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Pharmakologie der Heparine in der Thromboseprophylaxe

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Thrombosen und Embolien: Arzthaftung

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Zusammenfassung

Heparin besteht aus einem Gemisch von Polysacchariden unterschiedlicher Kettenlänge. Die Substanz wurde von McLEAN (1) als gerinnungshemmend erkannt und von HOWELL (2) nach dem Ursprungsort benannt. In kommerziellen Heparinpräparationen mit einem Molekulargewicht von etwa 12.000 Dalton liegen dementsprechend im Mittel 35 Saccharide oder 8–9 Tetrasaccharide vor (3). Die Molekulargewichtsverteilung dieser Präparationen reicht von 3.000 bis 30.000 Dalton. Die gerinnungshemmende Aktivität dieser Heparinfraktionen ist in vitro für Faktor Xa 2,5mal höher als für unfraktionierte Heparine, während die Inhibierung von aPTT etwa gleich ist (4, 5, 6). Die-Faktor-Xa/aPTT-Ratio beträgt, entsprechend für niedermolekulares Heparin, das 2,5fache im Vergleich zu unfraktioniertem Heparin (7).

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Authors and Affiliations

  1. 1. Medizinische Klinik, Fakultät für Klinische Medizin Mannheim der Universität Heidelberg, Theodor Kutzer Ufer, 68167, Mannheim, Deutschland

    Prof. Dr. med. J. Harenberg

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  1. Prof. Dr. med. J. Harenberg
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  1. Chirurgische Abteilung, Diakonissen-Krankenhaus, Diakonissenstraße 28, D-76199, Karlsruhe, Deutschland

    K. J. Husfeldt  & R. Raschke  & 

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© 1993 Springer-Verlag Berlin Heidelberg

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Harenberg, J. (1993). Pharmakologie der Heparine in der Thromboseprophylaxe. In: Husfeldt, K.J., Raschke, R. (eds) Thrombosen und Embolien: Arzthaftung. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-78297-8_4

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  • DOI: https://doi.org/10.1007/978-3-642-78297-8_4

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