在直接口服抗凝剂时代解释凝血混合研究结果
Moon Joo Kim1, Eric Salazar2, Bonnie Philips1
1Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston.
概括
直接口服抗凝剂 (DOAC) 干扰凝血混合研究. 实验室必须识别DOAC干扰,特别是在不寻常的模式中,以确保准确地解释前血时间 (PT) 和激活的部分血栓塑时间 (aPTT) 的结果.
科学领域:
- 血液学 血液学 血液学
- 临床化学 临床化学
- 实验室医学 实验室医学
背景情况:
- 直接口服抗凝剂 (DOAC) 越来越多地被处方,使凝血混合研究的解释变得复杂.
- 准确地解释前热血素时间 (PT) 和激活部分血栓形成时间 (aPTT) 混合研究对于诊断凝血障碍至关重要.
研究的目的:
- 调查直接口服抗凝剂 (DOAC) 在凝血混合研究中的干扰.
- 为了确定PT/aPTT混合研究中DOAC干扰的流行率和模式.
主要方法:
- 对2017年至2021年期间进行的1035项凝血混合研究的回顾性审查.
- 排除了399例正常PT和aPTT的病例.
- 在时间0和60分钟化后对aPTT混合研究的分析,通过实验室检测,药物记录和病史确认干扰因素.
主要成果:
- 混合研究纠正了最长时间的PT样本 (93%),但32个案例显示了不完全的纠正.
- 在这32个病例中,DOAC使用导致18例,而V因子抑制剂导致3例.
- 在化后观察到一个不寻常的aPTT延长模式,狼抗凝剂 (28%) 和DOAC (25%) 与特定因子抑制剂 (28%) 相似.
结论:
- 直接口服抗凝剂 (DOAC) 在凝血混合研究中显著干扰,导致不完全的纠正和不寻常的aPTT延长模式.
- 凝血实验室必须意识到PT/aPTT混合研究中的潜在DOAC干扰和其他混因素,以便准确的诊断解释.
相关概念视频
Anticoagulant Drugs: Low-Molecular-Weight Heparins
713
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
713
Coagulation
6.9K
The coagulation phase is a critical part of the body's process to prevent blood loss following injury to blood vessels. It involves chemical reactions that form a clot to seal the injured area. The clotting process begins shortly after injury, within 15-20 seconds for severe damage and 1-2 minutes for minor injuries.
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
6.9K
Disorders of Hemostasis
945
Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
945


