APTT监测对达比加群酯治疗VTE病人不良事件发生的影响

EFFECT OF ACTIVATED PARTIAL THROMBOPLASTIN TIME MEASUREMENT ON ADVERSE EVENTS IN PATIENTS WITH VENOUS THROMBOEMBOLISM TREATED WITH DABIGATRAN ETEXILATE

目的探讨监测活化部分凝血活酶时间(APTT)对达比加群酯治疗静脉血栓栓塞症(VTE)病人不良事件发生的影响。方法回顾性分析2015年1月—2017年12月我院采用达比加群酯抗凝治疗的589例VTE病人的临床资料,根据半年内APTT监测次数分为3组,未进行监测的病人151例(A组),仅进行1次监测的病人255例(B组),监测≥2次的病人183例(C组)。对比分析3组病人的临床资料及随访结果。结果半年内3组病人不良事件发生及停用药物比例比较差异无统计学意义(P>0.05),随访中监测APTT值几乎没有超出正常值上限2倍。结论达比加群酯治疗VTE病人期间监测APTT并不能有效减少临床不良事件的发生,应该寻找更加有效的监测指标,以减少病人不良事件的发生。

Objective To investigate the effect of activated partial thromboplastin time (APTT) measurement on adverse events in patients with venous thromboembolism (VTE) treated with dabigatran etexilate. Methods The clinical data of 589 eligible VTE patients were retrospectively analyzed, who underwent anticoagulant therapy with dabigatran etexilate in the Fifth Affiliated Hospital of Zhengzhou University from January 2015 to December 2017. The patients were divided into three groups based on the number of APTT measurements during the first 6 months after drug prescription, namely group A with 151 cases who did not receive any APTT measurement, group B with 255 cases who underwent measurement once, and group C with 183 cases who received two or more measurements. Then the clinical data and follow-up outcomes were compared between these groups. Results There were no significant differences in the rates of adverse events and drug discontinuation between the three groups during the six-month follow-up period ( P >0.05). Meanwhile, the APTT value during the follow-up period barely exceeded twice the upper limit of the normal value. Conclusion APTT measurements in the treatment of VTE patients with dabigatran etexilate cannot effectively reduce the incidence of clinical adverse events. Therefore, more effective indicators should be found to reduce the incidence of adverse events.