Establishing reference intervals of coagulation indices based on the ACL Top 700 system for children in Southwestern Fujian,China

BackgroundTill date, China has not issued industry standards for reference intervals (RIs) of pediatric blood coagulation indices. Here, we evaluated changes in the coagulation indices in the venous blood of healthy children aged 29 days to 12 years derived using the ACL Top 700 system and established appropriate RIs.MethodsWe analyzed venous blood from 1770 healthy children for five coagulation indices. RIs were established according to the Clinical and Laboratory Standards Institute C28-A3c guideline.ResultsThe coagulation indices were grouped by age. For prothrombin time (PT) and international normalization ratio (INR), the RIs of infants and toddlers were identical; preschool children had the same RI as school-age children. Pediatric RIs for PT and INR were slightly lower than those for adults. The RIs of activated partial thromboplastin time (APTT), thrombin time (TT), and fibrinogen (FIB) in childhood were divided into two groups by age (1 month to 1 year and 1–12 years). The RI of APTT in infants was the widest; the overall level of FIB in infants was the lowest; children's APTT and FIB RIs were lower than those of adults. The pattern of TT values and RI trends in childhood were similar to those of APTT.ConclusionsThere were minor changes in the RIs of coagulation indices for children. The RIs of PT, INR, APTT, TT, and FIB must be grouped by age. The RIs of coagulation indices for children were different from those for adults; therefore, establishing separate RIs for children is necessary.     

A Comparison of Coagulation Function in Patients Receiving Aspirin and Cefoperazone-Sulbactam With and Without Vitamin K1: A Retrospective,Observational Study

PurposeThe study objective was to explore whether prophylaxis with vitamin K₁ improves abnormal coagulation function–associated cefoperazone-sulbactam in patients treated in the long term with low-dose aspirin.MethodsThis retrospective, observational study assessed patients treated with long-term low-dose aspirin in a naval military hospital in China from 2004 to 2018, including all patients treated concurrently with cefoperazone-sulbactam with or without vitamin K₁. Differences in the coagulation index were analyzed statistically before and after receipt of cefoperazone-sulbactam.FindingsThe cohort included 227 patients. After cefoperazone-sulbactam treatment, the mean (SD) prothrombin time (PT) was 14.07 (3.07) seconds, activated partial thromboplastin time (aPTT) was 35.15 (4.78) seconds, and international normalized ratio (INR) was 1.49 (0.49) in the cefoperazone-sulbactam group, which was significantly higher than the PT of 11.55 (1.29), aPTT of 31.37 (2.20), and INR of 1.12 (0.35) before cefoperazone-sulbactam treatment. No significant difference was in the cefoperazone-sulbactam plus vitamin K₁ group. In addition, no significant difference was found in the thrombin time or fibrinogen level between before and after cefoperazone-sulbactam treatment in both groups. The mean (SD) platelet counts of the 2 groups were 197.34 (71.82) × 10⁹/L and 187.75 (72.66) × 1 0⁹/L after cefoperazone-sulbactam treatment, respectively, which was significantly lower than 231.77 (77.05) × 10⁹/L and 232.08 (84.48) × 10⁹/L before cefoperazone-sulbactam treatment. There were greater proportions of coagulation disorders (prolongation of PT, aPTT, INR, and bleeding) after cefoperazone-sulbactam treatment in the cefoperazone-sulbactam group compared with that in the cefoperazone-sulbactam plus vitamin K₁ group.ImplicationsResults indicate that, after adding cefoperazone-sulbactam to the regimens of patients receiving long-term low-dose aspirin, therapy contributed to remarkable increase in abnormal coagulation function and coagulation disorders. Prophylaxis with vitamin K₁ decreased the risk of these abnormalities in blood coagulation parameters associated with cefoperazone-sulbactam in patients taking long-term aspirin.     

