【摘要】 目的探讨普通肝素抗凝时,高岭土-血栓弹力图R时间目标值。方法检测不同浓度肝素时血液aPTT和R时间。检测15例(21例次)肝素抗凝患者的高岭土-血栓弹力图R时间和肝素酶-血栓弹力图△R%,比较R时间和△R%判断肝素抗凝效果。结果肝素浓度在0～0.5 u/ml,与aPTT、R时间均呈直线相关(P<0.01)。aPTT为正常值2倍时,肝素浓度为0.10～0.22 u/ml,肝素浓度在此范围内的R时间为13.9～22.3 min。21例次肝素抗凝患者R时间为7.7±3.4 min。肝素酶-血栓弹力图△R%为4.0±19.3%。R时间和肝素酶△R%判断肝素抗凝效果符合率为85.7%,无明显差别(P>0.05)。结论肝素治疗并达到抗凝效果时,高岭土-血栓弹力图R时间目标值为13.9～22.3min(取整数14～22 min),约为R时间正常上限的1.5～2倍(R时间正常值为5～10 min)。更多还原

【Abstract】 Objective To explore the target value of kaolin-thromboelastography R time for anticoagulation therapy with unfractionated heparin.Methods Activated partial thromboplastin time(aPTT) and kaolin-thromboelastography R time were detected when different concentration of unfractionated heparin was added to venous blood.21 times of kaolin-thromboelastography and heparinase-modified thromboelastography were conducted in 15 patients treated with heparin.The consistence rate of kaolin-thromboelastography R time and heparinase-modified thromboelastography △R % for evaluating the anticoagulation effect of heparin was compared.Results When the concentration of heparin was within 0 ～ 0.5 u /ml,there is a positive correlation betweena PTT and heparin concentration(P < 0.01),as well as between R time and heparin concentration(P < 0.01).When aPTT was 2 times normal value as often used clinically as the target value of anticoagulation with heparin,the concentration of heparin was 0.10 ～ 0.22 u /ml,and the R time was 13.9 ～ 22.3 min.The R time was 7.7 ± 3.4 min,△R % was 4.0 ± 19.3 % in 15 patients(21 times).No significance was seen for the evaluation of heparin anticoagulation effect using kaolin-thromboelastography R time and heparinase-modified thromboelastography △R %,with consistence rate being 85.7%(P > 0.05).Conclusion In anticoagulant therapy with unfractionated heparin,the target value of kaolin-thromboelastography R time was 13.9 ～ 22.3 min(14 ～22 min as integer),which is about 1.5 ～2 times upper normal value(normal R time is 5 ～10 min).更多还原