СРАВНИТЕЛЬНЫЙ МОНИТОРИНГ АНТИКОАГУЛЯНТНОЙ ТЕРАПИИ У РАНЕНЫХ С ТРОМБОЗАМИ ГЛУБОКИХ ВЕН НИЖНИХ КОНЕЧНОСТЕЙ

Abstract

Introduction. Deep vein thrombosis of the lower extremities (DVT) currently remains one of the most important problems affecting not only vascular surgeons, but also doctors of other specialties. Target. Carry out a comparative monitoring of methods for monitoring the effectiveness of anticoagulant therapy in the wounded using the Thrombodynamics test and determining anti-Xa activity. Materials and methods. The study included 30 wounded individuals with established DVT, hospitalized for examination and treatment at the Military Medical Academy. CM. Kirov. Against the background of treatment with enoxaparin sodium (hereinafter referred to as enoxaparin) at therapeutic doses, depending on body weight, all patients were assessed the parameters of the "Thrombodynamics" (TD) test and the determination of anti-Xa activity at the peak of the drug's action (after 3-4 hours), and on outcome (before the next injection) of the drug. Statistical data processing was carried out using the Statistica 10.0 application package. Results and discussion. A strong inverse correlation was established between the clot growth rate (V) of the TD test and the determination of anti-Xa activity at the peak (-0.777; p<0.05) and at the end (-0.715; p<0.05) of anticoagulant therapy. With the standard prescription of doses of anticoagulant therapy depending on body weight, it was found that 30% of patients did not reach the target values of the V TD test and anti-Xa activity and were in the hypercoagulable zone. Conclusion. The indicator of clot growth rate of the "Thrombodynamics" test correlates with the level of anti-Xa activity and can be used as another tool for laboratory monitoring of ongoing therapy with low molecular weight heparins (LMWH) in the wounded. The standard use of LMWH in therapeutic doses by body weight in the wounded does not always lead to the achievement of target coagulation parameters, which requires the development of a personalized approach to LMWH titration, which can be based on the indicators of TD tests and anti-Xa activity.