The Role Of Anti-Xa In Monitoring Anticoagulation In The Treat Ment Of Recurrent Abortion With Low Molecular Weight Heparin

Objective: To explore the efficacy evaluation of anti-Xa monitoring low molecular weight heparin(LMWH)in the treatment of recurrent spontaneous abortion(RSA)patients,and establish the rational drug use range of anti-Xa monitoring LMWH.The difference of anti-Xa among different treatment regimens and the related factors affecting the change of anti-Xa were analyzed.Research methods:Data of patients with recurrent abortion treated with low molecular weight heparin in the obstetric department of Shengjing Hospital Affiliated to China Medical University from January 2018 to December 2020 were collected.The patients were grouped according to the types of low molecular weight heparin therapy drugs and whether aspirin was used in combination,and the statistical differences of anti-Xa were compared before and after treatment and among different treatment plans.According to the treatment effect,the group was divided to evaluate the effective monitoring range of anti-Xa monitoring for different pregnancy outcomes.According to the change of Xa resistance in the monitoring range,the group was divided,and the influencing factors and their correlation were analyzed.Results: The difference of anti-Xa before and after treatment of low molecular weight heparin in patients with recurrent abortion was significant(P<0.05).The difference of anti-Xa in treatment effective group,treatment ineffective group and treatment side effect group was statistically significant(P<0.05).The proposed target range for anti-Xa monitoring of LWMH for RSA is 0.20-0.54IU/m L;The anti-Xa of enoxaparin sodium combined with aspirin was significantly higher than that of enoxaparin sodium alone(P<0.05).The proposed target range for enoxaparin sodium combined with aspirin for RSA is 0.21-0.54IU/m L,and the diagnostic threshold for effective anti-Xa in enoxaparin sodium alone is 0.27IU/m L.The Xa resistance was positively correlated with PT,APTT,TT and FT4(P<0.05).It was negatively correlated with FIB,DD,ADP,A.A and e GFR(P<0.05).The number of abortion was associated with anti-Xa being below the target monitoring range(P<0.05),and PT was associated with anti-Xa being above the target monitoring range(P<0.05).Conclusion:Anti-Xa can be used to monitor the efficacy of low molecular weight heparin in patients with recurrent abortion.The range of rational drug use for therapeutic monitoring was 0.20-0.54 IU/m L.Anti-Xa can evaluate the pregnancy outcome of different treatment regimens.The rational use range of anti-Xa in enoxaparin sodium combined with aspirin for recurrent abortion is 0.21-0.54 IU/m L.Xa resistance was positively correlated with PT,APTT,TT and FT4,and negatively correlated with FIB,DD,ADP and A.A.The number of miscarriages and PT were risk factors for anti-Xa alterations.