Thrombin Decrease in Thrombin Generation after Heparin Administration in a Homozygous Type II Heparin Binding Site Antithrombin-Deficient Pregnant Woman.

IF 2.9 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Medical Principles and Practice Pub Date : 2023-09-13 DOI:10.1159/000533801

Ivana Malikova, Martina Husakova, Jana Bilkova, Radka Brzezkova, Tomas Kvasnicka

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引用次数: 0

Abstract

Objectives: There is a major problem in providing prophylactic treatment in antithrombin (AT)-deficient pregnant women with a homozygous mutation of the heparin binding site (HBS) and AT level of 17 %. The aim of the study was to determine the effectiveness of heparin by monitoring changes in thrombin generation (TG) in vitro so that pregnant women are not exposed to stress in vivo.

Methods: We used the chromogenic method for determination of factor Xa (FXa) inhibition for enoxaparine, nadroparine, dalteparine, fondaparinux and unfractionated heparin (UFH) and the Thrombin Generation Assay (TGA).

Results: We found that the degree of inhibition is very different when different heparins are compared. Nadroparin reduces TG the most compared to low molecular weight heparins (LMWH).

Conclusion: Routine monitoring of anti FXa activity should be supplemented with TG monitoring, where the effect of LMWH does not manifest itself as this could help in estimating thrombophilic risk during pregnancy.

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纯合型II型肝素结合位点抗凝血酶缺乏孕妇服用肝素后凝血酶生成减少。

目的:对肝素结合位点(HBS)纯合突变且AT水平为17%的抗凝血酶(AT)缺乏孕妇进行预防性治疗是一个主要问题。该研究的目的是通过监测体外凝血酶生成(TG)的变化来确定肝素的有效性，从而使孕妇在体内不暴露于压力下。方法:采用显色法测定依诺肝素、纳德罗帕林、达替帕林、氟达肝素和未分离肝素(UFH)的Xa因子(FXa)抑制率和凝血酶生成法(TGA)。结果:对比不同的肝素，发现其抑制程度有很大差异。与低分子量肝素(LMWH)相比，Nadroparin降低TG的效果最大。结论:常规监测抗FXa活性应辅以TG监测，其中低分子肝素的作用不明显，因为这可能有助于估计妊娠期间的血栓形成风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical Principles and Practice 医学-医学：内科

CiteScore

6.10

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Medical Principles and Practice'', as the journal of the Health Sciences Centre, Kuwait University, aims to be a publication of international repute that will be a medium for dissemination and exchange of scientific knowledge in the health sciences.