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CLIN CHEM LAB MED：DOAC-Remove抵消了直接口服抗凝剂对真实静脉血栓栓塞患者激活蛋白C耐药性检测的影响？

2020-03-21 MedSci原创 MedSci原创

DOAC-Remove
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直接口服抗凝血剂(DOACs)可能导致对活化蛋白C抵抗(APC-R)比值检测的错误。本研究设计了一种基于活性炭的新型试剂- DOAC-Remove，以消除DOACs对混凝测定的干扰。

直接口服抗凝血剂(DOACs)可能导致对活化蛋白C抵抗(APC-R)比值检测的错误。本研究设计了一种基于活性炭的新型试剂- DOAC-Remove，以消除DOACs对混凝测定的干扰。本研究的目的是探讨DOAC-Remove的使用是否能够在DOACs治疗的患者中确定APC-R。

研究人员评估了74例静脉血栓栓塞(VTE)患者，其中25例使用利伐沙班，25例使用阿哌沙班，24例使用达比加群。采用基于Russell Viper毒液时间(RVVT)的凝血试验测定APC-R。分别在基线和DOAC清除后检测APC-R和DOAC浓度。检测血栓形成，包括V因子Leiden (FVL)突变。

研究结果显示，20例(27%)患者出现FVL突变。在43例(58.1%)患者中可测得基线APC-R比值，其中利伐沙班20例(80%)，阿哌沙班19例(76%)，达比加群4例(16.7%)。在APC-R基线可测量的患者中，23例患者的>2.9比值(53.5%)。经遗传证实16例(37.2%)APC-R比值<1.8提示FVL突变。4名(9.3%)达比加群FVL携带者APC-R阴性/可疑。在11例(14.9%)服用利伐沙班或阿哌沙班的患者中，自最后一次给药2-5小时后，观察到不可测量的APC-R。DOAC-Remove几乎完全抵消了所有血浆DOAC。添加DOAC-Remove后，所有APC-R比值均可测量。在4名假阴性APC-R的dabigatran上的FVL携带者中，DOAC-Remove导致APC-R比值<1.8。

研究结果表明，DOAC-Remove有效降低了血浆中DOACs的浓度，使APC-R法检测FVL成为可能。

原始出处：

Magdalena Kopytek，Michał Ząbczyk，DOAC-Remove abolishes the effect of direct oral anticoagulants on activated protein C resistance testing in real-life venous thromboembolism patients

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    2020-07-22 446798725_87912765

    #蛋白C#

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    2020-12-04 fusion

    #静脉#

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    2021-02-02 tongyongming

    #REM#

    0

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    2020-12-16 xue8602

    #静脉血#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2055191, encodeId=6c5c205519196, content=<a href='/topic/show?id=091688615da' target=_blank style='color:#2F92EE;'>#蛋白C#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88615, encryptionId=091688615da, topicName=蛋白C)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4f2c2500194, createdName=446798725_87912765, createdTime=Wed Jul 22 03:05:25 CST 2020, time=2020-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1698060, encodeId=fcac169806023, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Fri Dec 04 14:05:25 CST 2020, time=2020-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1752273, encodeId=dcba1e52273a9, content=<a href='/topic/show?id=28a915303ec' target=_blank style='color:#2F92EE;'>#REM#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15303, encryptionId=28a915303ec, topicName=REM)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=78bc36479935, createdName=tongyongming, createdTime=Tue Feb 02 19:05:25 CST 2021, time=2021-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1955475, encodeId=803719554e55e, content=<a href='/topic/show?id=0aeb991e44c' target=_blank style='color:#2F92EE;'>#静脉血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99174, encryptionId=0aeb991e44c, topicName=静脉血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Wed Dec 16 10:05:25 CST 2020, time=2020-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1309762, encodeId=a1821309e62ee, content=<a href='/topic/show?id=886438210fb' target=_blank style='color:#2F92EE;'>#口服抗凝剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38210, encryptionId=886438210fb, topicName=口服抗凝剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ed25376, createdName=gdsun, createdTime=Mon Mar 23 13:05:25 CST 2020, time=2020-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1441151, encodeId=17ab144115164, content=<a href='/topic/show?id=7f9ae242984' target=_blank style='color:#2F92EE;'>#直接口服抗凝剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72429, encryptionId=7f9ae242984, topicName=直接口服抗凝剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b9a54798293, createdName=若水124, createdTime=Mon Mar 23 13:05:25 CST 2020, time=2020-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610374, encodeId=84f716103e40e, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Mon Mar 23 13:05:25 CST 2020, time=2020-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1625209, encodeId=f441162520925, content=<a href='/topic/show?id=ead161e394' target=_blank style='color:#2F92EE;'>#DOAC-Remove#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6173, encryptionId=ead161e394, topicName=DOAC-Remove)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Mon Mar 23 13:05:25 CST 2020, time=2020-03-23, status=1, ipAttribution=)]
    2020-03-23 gdsun

