Abstract
Rivaroxaban is an oral direct factor FⅩa inhibitor with predictable pharmacokinetics and no routine monitoring, but the laboratory tests can help to assess the safety and effectiveness of rivaroxaban. The laboratory tests for rivaroxaban include liquid chromatography tandem mass spectrometry (LC-MS/MS), prothrombin time(PT), anti factor Ⅹ a activity(anti-Ⅹ a), thromboelastography(TEG) and rotational thromboelastography(ROTEM). LC-MS/MS can be used to quantitatively detect the blood of rivaroxaban with good specificity and sensitivity, but the instrument is expensive, technologically complex, and lack standardization, so it belongs to the laboratory developed tests(LDTs). Because of insufficient data of TEG and ROTEM, their clinical performance still needs to be verified. PT can detect treatment concentration of rivaroxaban, which can be used as a primary screening method to identify the overdose and the risk of severe bleeding, but the sensitivity of different reagents is different; anti-F Ⅹ a test can sensitively reflect the change of blood of rivaroxaban, and its clinical efficacy is similar to LC-MS/MS, and therefore it can be used as an effective method to guide doctors to use drugs rationally. Key words: Rivaroxaban; Chromatography, liquid; Tandem mass spectrometr; Prothrombin time; Factor Ⅹa; Clinical laboratory techniques
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