Emergency medicine misconceptions: Utility of routine coagulation panels in the emergency department setting

BackgroundCoagulation panels are ordered for a variety of conditions in the emergency department (ED).ObjectiveThis narrative review evaluates specific conditions for which a coagulation panel is commonly ordered but has limited utility in medical decision-making.DiscussionCoagulation panels consist of partial thromboplastin time (PTT) or activated partial thromboplastin time (aPTT), prothrombin time (PT), and international normalized ratio (INR). These tests evaluate the coagulation pathway which leads to formation of a fibrin clot. The coagulation panel can monitor warfarin and heparin therapy, evaluate for vitamin K deficiency, evaluate for malnutrition or severe systemic disease, and assess hemostatic function in the setting of bleeding. The utility of coagulation testing in chest pain evaluation, routine perioperative assessment, prior to initiation of anticoagulation, and as screening for admitted patients is low, with little to no change in patient management based on results of these panels. Coagulation testing should be considered in systemically ill patients, those with a prior history of bleeding or family history of bleeding, patients on anticoagulation, or patients with active hemorrhage and signs of bleeding. Thromboelastography and rotational thromboelastometry offer more reliable measures of coagulation function.ConclusionsLittle utility for coagulation assessment is present for the evaluation of chest pain, routine perioperative assessment, initiation of anticoagulation, and screening for admitted patients. However, coagulation panel assessment should be considered in patients with hemorrhage, patients on anticoagulation, and personal history or family history of bleeding.     

Dabigatran deliberate overdose: two cases and suggestions for laboratory monitoring

Context: Dabigatran etexilate (dabigatran) is a direct thrombin inhibitor anticoagulant agent. There is limited information about the changes in coagulation profile and outcomes in overdose. A monoclonal antibody has been developed to neutralize the anticoagulant effect of dabigatran. Case reports describe enhanced clearance of dabigatran by haemodialysis as an intervention to prevent haemorrhagic complications – however, the threshold for initiating haemodialysis is not well defined in an asymptomatic patient with normal renal function. Case details: Two patients presented following deliberate dabigatran overdoses. A 55-year-old woman ingested 10?×?150?mg dabigatran. A 21-year-old woman with a history of systemic lupus erythematosus and pulmonary embolus ingested 100?×?110?mg dabigatran. Both were admitted to the intensive care unit and managed expectantly. Serial coagulation tests normalized over 60 h. The half-life of dabigatran was not prolonged following overdose, being calculated between 7 and 11 h in each case. There was positive correlation between international normalized ratio (INR), prothrombin time (PT) and activated partial thromboplastin time (aPTT) with plasma dabigatran levels. Conclusion: There is limited experience with dabigatran overdoses. Normal aPTT, PT and INR assays 12 h following deliberate ingestion indicate that the drug concentration is not high. Individual risk assessment of bleeding risk needs to be formulated for each patient and expectant management is reasonable in the presence of normal renal function and absent risk factors for bleeding.     

不同血凝分析仪检测结果的一致性研究

目的 探讨不同实验室以及同一实验室的不同血凝分析仪检测结果的一致性.方法 将不同实验室的14台血凝分析仪分为3组,分别为STA系列(A组)、ACL系列(B组)、CA系列(C组),同时检测同一批号不同水平质控品(水平1、2、3)的凝血酶原时间(PT)、国际标准化比值(INR)、活化部分凝血活酶时间(APTT)、纤维蛋白原含量(FIB)及凝血酶时间(TT);并以同一实验室检测原理基本一致的2台血凝分析仪同时检测139份受检血浆的PT、INR、APTT、PT演算法测定FIB(PT-FIB)、Clauss法测定FIB(FIB-C).结果 3组血凝分析仪检测INR水平3的结果分别为5.35±0.20、4.35±1.00、4.46±0.30,差异无统计学意义(P＞0.05);检测TT水平3的结果分别为(17.1±0.3)s、(15.5±1.1)s、(14.8±1.8)s,差异无统计学意义(P＞0.05);其他各检测指标结果间差异有统计学意义(P＜0.05);两两比较的结果表明,B组和C组检测结果的符合率高达66.7%(10/15).同一实验室的ACL Futura和CA 510血凝分析仪检测PT的结果分别为(17.7±6.7)s、(20.1±10.9)s,检测INR的结果分别为1.75±1.07、1.64±0.91,检测PT-FIB的结果分别为(3.51±1.50)g/L、(3.68±1.93)g/L,检测FIB-C的结果分别为(2.61±1.31)g/L、(2.58±1.45)g/L,上述指标间差异均无统计学意义(P＞0.05);而检测APTT的结果分别为(49.9±21.5)s、(39.1±16.7)s,差异具有统计学意义(P＜0.05);同时,二者检测PT、INR、APTT、PT-FIB和FIB-C结果的相关性良好,r值分别为0.984 3、0.988 8,0.987 0,0.975 6,0.994 0;偏倚分析结果显示,2台血凝分析仪检测PT、INR、PT-FIB和FIB-C结果的一致性较好.结论 检测原理基本相同的不同血凝分析仪,其检测结果具有较好的一致性.不同血凝分析仪应通过定期比对和试剂的标准化,以改善和保证其检测结果的一致性.     

