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The Korean Journal of Pathology 1983;17(3): 275-281.
Monitoring of Heparin Treatment
Monitoring of Heparin Treatment -Comparison of TT, ACT, APTT and Plasma Heparin Concentration-
Heparin is used prophylactically in low doses mainly for patients undergoing surgery, and therapeutically in large doses for patients with acute venous or arterial thrombosis of pulmonary embolism. It is generally agreed that it is advantageous to monitor heparin therapy, but no such general agreement exists as to which tests are the most reliable. The activated partial thromboplastin time has gained popularity as an effective assay for following patients on heparin, and some investigators have used the thrombin time to monitor heparin. A new method for measuring the plasma heparin concentration using a chromogenic substrate has recently been made available. We therefore measured thrombin time(TT), activated partial thromboplastin time(APTT), activated coagulation time(ACT), and heparin concentration in 34 samples from 15 patients being treated with various heparin doses. Statistical correlation was evaluated between these coagulation tests and plasma heparin concentration. The results are as follows: 1) Heparin concentrations in 34 samples were 0.2-0.4 U/㎖ therapeutic range in 9 samples (27%), lower than 0.2 U/㎖ in 19 samples (56%), and higher than 0.4 U/㎖ in 6 samples (17%). 2) Statistical correlation coefficient between plasma heparin level and coagulation assays such as TT, APTT, ACT were 0.812, 0.780 and 0.715, respectively. 3) APTT was relatively well correlated with ACT, but correlations between other coagulation tests (APTT and TT, ACT and TT, ACT and CT) were less satisfactory. As a conclusion, TT, APTT and ACT were sensitive enough to heparin effect for use in monitoring of patients and the determination of heparin level in plasma can be practical method for therapeutic monitoring
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