Abstract:
The prothrombin time (PT) and the activated partial thromboplastin time (aPTT) are two basic tests for routine purposes, which are widely used in the clinical screening of coagulopathies. PT and aPTT are useful tests for detecting both symptomatic (hemorrhagic) and asymptomatic defects, but they are unsuitable for studying hypercoagulable states. However, these tests are available for studying the dynamic process of clot formation by means of the detection of the clot waveform analysis (CWA), which has been introduced several years ago. CWA can provide useful information on both hypocoagulable and hypercoagulable states. Nowadays it is possible to detect the whole clot formation both in the PT and aPTT tubes starting from the initial step of fibrin polymerization by means of specific and dedicated algorithm implemented in a coagulometer. In particular, CWA provides information on the velocity (first derivative), acceleration (second derivative), and density (delta) of clot formation. CWA has been applied to several pathologic conditions such as coagulation factor deficiency (including congenital hemophilia from factor VIII, IX, or XI deficiency), acquired hemophilia, disseminated intravascular coagulation (DIC), sepsis, replacement therapy management, chronic spontaneous urticarial, and liver cirrhosis, in patients with high venous thromboembolic risk before LMWH prophylaxis, and in patients with different hemorrhagic patterns along with an electron microscopy evaluation of the clot density. We report here materials and methods used for detecting the additional clotting parameters available in both PT and aPTT.
摘要:
凝血酶原时间(PT)和活化部分凝血活酶时间(aPTT)是常规目的的两个基本测试,广泛用于凝血病的临床筛查。PT和aPTT是检测有症状(出血性)和无症状缺陷的有用测试,但它们不适合研究高凝状态。然而,这些测试可用于通过检测凝块波形分析(CWA)来研究凝块形成的动态过程,这是几年前推出的。CWA可以提供有关低凝状态和高凝状态的有用信息。如今,可以通过在凝固计中实施的特定和专用算法从纤维蛋白聚合的初始步骤开始检测PT和aPTT管中的整个凝块形成。特别是,CWA提供有关速度(一阶导数)的信息,加速度(二阶导数),和凝块形成的密度(δ)。CWA已应用于多种病理状况,例如凝血因子缺乏(包括来自因子VIII的先天性血友病,IX,或XI缺陷),获得性血友病,弥散性血管内凝血(DIC),脓毒症,替代疗法管理,慢性自发性荨麻疹,肝硬化,在LMWH预防前静脉血栓栓塞风险高的患者中,以及具有不同出血模式的患者以及对凝块密度的电子显微镜评估。我们在此报告用于检测PT和aPTT中可用的其他凝血参数的材料和方法。