妊娠晚期孕妇凝血功能检测与分析

目的探讨妊娠晚期孕妇凝血功能检测的临床意义。方法采用Sysmex-1500型全自动凝血分析仪测定280例妊娠晚期孕妇（观察组）及140例健康育龄妇女（对照组）的凝血酶原时间（PT）、国际化标准比值（INR）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（Fbg），并进行分析比较。结果观察组的PT、INR、APTT均较对照组明显缩短，Fbg高于对照组，P〈0．01；而两组TT差异无统计学意义（P〉0．05）。结论妊娠晚期妇女血液处于高凝状态。检测其凝血功能，对预防或早期治疗弥散性血管内凝血（DIC）有一定的帮助。     

健康成人血浆凝血四项检测结果的分布及其参考区间的建立

目的初步建立连云港地区20~79岁健康成人血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)和纤维蛋白原(FIB)的参考区间。方法采用完全随机化方法选取2018年6月至2018年12月连云港市第二人民医院体检中心收治的2436例健康志愿者,男1395例,女1041例,年龄范围为20~79岁。将志愿者按照性别分为男性组和女性组,按照年龄分为20~29岁组、30~39岁组、40~49岁组、50~59岁组、60~69岁组、70~79岁组。采用ACL TOP700全自动凝血分析仪及其配套试剂检测血浆中PT、APTT、TT和FIB的水平,并依据CLSI C28-A3和WS/T 402-2012《临床实验室检验项目参考区间的制定》推荐方法建立血浆凝血四项的参考区间。结果连云港地区健康成人血浆中PT、APTT、TT和FIB的结果分布在性别、年龄方面比较,差异无统计学意义(P>0.05),故本研究建立血浆凝血四项的参考区间,PT为10.0~13.6 s,APTT为25.2~37.8 s,TT为11.9~17.7 s,FIB为2.13~4.56 g/L。结论连云港地区健康成人血浆PT、APTT、TT和FIB参考区间的建立,能够为临床相关疾病的诊断、监测和预后评估提供重要的参考价值。     

Coagulopathy parameters in patients with Crimean‐Congo hemorrhagic fever and its relation with mortality

Background: Crimean‐Congo hemorrhagic fever (CCHF) is an acute illness affecting multiple organ systems and characterized by ecchymosis, visceral bleeding, and hepatic dysfunction. In this study, we aimed to investigate the profile of coagulopathy markers (platelet count, activated partial tromboplastin time (aPTT), prothrombin time (PT), international normalized ratio (INR), fibrinogen, protein C, protein S, antithrombin III, activated protein C resistance (APCR), and D‐dimer) and their clinical significance in 83 CCHF‐infected patients. Subjects and methods: We studied 83 CCHF patients who were admitted to Ankara Numune Education and Research Hospital during the spring and summer of2007. We compared the coagulopathy markers of fatal CCHF patients (n=9) with nonfatal cases (n=74). Results: Platelet count, PT, aPTT, INR, and fibrinogen were prognostic factors associated with mortality for CCHF. Especially, platelet count<20×10⁹ cells/l and aPTT>60 sec were important. Protein C, protein S, APCR, and antithrombin III levels were not associated with mortality. Conclusion: Laboratory tests including classical parameters (platelet count, PT, aPTT, INR, and fibrinogen) of coagulopathy seem to be enough for the followup of CCHF. Protein S, protein C, APCR, and D‐dimer levels were not associated with mortality. J. Clin. Lab. Anal. 24:163–166, 2010. © 2010 Wiley‐Liss, Inc.     

Correlations between rotational thromboelastometry (ROTEM) and standard coagulation tests following viper snakebites