    #口服抗凝剂#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2055191, encodeId=6c5c205519196, content=<a href='/topic/show?id=091688615da' target=_blank style='color:#2F92EE;'>#蛋白C#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88615, encryptionId=091688615da, topicName=蛋白C)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4f2c2500194, createdName=446798725_87912765, createdTime=Wed Jul 22 03:05:25 CST 2020, time=2020-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1698060, encodeId=fcac169806023, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Fri Dec 04 14:05:25 CST 2020, time=2020-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1752273, encodeId=dcba1e52273a9, content=<a href='/topic/show?id=28a915303ec' target=_blank style='color:#2F92EE;'>#REM#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15303, encryptionId=28a915303ec, topicName=REM)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=78bc36479935, createdName=tongyongming, createdTime=Tue Feb 02 19:05:25 CST 2021, time=2021-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1955475, encodeId=803719554e55e, content=<a href='/topic/show?id=0aeb991e44c' target=_blank style='color:#2F92EE;'>#静脉血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99174, encryptionId=0aeb991e44c, topicName=静脉血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Wed Dec 16 10:05:25 CST 2020, time=2020-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1309762, encodeId=a1821309e62ee, content=<a href='/topic/show?id=886438210fb' target=_blank style='color:#2F92EE;'>#口服抗凝剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38210, encryptionId=886438210fb, topicName=口服抗凝剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ed25376, createdName=gdsun, createdTime=Mon Mar 23 13:05:25 CST 2020, time=2020-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1441151, encodeId=17ab144115164, content=<a href='/topic/show?id=7f9ae242984' target=_blank style='color:#2F92EE;'>#直接口服抗凝剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72429, encryptionId=7f9ae242984, topicName=直接口服抗凝剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b9a54798293, createdName=若水124, createdTime=Mon Mar 23 13:05:25 CST 2020, time=2020-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610374, encodeId=84f716103e40e, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Mon Mar 23 13:05:25 CST 2020, time=2020-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1625209, encodeId=f441162520925, content=<a href='/topic/show?id=ead161e394' target=_blank style='color:#2F92EE;'>#DOAC-Remove#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6173, encryptionId=ead161e394, topicName=DOAC-Remove)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Mon Mar 23 13:05:25 CST 2020, time=2020-03-23, status=1, ipAttribution=)]
    2020-03-23 若水124

