曾经困惑—达比加群酯的治疗监测

摘要：达比加群酯是口服直接凝血酶抑制剂，药代动力学通常可预测而不需常规监测，但在复杂临床情况下，实验室监测有助于评估达比加群酯的安全性和有效性。监测达比加群酯的主要实验项目有活化的部分凝血活酶时间（APTT）、蛇毒凝血时间（ECT）、稀释的蝰蛇毒时间（dRVVT）、凝血酶时间（TT）和稀释凝血酶时间（dTT）等，其中APTT和dRVVT可作为出血风险的筛查手段，TT可用于识别血中达比加群的残留抗凝效应，ECT和dTT与血中达比加群浓度线性相关，可作为指导达比加群酯管理的有效手段。

__________________________

Dabigatran was an oral direct thrombin inhibitor, which pharmacokinetics was predictable and did not require routine monitoring, but in complex clinical conditions, the laboratory monitoring was helpful to evaluate the safety and effectiveness of Dabigatran. The main testing of Dabigatran included activated partial thromboplastin time(APTT), ecarin clotting time(ECT), dilute thrombin time(dTT), thrombin time(TT) and dilute Russell viper venom time(dRVVT). APTT and dRVVT could be used as screening methods for bleeding risk; TT could be used to identify the residual anticoagulant effect of Dabigatran in blood; ECT and dTT were linearly correlated with the concentration of Dabigatran, which could be used as an effective way to guide drug management.