PDF(Pubmed)
Abstract：
Thromboembolism, a global leading cause of mortality, needs accurate risk assessment for effective prophylaxis and treatment. Current stratification methods fall short in predicting thrombotic events, emphasizing the need for a deeper understanding of clot properties. Fibrin clot permeability, a crucial parameter in hypercoagulable states, impacts clot structure and resistance to lysis. Current clot permeability measurement limitations propel the need for standardized methods. Prior findings underscore the importance of clot permeability in various thrombotic conditions but call for improvements and more precise, repeatable, and standardized methods. Addressing these challenges, our study presents an upgraded, portable, and cost-effective system for measuring blood clot permeability, which utilizes a pressure-based approach that adheres to Darcy\'s law. By enhancing precision and sensitivity in discerning clot characteristics, this innovation provides a valuable tool for assessing thrombotic risk and associated pathological conditions. In this paper, the authors present a device that is able to automatically perform the permeability measurements on plasma or fibrinogen in vitro-induced clots on specific holders (filters). The proposed device has been tailored to distinguish clot permeability, with high precision and sensitivity, between healthy subjects and high cardiovascular-risk patients. The precise measure of clot permeability represents an excellent indicator of thrombotic risk, thus allowing the clinician, also on the basis of other anamnestic and laboratory data, to attribute a risk score to the subject. The proposed instrument was characterized by performing permeability measurements in plasma and purified fibrinogen clots derived from 17 Behcet patients and 15 sex- and age-matched controls. As expected, our results clearly indicate a significant difference in plasma clot permeability in Behcet patients with respect to controls (0.0533 ± 0.0199 d vs. 0.0976 ± 0.0160 d, p < 0.001). This difference was confirmed in the patient\'s vs. control fibrin clots (0.0487 ± 0.0170 d vs. 0.1167 ± 0.0487 d, p < 0.001). In conclusion, our study demonstrates the feasibility, efficacy, portability, and cost-effectiveness of a novel device for measuring clot permeability, allowing healthcare providers to better stratify thrombotic risk and tailor interventions, thereby improving patient outcomes and reducing healthcare costs, which could significantly improve the management of thromboembolic diseases.
摘要：
血栓栓塞,全球主要的死亡原因，需要准确的风险评估以进行有效的预防和治疗。目前的分层方法不足以预测血栓事件，强调需要更深入地了解凝块特性。纤维蛋白凝块通透性,高凝状态的关键参数，影响凝块结构和抗裂解性。当前的凝块渗透性测量限制推动了对标准化方法的需要。先前的研究结果强调了凝块通透性在各种血栓条件下的重要性，但需要改进和更精确，可重复,标准化的方法。应对这些挑战，我们的研究提出了一个升级，便携式，和经济有效的血凝块渗透性测量系统，它采用了一种坚持达西定律的基于压力的方法。通过提高识别凝块特性的精度和灵敏度，这项创新为评估血栓形成风险和相关病理状况提供了有价值的工具.在本文中,作者提出了一种装置,该装置能够在特定支架(过滤器)上对体外诱导的血凝块中的血浆或纤维蛋白原自动进行通透性测量.拟议的装置已被定制以区分凝块渗透性，具有高精度和灵敏度，在健康受试者和高心血管风险患者之间。凝块通透性的精确测量代表了血栓形成风险的一个很好的指标，因此允许临床医生，还基于其他记忆和实验室数据，将风险评分归因于主题。拟议的仪器的特征在于对来自17名Behcet患者和15名性别和年龄匹配的对照者的血浆和纯化的纤维蛋白原凝块进行渗透性测量。不出所料,我们的结果清楚地表明，与对照组相比，Behcet患者的血浆凝块通透性存在显着差异（0.0533±0.0199d与0.0976±0.0160d,p<0.001)。这种差异在患者的vs.对照纤维蛋白凝块(0.0487±0.0170dvs.0.1167±0.0487d,p<0.001)。总之,我们的研究证明了可行性，功效,便携性,以及用于测量凝块渗透性的新型设备的成本效益，允许医疗保健提供者更好地分层血栓风险和定制干预措施，从而改善患者预后并降低医疗成本，这可以显着改善血栓栓塞性疾病的管理。
