— 藥理與非經腸給藥 · MEDIUM · MCQ —
一位接受肝素（heparin）連續靜脈輸注的病人，護理師應監測哪項檢驗值以評估治療效果？
A nurse is caring for a client receiving a continuous IV infusion of heparin. Which laboratory value should the nurse monitor to assess the effectiveness of this therapy?
- APlatelet count血小板計數
- BInternational Normalized Ratio (INR)國際標準化比值 (INR)
- CActivated partial thromboplastin time (aPTT)✓ 正解活化部分凝血活酶時間 (aPTT)
- DProthrombin time (PT)凝血酶原時間 (PT)
— Explanation · 中文詳解 —
肝素（Heparin）主要透過影響內源性凝血路徑發揮作用，臨床上以 aPTT 來監測其抗凝血效果。PT 與 INR 是用來監測口服抗凝血劑（如 warfarin）的指標。血小板計數則是監測肝素誘發之血小板低下症（HIT）的關鍵，而非治療效果的評估指標。
Heparin acts primarily on the intrinsic coagulation pathway, and aPTT is used clinically to monitor its anticoagulant effect. PT and INR are used to monitor oral anticoagulants such as warfarin. Platelet count is the key indicator for detecting heparin-induced thrombocytopenia (HIT), not for evaluating therapeutic efficacy.
✦ 台美臨床差異
兩地皆使用 aPTT 監測，但目前美國部分機構已引入 Anti-Xa 監測，台灣多仍以 aPTT 為主。