BackgroundA high prevalence of venom-induced consumption coagulopathy has been reported in individuals with viper snakebites. Rotational thromboelastometry (ROTEM) is a rapid technique that could be advantageous in assessing and monitoring coagulation disorders.PurposeTo explore correlations between ROTEM and standard coagulation tests.Patients and methodsThis prospective observational study was performed among 41 patients with viper envenomation admitted to the Vietnam Poison Control Center from April 2016 to October 2017. Standard coagulation measurements [platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT), and fibrinogen level] and ROTEM indicators [clotting time (CT), amplitude (at set time: 5 and 10 minutes), clot information time (CFT) and maximum clot firmness (MCF) for extrinsic (EXTEM), intrinsic (INTEM), and fibrin based (FIBTEM) ROTEM] were obtained.ResultsFor INTEM, EXTEM, the FIBTEM, proportions of patients with prolonged CT were 34.1%, 63.4%, and 61.0% respectively and the proportions of patients with decreased MCF were 62.2%, 62.2%, and 35.5%, respectively. Moderate correlations were observed between PT and EXTEM CT (r = 0.627), aPTT and INTEM CT (r = 0.626), fibrinogen and FIBTEM MCF (r = 0.723), and platelet count and EXTEM MCF (0.60).ConclusionROTEM indicated a hypocoagulation state in patients with viper snakebite and was moderately correlated with standard coagulation parameters.     

Complete clinical course of envenomation by Protobothrops mangshanensis: delayed coagulopathy and response to Trimeresurus albolabris antivenom

Introduction: Protobothrops mangshanensis, the Mangshan pit viper, is a rare pit viper native to the area surrounding Mount Mang in China’s Hunan province. Toxicity from envenomation is not well characterized. Case details: A 33-year-old male presented to an emergency department (ED) after being bitten on the forearm by his P. mangshanensis. He complained of mild swelling and pain at the bite site. He was admitted for observation and toxicology consultation. Following initially normal coagulation studies including platelets, prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen and D-dimer, fibrinogen decreased to 121?mg/dL and D-dimer concurrently rose to 377?ng/mL over 24?h. On hospital day 2 fibrinogen stabilized at 109?mg/dL and he was discharged with outpatient laboratory monitoring. Three days later, he returned with bruising to the contralateral arm. Fibrinogen was undetectable (<40?mg/dL) and PT was 14.6?s. He declined admission but returned 2 d later with bruising to the nose. Bloodwork revealed immeasurably prolonged PT, aPTT, and thrombin time, but he eloped. Late that evening he returned and was treated with three vials of Green pit viper (Trimeresurus albolabris) antivenom. Within 24 h coagulopathy improved markedly; at five days, coagulation abnormalities resolved. Discussion: Mangshan pit viper envenomations may cause isolated hemotoxicity, despite molecular studies suggesting additional neurotoxicity and myotoxicity. T. albolabris antivenom appears effective in treating the resultant coagulopathy. Conclusion: We report the natural history of envenomation by the Mangshan pit viper. A delayed coagulopathy, apparently fibrinolytic in nature, is unaccompanied by local tissue destruction and responsive to Green pit viper antivenom.     

Thromboelastography (TEG®) compared to conventional coagulation tests in surgical patients – a laboratory evaluation

Abstract

Background. Several methods exist for evaluation of hypocoagulation in patients with perioperative bleeding, e.g. thromboelastography (TEG^®) and conventional methods (platelet count, aPTT, INR and fibrinogen). Considering the vast experience of conventional methods it is important to investigate how well the methods correspond. Methods. Sixty surgical patients were included prospectively and blood samples were taken perioperatively. TEG^® and conventional parameters were analyzed simultaneously. An assessment of coagulopathy, based on a synthesis of the conventional methods, was done by two experienced coagulation specialists, blinded from the results of TEG^® and from the results of each other. Hypocoagulation, defined by TEG^® parameters; reaction time (R-time), angle, maximal amplitude (MA) and fibrinolysis, was evaluated according to a commonly used algorithm. Results. To detect a platelet count below 150 × 10⁹ L^?1, the sensitivity of TEG was 17% (95% CI, 7–36%) with angle and 25% (95% CI, 11–45%) with MA. The sensitivity to detect fibrinogen below 2 g/L was 11% (95% CI, 3–29%) with angle and 21% with MA (95% CI, 8–43%). To detect aPTT more than 40 s and INR more than 1.2 with R-time, the sensitivity was 19% (95% CI, 8–37%) and 0% (95% CI, 0–69%) respectively. The agreement of the evaluator's assessments of hypocoagulation was 100%, but the agreement with the overall TEG^® analysis was poor with a sensitivity of 33% and a specificity of 95%. Conclusion. The agreement between conventional laboratory tests and TEG is poor, but it remains uncertain which type of coagulation tests that best reflects the actual bleeding risk.     

