Title: Monitoring dabigatran
题目：达比加群抗凝作用的监测
Author 作者: Ellen Lemkin
 
Dabigatran is an oral thrombin inhibitor approved for the prevention of thromboembolism in patients with atrial fibrillation and for those undergoing orthopedic surgery.
达比加群是一种预防房颤和骨科手术病人血栓栓塞的口服凝血酶抑制剂。
 
In normal situations, it is not necessary to monitor any laboratory values. However, in the potential overdose situation or in the event of bleeding, it would be useful to assess the anticoagulant status. 
在正常情况下，没有必要监测任何的实验室指标。但是，在服用过量或有出血倾向时，监测抗凝状态是有意义的。
The thrombin clotting time (TT) directly assesses the activity of direct thrombin inhibitors (like dabigatran), and displayes a linear dose-response curve over therapeutic concentrations. At high levels, the test frequently exceeds the maximum measurements.
凝血酶凝血时间（TT）可用来直接反应凝血酶抑制剂（如达比加群）的活性，并与剂量与治疗效果成线性关系。如剂量过高，这个结果会超过可测范围。
The PT and INR are less sensitive and cannot be recommended.
PT和INR都不敏感，不建议（作为监测指标）。
The activated partial thromboplastin time can provide qualitative assessment of anticoagulant activity but is not sensitive at supratherapeutic doses. 
活性部分凝血酶原时间（aPTT）可以提供量化的抗凝活性，但对于高于治疗量的剂量不敏感。
 
Bottom Line:
要点：

In emergency situations, the aPTT and TT are the most effective qualitative methods widely available for determining the presence or absence of anticoagulant effect in patients receiving dabigatran.
在急诊情况下，aPTT和TT是最有效的用于评价达比加群抗凝作用存在与否的定性指标。

References 参考文献
Rye J, Stangier J, Haertter S, et al. Dabigatran etexilate - a novel, reversible, oral direct thrombin inhibitor: Interpretation of coagulation assays and reversal of anticoagulant activity. Thrombosis and Haemostasis 2010. 103;1116-1127.