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肺血栓栓塞症患者肝素剂量 浓度与APTT关系初步探讨

0.382~0.836(linear)and 0.409~0.762(lg).Coefficients of correlation between the individual were 0.779(linear)and 0.707(lg).Coefficients of determination were 0.607(linear)and 0.500(lg).The regression formula were APTT=132.99×(heparin concentration)+35.11,lgAPTT=0.599×(heparin concentration)+1.671,heparin concentration=0.0045×APTT-0.055 and heparin concentration=0.874×lgAPTT-1.260.②Linear relationship between heparin dosage and concentration was found as follow:Nearly all of coefficients of correlation and determination between individual and within individual were P>0.05.The linear regression formula of single factor with statistics significance could not been found.③Linear relationship between heparin dosage and APTT was examined as follow:correlation cofficients within individual were 0.548~0.883(linear).Coefficients of determination were 0.300~0.780(linear).correlation cofficients between individual were 0.164~0.609(linear).Coefficients of determination were 0.027~0.371(linear).The regression formula were APTT=2.72×(heparin dosage)+35.265(P=0.003)and heparin dosage =0.0144×

  APTT+10.356(P=0.003).Conclusion ①There are good positive correlation and linear ralationship between heparin concentration(anti Ⅱ factor method)and APTT,which make APTT as a substitution for heparin concentration measurement in clinical practice.Heparin concentration in effective anticoagulation range predicted by regression equation are 0.152~0.260 u/ml(linear)and 0.130~0.300u/ml(lg)respectively.②The relationship among heparin dosage,concentration and APTT are affected by multiple factors.Linear regression of single factor is not enough to reveal properly the relationship between heparin dosage and concentration.

  [Key words] heparin;APTT;pulmonary thrombo embolism;anticoagulation therapy

  肝素在体内抗凝活性的发挥与其分子量、分子链长度、给药途径、给药量、体内血管内皮功能、血小板功能、V-W因子等体液因子及人体炎症状态等有关,由于其血浆浓度的不稳定性,应用肝素抗凝治疗PTE时应动态监测血浆肝素浓度。但因其费用昂贵、操作繁杂,临床未能普遍推广。现在临床上多采用价廉快捷的APTT监测来替代肝素浓度的测定。鉴于APTT与肝素之间存在的依赖关系,探讨

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