Clinical tseem ceeb
Nws yeej muaj tib lub ntsiab lus raws li lub sij hawm coagulation, tab sis nrog siab rhiab heev.Feem ntau ntawm APTT kev txiav txim siab txoj kev siv tam sim no tuaj yeem ua qhov txawv txav thaum lub plasma coagulation factor qis dua 15% mus rau 30% ntawm qib ib txwm muaj.
(1) APTT ncua sij hawm: qhov tshwm sim APTT yog 10 vib nas this ntev tshaj li qhov kev tswj hwm ib txwm muaj.APTT yog qhov kev ntsuam xyuas txhim khu kev qha tshaj plaws rau endogenous coagulation factor deficiency thiab feem ntau yog siv los tshawb pom mob hemophilia.Txawm hais tias qhov tseem ceeb Ⅷ: C qib tuaj yeem kuaj tau qis dua 25% ntawm hemophilia A, qhov rhiab heev rau subclinical hemophilia (factor Ⅷ> 25%) thiab cov neeg muaj hemophilia tsis zoo.Cov txiaj ntsig ntev kuj tseem pom nyob rau hauv yam Ⅸ (hemophilia B), Ⅺ thiab Ⅶ tsis txaus;thaum cov ntshav anticoagulant tshuaj xws li coagulation factor inhibitors los yog heparin qib nce, prothrombin, fibrinogen thiab factor V, X deficiency kuj yuav ua tau ntev, tab sis qhov rhiab heev yog me ntsis tsis zoo;Kev ncua ntev ntawm APTT kuj tuaj yeem pom nyob rau hauv lwm cov neeg mob uas muaj kab mob siab, DIC, thiab cov ntshav tso nyiaj ntau.
(2) APTT luv luv: pom hauv DIC, prethrombotic xeev thiab kab mob thrombotic.
(3) Kev saib xyuas kev kho mob heparin: APTT yog qhov nkag siab zoo rau cov ntshav plasma heparin, yog li nws yog qhov siv dav hauv kev soj ntsuam ntsuas ntsuas tam sim no.Lub sijhawm no, nws yuav tsum tau muab sau tseg tias qhov ntsuas APTT yuav tsum muaj kev sib raug zoo nrog cov ntshav plasma concentration ntawm heparin hauv kev kho mob, txwv tsis pub nws yuav tsum tsis txhob siv.Feem ntau, thaum kho heparin, nws raug nquahu kom tswj hwm APTT ntawm 1.5 txog 3.0 npaug ntawm kev tswj ib txwm.
Kev txheeb xyuas qhov tshwm sim
Clinically, APTT thiab PT feem ntau yog siv los kuaj xyuas cov ntshav coagulation muaj nuj nqi.Raws li kev ntsuas ntsuas, muaj kwv yees li plaub qhov xwm txheej hauv qab no:
(1) Ob qho tib si APTT thiab PT yog ib txwm muaj: Tsuas yog cov tib neeg ib txwm muaj, nws tsuas yog pom nyob rau hauv keeb kwm thiab theem nrab FXIII tsis txaus.Cov uas tau txais yog muaj nyob rau hauv cov kab mob siab heev, mob qog nqaij hlav, malignant lymphoma, leukemia, anti-factor XIII antibody, autoimmune anemia thiab pernicious anemia.
(2) Ntev APTT nrog PT ib txwm: Feem ntau ntawm cov ntshav los ntshav yog tshwm sim los ntawm qhov tsis xws luag hauv txoj hauv kev coagulation.Xws li hemophilia A, B, thiab yam Ⅺ deficiency;muaj cov tshuaj tiv thaiv kab mob Ⅷ, Ⅸ, Ⅺ cov tshuaj tiv thaiv kab mob hauv cov ntshav.
(3) Ib txwm APTT nrog lub sijhawm ntev PT: feem ntau los ntshav los ntawm qhov tsis xws luag hauv txoj kev coagulation extrinsic, xws li caj ces thiab tau txais yam VII tsis txaus.Cov uas tau txais yog muaj nyob rau hauv kab mob siab, DIC, anti-factor VII antibodies nyob rau hauv cov ntshav ncig thiab qhov ncauj anticoagulants.
(4) Ob leeg APTT thiab PT yog ntev: feem ntau los ntshav los ntawm qhov tsis xws luag hauv txoj kev coagulation, xws li caj ces thiab tau txais yam X, V, II thiab kuv tsis txaus.Cov uas tau txais yog pom nyob rau hauv kab mob siab thiab DIC, thiab yam X thiab II yuav raug txo kom tsawg thaum siv cov tshuaj tiv thaiv qhov ncauj.Tsis tas li ntawd, thaum muaj anti-factor X, anti-factor V thiab anti-factor II antibodies nyob rau hauv cov ntshav ncig, lawv kuj tau ntev raws li.Thaum siv tshuaj heparin hauv kev kho mob, ob qho tib si APTTT thiab PT raug ncua ntev raws li.