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求大神幫忙翻譯一段英文，真心不會(huì)，謝謝
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Because in clinical practice, it is not possible to measure LMWH levels directly; pharmacokinetic studies have used such surrogate markers of activity as anti-Xa activity, but there are a number of difficulties with this. First, anti-Xa activity represents the amount of heparin present, rather than the degree of antithrombotic effect. Second, at equivalent anti-Xa activities, antifactor IIa activity of different products shows marked variations. Finally, conflicting evidence exists about whether anti-Xa levels predict for bleedingcomplications clinically. Several studies have looked at the pharmacokinetics and dynamics of different LMWHs in patients with CKD stages 1 to 3. In patients enrolled in the TIMI IIA trial, (aspirin plus enoxaparin), pharmacokinetic and pharmacodynamic profiles after enoxaparin therapy were assessed. Patients with an sCr level of 2.0 mg/dL or greater [177 mol/L] were excluded from the trial. CrCl was the most influential factor on enoxaparin clearance, area under the curve, and anti-Xa activity. Drug clearance was decreased by 22% in patients with a CrCl less than 40 mL/min (0.67mL/s) compared with those with greater CrCls (mean, 88 mL/min [1.47 mL/s]). The linear character of the elimination curve (Fig 2) led the investigators to extrapolate that enoxaparin clearance would be reduced by approximately 50% in patients with a CrCl less than 20 mL/min (0.33mL/s). Although numbers were small, patients with a CrCl less than 40 mL/min (0.67 mL/s) had greater trough and peak anti-Xa activity compared with those with normal renal function (P=0.0017 and P =0.0044, respectively) and were more likely to experience major hemorrhagic events. |
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李氏氏
禁蟲 (正式寫手)
- 翻譯EPI: 45
- 應(yīng)助: 79 (初中生)
- 金幣: 1468.3
- 散金: 3
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- 注冊(cè): 2012-12-26
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【答案】應(yīng)助回帖
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liboygg: 金幣+100, 翻譯EPI+1, ★★★★★最佳答案, 謝謝，條理很清晰 2013-01-04 17:03:08
liboygg: 金幣+100, 翻譯EPI+1, ★★★★★最佳答案, 謝謝，條理很清晰 2013-01-04 17:03:08
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Because in clinical practice, it is not possible to measure LMWH levels directly; pharmacokinetic studies have used such surrogate markers of activity as anti-Xa activity, but there are a number of difficulties with this. First, anti-Xa activity represents the amount of heparin present, rather than the degree of antithrombotic effect. Second, at equivalent anti-Xa activities, antifactor IIa activity of different products shows marked variations. Finally, conflicting evidence exists about whether anti-Xa levels predict for bleeding complications clinically. 因?yàn)榕R床試驗(yàn)尚不能直接測(cè)量低分子肝素的水平。 藥物代謝動(dòng)力學(xué)領(lǐng)域曾經(jīng)有研究使用這種活性替代物來代替抗Xa因子活性。然而此方法任存在一些困難。首先抗Xa因子活性反映的是肝素的存在量而不是抗血栓作用的程度。其次在同等的抗Xa活性作用下，不同的產(chǎn)品IIa抗體因素的活性有明顯的差異。最后抗Xa因子水平預(yù)測(cè)是否會(huì)導(dǎo)致出血并發(fā)癥臨床上還存在爭(zhēng)議。 Several studies have looked at the pharmacokinetics and dynamics of different LMWHs in patients with CKD stages 1 to 3. In patients enrolled in the TIMI IIA trial, (aspirin plus enoxaparin), pharmacokinetic and pharmaco dynamic profiles after enoxaparin therapy were assessed. Patients with an sCr level of 2.0 mg/dL or greater [ 177 mol/L] were excluded from the trial. 一些研究者對(duì)CKD處于1-3期的患者在不同的低分子量肝素的條件下的藥代動(dòng)力學(xué)和動(dòng)態(tài)進(jìn)行了研究。運(yùn)用TIMI IIA試驗(yàn)，使用阿司匹林加依諾肝素，對(duì)患者經(jīng)依諾肝素治療后的藥代動(dòng)力和藥效數(shù)據(jù)進(jìn)行了評(píng)估。sCr 水平在2.0 mg/dL 或者大于[ 177 mol/L]的患者排除在此實(shí)驗(yàn)之外. CrCl was the most influential factor on enoxaparin clearance, area under the curve, and anti-Xa activity. Drug clearance was decreased by 22% in patients with a CrCl less than 40 mL/min (0.67mL/s) compared with those with greater CrCls (mean, 88 mL/min [1.47 mL/s]). CrCl是伊諾肝素清除性，曲線下面積和抗Xa活性三者最大的影響因素。與患者CrCl在高于88 mL/min [1.47 mL/s]的情況下相比， CrCl少于40 mL/min (0.67mL/s)的患者藥物的清除率下降了22%。 The linear character of the elimination curve (Fig 2) led the investigators to extrapolate that enoxaparin clearance would be reduced by approximately 50% in patients with a CrCl less than 20 mL/min (0.33mL/s). Although numbers were small, patients with a CrCl less than 40 mL/min (0.67 mL/s) had greater trough and peak anti-Xa activity compared with those with normal renal function (P =0.0017 and P =0.0044, respectively) and were more likely to experience major hemorrhagic events. 研究者根據(jù)消除曲線（見圖2）的線性特征推斷當(dāng)患者CrCl少于20 mL/min (0.33mL/s)時(shí)依諾肝素的清除率可以下降大約50%。與腎功能正常者（P = 0.0017，P = 0.0044，分別）相比，雖然這種情況很少， CrCl小于40 mL/min (0.67 mL/s) 患者有更大的波谷和高抗Xa活性并且伴有大出血的可能性比較大。 |
2樓2013-01-04 10:17:55
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