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抗凝治疗是通过抑制体内凝血过程的某些环节,制止血栓形成及防止血栓扩大,但对已形成的血栓则无效,故应争取尽早治疗,以获得较好的防栓效果。抗凝药物以肝素和华法林最为常用。 1 肝素(heparin) 1.1 抗凝机制肝素是治疗急性静脉血栓、各种血栓栓塞性疾病,以及心肺体外循环、血液透析的主要抗凝药物,它也可用于短期静脉血栓形成的预防用药。普通肝素并非均一物质,其分子量为3000～40000,平均15000。它是一种酸性粘多糖,为粘多糖硫酸酯,其硫酸基团带有强大的阴电荷,当硫酸基团被水解或被带有阳电荷的鱼精蛋白中和,肝素的抗凝作用即消失。肝素本身无抗凝作用,其抗凝效应必须通过抗凝血酶III(AT-III)和肝素辅因子II(HcII)。AT-III是一种肝素依赖性抗凝蛋白质。肝素与AT-III分子上的赖
Anticoagulant therapy is through the inhibition of some aspects of the process of coagulation in the body to stop the thrombus formation and prevent thrombus expansion, but the formation of thrombus is invalid, it should strive for early treatment in order to obtain a better anti-suppressive effect. Anticoagulants are most commonly used with heparin and warfarin. 1 heparin 1.1 anticoagulant mechanism heparin is the treatment of acute venous thrombosis, a variety of thromboembolic diseases, and cardiopulmonary bypass, hemodialysis major anticoagulant drugs, it can also be used for the prevention of short-term venous thrombosis. Unfractionated heparin is not a homogeneous substance, its molecular weight of 3000 to 40,000, an average of 15,000. It is an acidic mucopolysaccharide which is a mucopolysaccharide sulfate whose sulfate groups bear a strong negative charge. When the sulfate group is hydrolyzed or neutralized with protamine with a positive charge, the anticoagulant action of heparin disappear. Heparin itself has no anticoagulant effect and its anticoagulant effect must pass through antithrombin III (AT-III) and heparin cofactor II (HcII). AT-III is a heparin-dependent anticoagulant protein. Heparin and AT-III molecules on the Lai