: To compare two methods of determining a therapeutic range of activated partial thromboplastin time (aPTT) results. Design: Cohort studies. Setting: Referral teaching hospital. Patients: Inpatients who received unfractionated heparin intravenously for venous thromboembolic disease. Measurements: A therapeutic range determined by aPTT ratios of 1.5 to 2.5 times the control value as compared with a therapeutic range determined by protamine titration heparin levels of 0.2 to 0.4 U/mL. Results: For all aPTT reagents studied, a ratio of 1.5 times the control value is much less than a minimum protamine titration heparin level of 0.2 U/mL. Various manufacturers' aPTT reagents and reagent lots from the same manufacturer show considerable variation in response to heparin and therefore have different therapeutic ranges. Conclusions: A different dose of heparin would be required to produce an aPTT ratio of 1.5 times the control value, depending on the reagent used. Establishing a therapeutic range for aPTT results using protamine titration heparin levels of 0.2 to 0.4 U/mL as a reference standard is practical and compensates for the variable response of aPTT reagents to heparin.

引用

页码：104 / 109

页数：6

共 28 条

[1] MEASUREMENT OF THE ACTIVATED PARTIAL THROMBOPLASTIN TIME FROM A CAPILLARY (FINGERSTICK) SAMPLE OF WHOLE-BLOOD - A NEW METHOD FOR MONITORING HEPARIN-THERAPY [J].