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首页> 外文期刊>British Journal of Haematology >Normal prothrombin time in the presence of therapeutic levels of rivaroxaban
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Normal prothrombin time in the presence of therapeutic levels of rivaroxaban

机译：在存在治疗水平的利伐沙班的情况下正常凝血酶原时间

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摘要

The introduction of new oral anticoagulants, such as rivaroxaban, is simplifying the management of stroke prevention in atrial fibrillation and treatment of venous thrombosis. Their wide therapeutic range and predictable pharmacokinetics make monitoring unnecessary except in specific situations, such as bleeding, renal or liver failure, overdoses, prior to urgent invasive procedures and at the time of thrombotic episodes whilst on treatment. Rivaroxaban levels can be reliably measured using specifically calibrated anti-activated factor X (Xa) assays but these are not yet widely available. It would therefore be preferable if standard coagulation tests, such as the prothrombin time (PT) and activated partial thromboplastin time (APTT), could be used to assess the anticoagulant intensity in emergency situations, such as bleeding or prior to emergency surgery. Recently published guidelines for the assessment of anticoagulant intensity using routine coagulation screens from the British Committee for Standards in Haematology (BCSH) suggested the PT can be used to determine the degree of anticoagulation (but not the drug level) in patients on rivaroxaban if a reagent with known sensitivity is used (Baglin et al, 2012). It has been suggested that a normal PT with most reagents excludes therapeutic anticoagulation with rivaroxaban (Baglin et al, 2012; Schulman & Crowther, 2012).
机译：新型口服抗凝剂（如利伐沙班）的引入正在简化房颤中风预防的管理和静脉血栓形成的治疗。它们的广泛治疗范围和可预测的药代动力学使得除了在特定情况下（例如出血，肾或肝衰竭，用药过量），紧急侵入性手术之前以及在治疗期间发生血栓性发作时无需进行监测。利伐沙班水平可以使用经过专门校准的抗活化因子X（Xa）测定法可靠地测量，但这些方法尚未广泛使用。因此，如果可以将标准凝血测试（例如凝血酶原时间（PT）和活化的部分凝血活酶时间（APTT））用于评估紧急情况（例如出血或紧急手术之前）的抗凝强度，则将是更可取的。最近发布的使用英国血液学标准委员会（BCSH）常规凝结筛查方法评估抗凝强度的指南建议，如果使用试剂，则PT可用于确定利伐沙班患者的抗凝程度（而非药物水平）使用已知灵敏度的（Baglin et al，2012）。已经提出，具有大多数试剂的正常PT排除了利伐沙班的治疗性抗凝作用（Baglin等，2012; Schulman＆Crowther，2012）。

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