— 藥理與非經腸給藥 · MEDIUM · MCQ —
病人確診深層靜脈栓塞並開始肝素滴注。護理師應監測哪項實驗室數值以評估治療效果？
A client is diagnosed with deep vein thrombosis and started on a heparin drip. Which laboratory value should the nurse monitor to evaluate the effectiveness of the therapy?
- AInternational Normalized Ratio (INR)國際標準化比值 (INR)
- BProthrombin time (PT)凝血酶原時間 (PT)
- CActivated partial thromboplastin time (aPTT)✓ 正解活化部分凝血活酶時間 (aPTT)
- DPlatelet count血小板計數
— Explanation · 中文詳解 —
肝素（Heparin）主要抑制凝血因子 IIa 與 Xa，其抗凝血效果需透過 aPTT 監測，通常目標值為正常值的 1.5-2.5 倍。PT/INR 用於監測 Warfarin；血小板數則是用於偵測肝素引起之血小板減少症（HIT），而非治療效力。
Heparin primarily inhibits clotting factors IIa and Xa, and its anticoagulant effect is monitored by aPTT, with a therapeutic target generally 1.5-2.5 times the normal value. PT/INR is used to monitor warfarin therapy; platelet count is used to detect heparin-induced thrombocytopenia (HIT) rather than the efficacy of treatment.
✦ 台美臨床差異
兩國臨床皆以 aPTT 作為肝素監測指標，但目前抗 Xa 因子監測法在某些大型醫學中心亦被採用。