Ukubaluleka kweklinikhi
Ngokwesiseko inentsingiselo efanayo nexesha lokuhlangana, kodwa ngovakalelo oluphezulu.Uninzi lweendlela zokumisela i-APTT ngoku ezisetyenziswayo zinokuba zingaqhelekanga xa i-plasma coagulation factor ingaphantsi kwe-15% ukuya kwi-30% yezinga eliqhelekileyo.
(1) Ukwandiswa kwe-APTT: umphumo we-APTT yimizuzwana eyi-10 ubude kunolawulo oluqhelekileyo.I-APTT lolona vavanyo luthembekileyo lovavanyo lokusilela kwe-endogenous coagulation factor kwaye isetyenziswa ikakhulu ukufumanisa i-haemophilia ephakathi.Nangona i-factor Ⅷ: Amanqanaba e-C angafunyanwa ngaphantsi kwe-25% ye-hemophilia A, uvakalelo kwi-subclinical hemophilia (i-factor Ⅷ>25%) kunye nabathwali be-hemophilia ababi.Iziphumo ezinde zikwabonwa kwi-factor Ⅸ (hemophilia B), Ⅺ kunye Ⅶ ukusilela;xa izinto ze-anticoagulant zegazi ezifana ne-coagulation factor inhibitors okanye amanqanaba e-heparin enyuka, i-prothrombin, i-fibrinogen kunye ne-factor V, ukusilela kwe-X nako Kunokwandiswa, kodwa uvakalelo luncinci;Ukwandiswa kwe-APTT kunokubonwa nakwezinye izigulana ezinesifo sesibindi, i-DIC, kunye nenani elikhulu legazi lebhanki.
(2) Ukunciphisa i-APTT: kubonakala kwi-DIC, i-prethrombotic state kunye nesifo se-thrombotic.
(3) Ukubeka iliso kunyango lwe-heparin: I-APTT inomdla kakhulu kwi-concentration ye-plasma heparin, ngoko ke isalathiso sokubeka iliso kwibhubhoratri esetyenziswa ngokubanzi ngoku.Ngeli xesha, kufuneka kuqatshelwe ukuba umphumo wokulinganisa i-APTT kufuneka ube nobudlelwane bomgca kunye ne-plasma yoxinaniso lwe-heparin kuluhlu lwezonyango, ngaphandle koko akufanele kusetyenziswe.Ngokuqhelekileyo, ngexesha lonyango lwe-heparin, kuyacetyiswa ukuba kugcinwe i-APTT kwi-1.5 ukuya kwi-3.0 ngamaxesha olawulo oluqhelekileyo.
Uhlalutyo lweziphumo
Ngokweklinikhi, i-APTT kunye ne-PT zihlala zisetyenziswa njengovavanyo lokuhlola umsebenzi we-blood coagulation.Ngokweziphumo zomlinganiselo, kukho malunga nezi meko zine zilandelayo:
(1) Zomibini i-APTT kunye ne-PT ziqhelekileyo: Ngaphandle kwabantu abaqhelekileyo, kubonakala kuphela kwifa kunye nokusilela kwe-FXIII yesibini.Ezifunyenweyo zixhaphake kwisifo esinzima sesibindi, i-tumor yesibindi, i-lymphoma enobungozi, i-leukemia, i-anti-factor XIII antibody, i-anemia ye-autoimmune kunye ne-anemia eyingozi.
(2) I-APTT yexesha elide kunye ne-PT eqhelekileyo: Uninzi lweengxaki zokuphuma kwegazi zibangelwa yiziphene kwindlela ye-intrinsic coagulation.Enje ngehemophilia A, B, kunye nokusilela kwefactor Ⅺ;kukho i-anti-factor Ⅷ, Ⅸ, Ⅺ antibodies kumjikelezo wegazi.
(3) I-APTT eqhelekileyo kunye ne-PT ende: uninzi lweengxaki zokuphuma kwegazi ezibangelwa ziziphene kwi-extrinsic coagulation pathway, ezifana ne-genetic kunye ne-acquired factor VII deficiency.Ezifunyenweyo zixhaphake kwisifo sesibindi, i-DIC, i-anti-factor VII antibodies kwi-circulation yegazi kunye ne-anticoagulants yomlomo.
(4) Zomibini i-APTT kunye ne-PT zihlala ixesha elide: uninzi lweengxaki zokuphuma kwegazi ezibangelwa yiziphene kwindlela yokudibanisa eqhelekileyo, njengemfuza kunye ne-function factor X, V, II kunye nokusilela.Ezifunyenweyo zibonwa kakhulu kwisifo sesibindi kunye ne-DIC, kwaye izinto X kunye ne-II zinokuncitshiswa xa kusetyenziswa i-anticoagulants yomlomo.Ukongezelela, xa kukho i-anti-factor X, i-anti-factor V kunye ne-anti-factor II antibodies kwi-circulation yegazi, nazo zongezwa ngokufanelekileyo.Xa i-heparin isetyenziselwa iklinikhi, zombini i-APTTT kunye ne-PT zithatha ixesha elide ngokufanelekileyo.