PDF(Pubmed)
Abstract：
Clot waveform analysis (CWA) observes changes in transparency in a plasma sample based on clotting tests such as activated partial thromboplastin time (APTT), prothrombin time (PT), and thrombin time (TT). Evidence indicates that not only an abnormal waveform but also peak times and heights in derivative curves of CWA are useful for the evaluation of hemostatic abnormalities. Modified CWA, including the PT with APTT reagent, dilute PT (small amount of tissue factor [TF]-induced clotting factor IX [FIX] activation; sTF/FIXa), and dilute TT, has been proposed to evaluate physiological or pathological hemostasis. We review routine and modified CWA and their clinical applications. In CWA-sTF/FIXa, elevated peak heights indicate hypercoagulability in patients with cancer or thrombosis, whereas prolonged peak times indicate hypocoagulability in several conditions, including clotting factor deficiency and thrombocytopenia. CWA-dilute TT reflects the thrombin burst, whereas clot-fibrinolysis waveform analysis reflects both hemostasis and fibrinolysis. The relevance and usefulness of CWA-APTT and modified CWA should be further investigated in various diseases.
摘要：
凝块波形分析（CWA）根据凝血测试（如活化部分凝血活酶时间（APTT））观察血浆样品透明度的变化，凝血酶原时间（PT），和凝血酶时间（TT）。证据表明，不仅异常波形，而且CWA导数曲线中的峰值时间和高度也可用于评估止血异常。修改后的CWA,包括带APTT试剂的PT，稀释PT（少量组织因子[TF]诱导的凝血因子IX[FIX]激活；sTF/FIXa），和稀释的TT，已被提议用于评估生理或病理止血。我们回顾了常规和改良的CWA及其临床应用。在CWA-sTF/FIXa中，升高的峰值高度表明癌症或血栓形成患者的高凝状态，而延长的峰值时间表明在几种情况下低凝状态，包括凝血因子缺乏和血小板减少。CWA稀释的TT反映了凝血酶爆发，而凝块-纤维蛋白溶解波形分析反映了止血和纤维蛋白溶解。应进一步研究CWA-APTT和改良CWA在各种疾病中的相关性和实用性。