样本存放时间对凝血指标影响的实验评估

目的研究标本放置时间对部分血凝检测结果的影响,为规范分析前过程提供实验依据。方法随机选取100份枸橼酸钠抗凝外周血标本分别在室温放置1、2、4、6、8和10 h后进行血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)和纤维蛋白原(Fbg)含量的测定。根据不同检测项目和时间段分组,使用SAS统计软件包对上述4项指标在放置2、4、6、8、10 h所得到的检测结果与放置1 h内检测的结果进行配对t检验。结果PT、TT测定在标本采集1 h内的结果与2和4 h后检测结果差异无统计学意义(P>0.05),与6 h后检测的结果之间差异有统计学意义(P<0.01)。APTT测定在标本采集1 h内检测的结果与2、4、6、8和10 h后检测的结果之间差异有统计学意义(P<0.01)。Fbg测定在标本采集1 h内的结果与2 h检测的结果差异无统计学意义(P>0.05),而与之后的结果差异有统计学意义(P<0.01)。结论用于凝血试验的标本在室温存放一段时间后,对不同检测项目均造成一定影响,标本采集后应在1 h内检测,如不能做到也应在2 h内检测完毕,否则会对检测结果造成明显影响。     

Stability of prothrombin time and activated partial thromboplastin time tests under different storage conditions

Prothrombin time (PT) and activated partial thromboplastin time (aPTT) are common laboratory tests that are useful in the diagnosis of coagulation disorders and monitoring anticoagulant therapy. Recent expansions in the outreach laboratory services at our institution prompted us to investigate the shipping limitations for some tests, including PT and aPTT. Although we followed NCCLS guidelines for the collection of blood specimens, we observed falsely elevated PT and aPTT values due to the different storage conditions. The objective of this study is to determine the effect of conditions and duration of storage on PT and aPTT tests using plasma and whole blood samples, respectively. For this study, 36 plasma samples with normal and prolonged PT and aPTT were exposed to different storage conditions. Blood was centrifuged immediately and plasma was stored at room temperature (RT), refrigerated at 4°C, or frozen at −20°C. The samples were analyzed at 0 h and repeated at 6, 12 and 24 h under various conditions. Although statistically significant differences were observed for plasma samples for normal PT tests after 12 h at refrigerated and frozen storage conditions, the differences would not change the clinical interpretation of the results. On the other hand, samples stored refrigerated or at RT showed significant differences for aPTT at 24 h. These differences would change clinical interpretation, especially for samples with normal or near normal aPTT times. Interestingly, aPTT was significantly higher for samples stored frozen when compared to refrigerated and RT conditions at 6 h. Similar patterns were also observed on ten whole blood samples with normal PT and aPTT values. In conclusion, either plasma or whole blood samples can be accepted for PT testing up to 24 h and for aPTT testing up to 12 h only, when transported either at RT or at 4°C.     

Non-frozen transports of whole blood samples do not cause relevant bias for global coagulation tests in clinical trials evaluating the drug safety

Sample shipments with dry ice have a large economic impact on clinical research. Therefore, the bias caused for global coagulation tests by non-frozen transports of whole blood instead of frozen plasma was investigated experimentally and by a meta-analysis of 6-year central laboratory data. In the experiment, aliquots from 14 healthy volunteers were kept as whole blood at 20+/-2 degrees C and as frozen plasma until an analysis of prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin time (TT), and antithrombin III (ATIII) at day 0, 1, 2, and 3 from collection. Within these 3 days only PT and aPTT demonstrated any changes: in blood samples kept at 20+/-2 degrees C these amounted about 10% for both. In frozen plasma, aPTT did not change whereas PT increased by 14%. In a meta-analysis of central laboratory data, PT and aPTT results were grouped across various phase II-IV trials by the type of sample transfer, either as frozen plasma on dry ice or non-frozen as whole blood. For the latter the mean difference to a reference group of phase I trials with same-day analysis was in line with the amount of bias found in the experiment (aPTT, 34.6+/-6.0 vs. 31.6+/-3.5 s; PT, 87.7+/-13.3 vs. 97.3+/-7.9%). The consistent bias resulted in shifted, but still normal distribution curves with a total rate of clinically relevant outliers of about 1.9% for aPTT and 2.4% for PT. Biases thus appear irrelevant for a common safety evaluation within clinical trials. Non-frozen whole blood transports for the measurement of global coagulation tests appear justified for this purpose, if protocols do not require frozen shipments for other reasons. However, transit time must not exceed 2 days and pre-analytical conditions should be consistent within the same trial.     

