護理師照護一位使用肝素（Heparin）點滴的病人。應監測哪項實驗室數值以評估治療效果？
A nurse is caring for a client receiving heparin infusion. Which laboratory value should the nurse monitor to assess the therapeutic effect?
- AActivated partial thromboplastin time (aPTT)✓ 正解活化部分凝血活酶時間 (aPTT)
- BProthrombin time (PT)凝血酶原時間 (PT)
- CInternational normalized ratio (INR)國際標準化比值 (INR)
- DPlatelet count血小板計數
肝素（Heparin）的作用機轉主要影響內源性凝血路徑，臨床上以 aPTT 監測治療效果。PT 與 INR 是用來監測華法林（Warfarin）的。D 雖然重要（因為要監測肝素引起的血小板低下症 HIT），但不是評估「治療效果（抗凝血強度）」的主要指標。
Activated partial thromboplastin time (aPTT) is the standard laboratory test used to monitor the therapeutic effect of heparin because heparin primarily affects the intrinsic coagulation pathway. While platelet counts are monitored to detect heparin-induced thrombocytopenia, they do not assess anticoagulation efficacy. Prothrombin time (PT) and international normalized ratio (INR) are used to monitor warfarin therapy.
台美皆使用 aPTT 監測，但目前臨床漸趨向使用 Anti-Xa assay 來精準測量肝素濃度，這在兩地的大型教學醫院皆已施行。