精准抗凝的时代需要精准监测

Precise anticoagulation asks for precise monitoring

血栓性疾病是当今社会主要疾病负担,也是人类主要的死亡原因。血栓性疾病治疗主要是抗凝溶栓和抗血小板治疗。抗凝药物除传统的华法林、肝素、低分子量肝素外,直接口服抗凝血药物已经在临床广泛使用。使用抗栓药物一方面要考虑其有效性,是否减少血栓负荷(凝血强度),另一方面,药物过量往往导致出血,有些甚至是致命性出血。使得抗凝溶栓药物在一个合理的治疗窗内使用,既要达到有效治疗剂量又不会出现不可控的出血,这恰恰是血凝学实验室的责任,可以说精准抗凝的时代需要精准的监测。

Thrombotic diseases are the main cause of death and the main disease burden around the world. Treatment of thrombotic diseases is mainly anticoagulant thrombolysis and antiplatelet therapy. Not only traditional anticoagulant drugs such as warfarin, heparin and low molecular weight heparin but also direct oral anticoagulation drugshave been widely used in clinical practice. On the one hand, while using anti-thrombotic therapy, we need to consider the effect of reducing thrombosis burden (strength of coagulation);on the other hand, overdosingoften leads to bleeding or even fatal bleeding. Anti-thrombotic therapy should under reasonable range, it balances between the effect of antithrombosis and adverse effect of bleeding. The anticoagulant thrombolytic drug need to be used in a reasonable therapeutic window, and it is necessary to achieve an therapeutic effect without uncontrolled bleeding. This is the responsibility of the coagulation laboratory. The era of precise anticoagulation requires precise anticoagulation monitoring.