达比加群酯对1例肺栓塞患者凝血功能的影响

Effect of Dabigatran Etexilate on Blood Coagulation Indexes in a Patient with Pulmonary Embolism

目的探讨达比加群酯对凝血功能的影响及抗凝活性监测的意义。方法临床药师根据1例肺栓塞患者服用达比加群酯的凝血指标,提出合理的药物治疗建议。结果患者部分凝血活酶时间(activated partial thromboplastin time,APTT)延长超过正常上限(upper limit of normal,ULN)2倍,临床药师建议服药后12 h重新检验APTT,目标值为1.5倍ULN,患者复查后达标。结论特殊人群常规凝血指标监测有助于明确抗凝疗效,采血时机非常关键。APTT可供定性评估,但结果解读需谨慎。

OBJECTIVE To discuss the influence of dabigatran etexilate on coagulation function and the significance of anticoagulant activity monitoring. METHODS The clinical pharmacist put forward some reasonable drug treatment suggestions according to the coagulation indexes of dabigatran etexilate in a patient with pulmonary embolism. RESULTS The patient with activated partial thromboplastin time（APTT） prolonged more than 2 times of the upper limit of normal（ULN）, and clinical pharmacist suggested the APTT should be re-examined 12 h after the last dose and target value was 1.5 times of ULN, and the target was met after the re-examination. CONCLUSION Routine coagulation tests can help determine anticoagulant effect in specific populations and the timing of blood sampling is very critical. The APTT may provide a qualitative assessment but the results need to carefully interpretate.