— 藥理與非經腸給藥 · MEDIUM · MCQ —
一位深層靜脈栓塞病人正在接受肝素（Heparin）點滴輸注。護理師應監測哪項檢驗值以評估治療成效？
A client is receiving heparin infusion for deep vein thrombosis. Which laboratory value should the nurse monitor to evaluate the effectiveness of this therapy?
- AActivated partial thromboplastin time (aPTT)✓ 正解活化部分凝血活酶時間 (aPTT)
- BInternational Normalized Ratio (INR)國際標準化比值 (INR)
- CPlatelet count血小板計數
- DProthrombin time (PT)凝血酶原時間 (PT)
— Explanation · 中文詳解 —
肝素（未分級肝素）主要影響內源性凝血路徑，故需監測 aPTT；PT 和 INR 是用來監測華法林（Warfarin）的指標。血小板計數雖需監測以防肝素引發之血小板低下症，但非用於評估抗凝血療效的指標。
Activated partial thromboplastin time (aPTT) is the standard laboratory test used to monitor the therapeutic effectiveness of unfractionated heparin. Heparin primarily affects the intrinsic coagulation pathway, which is measured by aPTT, whereas PT and INR are used to monitor warfarin therapy. Although platelet counts are monitored to detect heparin-induced thrombocytopenia, they do not assess anticoagulant efficacy.
✦ 台美臨床差異
美台臨床皆以 aPTT 監測肝素，但目前美國多傾向改用抗 Xa 因子活性監測，台灣部分醫學中心亦逐步跟進。