凝血指标、D-二聚体、FDP及抗凝血酶Ⅲ在肺癌诊治中的意义

目的探讨凝血指标、D-二聚体、FDP及抗凝血酶Ⅲ在肺癌诊治中的意义。方法收集肺癌患者115例作为肺癌组,健康体检者30例作为对照组,采用Stago-COMPACT全自动凝血分析仪对其血浆D-二聚体、纤维蛋白原（FIB）、抗凝血酶Ⅲ、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白（原）降解产物（FDP）进行检测。结果肺癌患者PT、APTT、TT、FIB、D-二聚体、FDP高于对照组（P〈0.05）,肺癌转移患者D-二聚体明显高于肺癌局限者（P〈0.05）。肺癌患者抗凝血酶Ⅲ低于对照组（P〈0.05）。结论凝血指标、D-二聚体、FDP及抗凝血酶Ⅲ对肺癌的转移及疾病的预后具有重要的诊断价值。     

Coagulation defects in trauma patients: etiology, recognition, and therapy

Trauma patients have many reasons to have defects in coagulation. These can be caused by the trauma or because of pre-existing disorders. Trauma patients who are at risk for coagulation defects should be screened with the basic tests (aPTT, INR/PT, platelet counts, hematocrit, and fibrinogen), with therapy based on the results. Attention also should be paid to any other correctable factors such as hypothermia. Finally, pre-existing disorders can influence the patient's hemostasis greatly and may require specific therapies.     

The evaluation of hemostatic disorders in patients with systemic lupus erythematosus]

AIM: Assessment of hemostasis in SLE patients. MATERIALS AND METHODS: We studied different coagulation parameters such as activated partial thromboplastin time (APTT), thrombin time (TT), prothrombin time (PT), activated clotting time (ACT); platelet aggregation (spontaneous and induced), fibrinolytic activity, concentration of fibrinogen, fibrinogen degradation products (FDP) and serotonin. RESULTS: Coagulation abnormalities were found with prevalence of hypercoagulation in APTT and TT tests. Fibrinolysis was inhibited. Levels of serotonin, FDP and spontaneous aggregation activity significantly increased. CONCLUSION: The above changes were typical for lingering DIC syndrome.     

临产孕妇凝血功能检测的临床意义

目的了解孕妇分娩前的凝血功能,探讨临产孕妇检测凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fib)的临床意义。方法对320例临产孕妇和130例健康非孕妇女的凝血四项指标检测结果进行比较分析。结果临产孕妇与健康非孕妇女比较,PT、APTT、TT显著降低,Fib明显升高,差异均有统计学意义(P<0.05)。结论在产前及分娩过程中及时监测各项凝血指标对预测、预防和治疗产妇异常出血有重要意义。     

正常高值血压孕产妇凝血指标与妊娠结局的临床分析

目的:探讨正常高值血压孕产妇的凝血指标与妊娠结局。方法:回顾性分析2015～2017年在本院产检并分娩的1 500例孕妇的临床资料,其中正常高值血压组、正常血压组、妊娠期高血压疾病(HDP)组各500例,将一般资料、孕晚期血小板计数(PLT)、平均血小板体积(MPV)、血小板分布宽度(PDW)、凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)及纤维蛋白原(FIB)与妊娠结局进行分析。结果:正常高值血压组孕产妇孕次、产次、孕前体质指数(BMI)、孕期增重(GWG)以及孕晚期PT、FIB、剖宫产率,与正常血压组孕产妇差异有统计学意义(P0.05)。正常高值血压组孕产妇孕前BMI,孕晚期PLT、MPV、PDW、PT、APTT,胎盘早剥、产后出血、剖宫产率、早产、羊水过少、小于孕龄儿及胎儿窘迫,与HDP组孕产妇差异有统计学意义(P0.05)。结论:正常高值血压孕产妇部分凝血指标发生变化,除剖宫产率升高外,不良妊娠结局并未显著增加,临床一般无需特别纳入妊娠期高血压疾病管理。     

吲哚布芬对2型糖尿病患者血小板聚集及凝血机制的影响

[目的]观察吲哚布芬对2型糖尿病患者血小板聚集功能及凝血机制的影响.[方法]分别以比浊法和凝固法检测应用吲哚布芬治疗前后2型糖尿病患者的血小板最大聚集率(MAR)和凝血全套各指标的变化.[结果]经吲哚布芬治疗后,61例2型糖尿病患者活化部分凝血活酶时间(APTT)、纤维蛋白原凝固时间(FIBT)明显延长(P<0.05)...