— 藥理與非經腸給藥 · EASY · MCQ —
病人正在接受肝素（Heparin）持續靜脈滴注。護理師應監測哪項實驗室數值以評估治療效果？
A client is receiving a continuous intravenous infusion of heparin. Which laboratory value should the nurse monitor to evaluate the effectiveness of the therapy?
- AActivated partial thromboplastin time (aPTT)✓ 正解活化部分凝血活酶時間 (aPTT)
- BPlatelet count血小板計數
- CInternational Normalized Ratio (INR)國際標準化比值 (INR)
- DProthrombin time (PT)凝血酶原時間 (PT)
— Explanation · 中文詳解 —
肝素（Heparin）的作用機轉主要影響內源性凝血路徑，臨床上以 aPTT 監測其抗凝血療效。PT 及 INR 主要用於監測口服抗凝血劑 Warfarin 的效果。血小板計數雖需監測以防肝素引起的血小板低下症（HIT），但並非用於評估治療效果。
Heparin's mechanism of action mainly affects the intrinsic coagulation pathway, and the aPTT is used clinically to monitor its anticoagulant effect. PT and INR are primarily used to monitor the effect of the oral anticoagulant warfarin. Although platelet count should be monitored to detect heparin-induced thrombocytopenia (HIT), it is not used to evaluate therapeutic effectiveness.
✦ 台美臨床差異
台美臨床對於肝素監測指引皆一致，皆以 aPTT 作為主要監測指標。