中国临床药学杂志2024，Vol.33Issue(5)：339-344,6.DOI:10.19577/j.1007-4406.2024.05.003
急性肺血栓栓塞症患者低分子肝素抗凝治疗中抗Xa因子活性的影响因素分析
Analysis of factors influencing anti-factor Xa activity in low molecular heparin anticoagulation in patients with acute pulmonary thromboembolism
摘要
Abstract
AIM To analyze the related factors affecting the activity of anti-factor Xa in initial gastrointestinal low molecular weight heparin(LMWH)anticoagulant therapy in patients with acute pulmonary thromboembolism(PTE),so as to improve the efficacy and safety of anticoagulant therapy.METHODS A total of 158 patients diagnosed with acute PTE from January 2018 to December 2022 were collected to detect activity of anti-factor Xa after the third dose of LMWH,and the related factors affecting the anti-factor Xa were analyzed.RESULTS Among 158 patients included,56 patients(35.4％)of activity of anti-factor Xa were not up to standard,93 patients(58.9％)were up to standard,and 9 patients(5.7％)were over anticoagulant activity.Correlation analysis indicated that creatinine clearance and activated partial thromboplastin time baseline were negatively correlated with anti-factor Xa,while anti-β2 glycoprotein antibody,antithrombin Ⅲ activity and anticoagulant medication dosage were positively correlated with anti-factor Xa.Further multiple linear regression was used to obtain the regression equation:Yactivity of anti-factor Xa=0.1 07-0.003Xcreatinine clearance＋0.594Xanticoagulant medication dosage+0.287Xantithrombin Ⅲ activity+0.001Xanti-β2glycoprotein antibody.Regression analysis indicated that patients without diseases that increase the binding of heparin-binding proteins had higher levels of activity of anti-factor Xa compared to those with such diseases(P＜0.05).CONCLUSION The factors affecting the anticoagulant activity of LMWH in patients with acute PTE are creatinine clearance rate,APTT baseline,anti-β2 glycoprotein antibody,antithrombin Ⅲ activity and medication dosage.Before anticoagulation of LMWH in PTE patients,anti-thrombin Ⅲ activity,anti-β2 glycoprotein antibody and renal function should be detected,anti-factor Xa should be monitored to adjust the dosage of LMWH to ensure the safety and effectiveness during anticoagulation.关键词
低分子肝素/抗凝/肺血栓栓塞症/抗Xa因子/多元线性回归Key words
low molecular weight heparin/anticoagulant/pulmonary thromboembolism/anti-factor Xa/multiple linear regression分类
马克思主义、列宁主义、毛泽东思想、邓小平理论引用本文复制引用
姚莉,姜倩,崔梦茹,黄渲棋,赵生俊..急性肺血栓栓塞症患者低分子肝素抗凝治疗中抗Xa因子活性的影响因素分析[J].中国临床药学杂志,2024,33(5):339-344,6.基金项目
新疆维吾尔自治区药学会科研基金资助项目(编号YXH201804) （编号YXH201804）