    #直接口服抗凝剂#

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=2055191, encodeId=6c5c205519196, content=<a href='/topic/show?id=091688615da' target=_blank style='color:#2F92EE;'>#蛋白C#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88615, encryptionId=091688615da, topicName=蛋白C)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4f2c2500194, createdName=446798725_87912765, createdTime=Wed Jul 22 03:05:25 CST 2020, time=2020-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1698060, encodeId=fcac169806023, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Fri Dec 04 14:05:25 CST 2020, time=2020-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1752273, encodeId=dcba1e52273a9, content=<a href='/topic/show?id=28a915303ec' target=_blank style='color:#2F92EE;'>#REM#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15303, encryptionId=28a915303ec, topicName=REM)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=78bc36479935, createdName=tongyongming, createdTime=Tue Feb 02 19:05:25 CST 2021, time=2021-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1955475, encodeId=803719554e55e, content=<a href='/topic/show?id=0aeb991e44c' target=_blank style='color:#2F92EE;'>#静脉血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99174, encryptionId=0aeb991e44c, topicName=静脉血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Wed Dec 16 10:05:25 CST 2020, time=2020-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1309762, encodeId=a1821309e62ee, content=<a href='/topic/show?id=886438210fb' target=_blank style='color:#2F92EE;'>#口服抗凝剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38210, encryptionId=886438210fb, topicName=口服抗凝剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ed25376, createdName=gdsun, createdTime=Mon Mar 23 13:05:25 CST 2020, time=2020-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1441151, encodeId=17ab144115164, content=<a href='/topic/show?id=7f9ae242984' target=_blank style='color:#2F92EE;'>#直接口服抗凝剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72429, encryptionId=7f9ae242984, topicName=直接口服抗凝剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b9a54798293, createdName=若水124, createdTime=Mon Mar 23 13:05:25 CST 2020, time=2020-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610374, encodeId=84f716103e40e, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Mon Mar 23 13:05:25 CST 2020, time=2020-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1625209, encodeId=f441162520925, content=<a href='/topic/show?id=ead161e394' target=_blank style='color:#2F92EE;'>#DOAC-Remove#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6173, encryptionId=ead161e394, topicName=DOAC-Remove)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Mon Mar 23 13:05:25 CST 2020, time=2020-03-23, status=1, ipAttribution=)]
    2020-03-23 ms3994565386320060

    #Med#

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=2055191, encodeId=6c5c205519196, content=<a href='/topic/show?id=091688615da' target=_blank style='color:#2F92EE;'>#蛋白C#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88615, encryptionId=091688615da, topicName=蛋白C)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4f2c2500194, createdName=446798725_87912765, createdTime=Wed Jul 22 03:05:25 CST 2020, time=2020-07-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1698060, encodeId=fcac169806023, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Fri Dec 04 14:05:25 CST 2020, time=2020-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1752273, encodeId=dcba1e52273a9, content=<a href='/topic/show?id=28a915303ec' target=_blank style='color:#2F92EE;'>#REM#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15303, encryptionId=28a915303ec, topicName=REM)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=78bc36479935, createdName=tongyongming, createdTime=Tue Feb 02 19:05:25 CST 2021, time=2021-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1955475, encodeId=803719554e55e, content=<a href='/topic/show?id=0aeb991e44c' target=_blank style='color:#2F92EE;'>#静脉血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99174, encryptionId=0aeb991e44c, topicName=静脉血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Wed Dec 16 10:05:25 CST 2020, time=2020-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1309762, encodeId=a1821309e62ee, content=<a href='/topic/show?id=886438210fb' target=_blank style='color:#2F92EE;'>#口服抗凝剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38210, encryptionId=886438210fb, topicName=口服抗凝剂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ed25376, createdName=gdsun, createdTime=Mon Mar 23 13:05:25 CST 2020, time=2020-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1441151, encodeId=17ab144115164, content=<a href='/topic/show?id=7f9ae242984' target=_blank style='color:#2F92EE;'>#直接口服抗凝剂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72429, encryptionId=7f9ae242984, topicName=直接口服抗凝剂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b9a54798293, createdName=若水124, createdTime=Mon Mar 23 13:05:25 CST 2020, time=2020-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610374, encodeId=84f716103e40e, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Mon Mar 23 13:05:25 CST 2020, time=2020-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1625209, encodeId=f441162520925, content=<a href='/topic/show?id=ead161e394' target=_blank style='color:#2F92EE;'>#DOAC-Remove#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6173, encryptionId=ead161e394, topicName=DOAC-Remove)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=xugumin, createdTime=Mon Mar 23 13:05:25 CST 2020, time=2020-03-23, status=1, ipAttribution=)]
    2020-03-23 xugumin

    #DOAC-Remove#

    0