应用Sonoclot体外监测低分子肝素及磺达肝癸钠的抗凝作用

摘要

目的:探讨Sonoclot凝血仪在分析监测凝血与血小板功能的临床价值.方法:在gb试剂杯加入不同浓度的低分子肝素钠(0～1.6 IU/mL抗Xa因子)、低分子肝素钙(0～1.64 IU/mL抗Xa因子)、磺达肝癸钠(0～1.52 μg/mL),抽取10例健康志愿者血样,并加入有药物的试剂杯中,用Sonoelot凝血仪进行检测,检测指标分别包括激活凝血时间(ACT)、凝血速率(CR)和血小板功能(PF).结果:(1)3种抗凝药物随着浓度的增加,其ACT值逐渐增加,CR值逐渐下降,PF值逐渐下降.(2)对于同一治疗量的3种抗凝药物,低分子肝素钠(1.2 IU/mL抗Xa因子)与低分子肝素钙(1.23 IU/mL抗Xa因子),其ACT、CR、PF3个参数的比较,P＞0.05,无统计学差异.磺达肝癸钠(0.77 μg/mL)与低分子肝素钠(1.2 IU/mL抗Xa因子)和低分子肝素钙(1.23 IU/mL抗Xa因子)相比,其ACT、CR、PF3个参数均有差异性,均P＜0.01.结论:Sonoclot凝血仪可以快速检测低分子肝素及磺达肝癸钠的抗凝效果以及对于血小板功能的影响,可以对临床给药剂量和个体化治疗做出指导.%Objective: To examine the Sonoclot analyzer's capability and in monitoring the blood coagulation and platelet function in vitro and evaluate its practical clinical significance. Methods: The blood samples were taken from 10 healthy volunteers after 1 h break. The samples were added into the gb cups in which different concentrations of low-molecular-weight heparin sodium (LHWHs)(0~l .6 IU/mL anti-Xa factor ), low-molecular-weight heparin calcium(LHWHc) (0-1.64 IU/mL anti-Xa factor) and fondaparinux( 0 ~ 1.52μg/mL ) were added respectively in advance. The ACT, CR and PF were tested by the Sonoclot anaylzer. Results: (1) ACT in three groups increased sig-nificantly(P＜0.01) with the increasing concentration of LMWHs, LMWHc and fondaparinux. CR and PF decreased significantly(P＜0.01) with the increasing concentration of LMWHs, LMWHc and fondaparinux. (2)There was no significant difference between the LMWHs (1.2 IU/mL anti-Xa factor) and LMWHc (1.23 IU/mL anti-Xa factor) grouplin terms of the ACT and PF (P＞0.05) in the concentration(1.2 IU/ mL LMWHs and 1.23 IU/mL LMWHc). There was significant difference between fondaparinux (0.77μg/mL) LMWHs(1.2 IU/mL anti-Xa factor) and LMWHc(1.23 IU/mL anti-Xa factor) with respect to ACT, CR and PF(P＜0.01). Conclusion: Sonoclot analyzer can quickly detect low-molecular-weight heparin and fondaparinux anticoagulation effect and the platelet function, it can be reliable in providing guidance for clinical dose and individual treatment.