达比加群酯对1例肺栓塞患者凝血功能影响.PDFVIP

达比加群酯对 1 例肺栓塞患者凝血功能的影响  a b 章晔 ，陈晔 (浙江中医药大学附属第二医院，a.药剂科，b. 呼吸科，杭州 310005) 摘要：目的 探讨达比加群酯对凝血功能的影响及抗凝活性监测的意义。方法 临床药师根据 1 例肺栓塞患者服用达比 加群酯的凝血指标，提出合理的药物治疗建议。结果 患者部分凝血活酶时间(activated partial thromboplastin time ，APTT) 延长超过正常上限(upper limit of normal ，ULN)2 倍，临床药师建议服药后 12 h 重新检验 APTT ，目标值为 1.5 倍 ULN ， 患者复查后达标。结论 特殊人群常规凝血指标监测有助于明确抗凝疗效，采血时机非常关键。APTT 可供定性评估， 但结果解读需谨慎。 关键词：达比加群酯；肺栓塞；凝血功能；临床药师 中图分类号：R969.4 文献标志码：B 文章编号：1007-7693(2018)09-1405-03 DOI: 10.13748/ki.issn1007-7693.2018.09.029 引用本文：章晔, 陈晔. 达比加群酯对 1 例肺栓塞患者凝血功能的影响[J]. 中国现代应用药学, 2018, 35(9): 1405-1407. Effect of Dabigatran Etexilate on Blood Coagulation Indexes in a Patient with Pulmonary Embolism a b ZHANG Ye ，CHEN Ye (The Second Affiliated Hospital of Zhejiang Chinese Medical University, a.Department of Pharmacy, b.Department of Respiratory, Hangzhou 310005, China) ABSTRACT: OBJECTIVE To discuss the influence of dabigatran etexilate on coagulation function and the significance of anticoagulant activity monitoring. METHODS The clinical pharmacist put forward some reasonable drug treatment suggestions according to the coagulation indexes of dabigatran etexilate in a patient with pulmonary embolism. RESULTS The patient with activated partial thromboplastin time(APTT) prolonged more than 2 times of the upper limit of normal(ULN), and clinical pharmacist suggested the APTT should be re-examined 12 h after the last dose and target value was 1.5 times of ULN, and the target was met after the re-examination. CONCLUSION Routine coagulation tests can help determine anticoagulant effect in specific populations and the timing of blood sampling is very critical. The APTT may provide a qualitative assessment but the results need to carefully interpretate. KEY WORDS: dabigatran etexilate; pul