A new global assay of coagulation and fibrinolysis
A new global assay of coagulation and fibrinolysis
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DOI：
10.1016/j.thromres.2004.12.009
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发表时间：
2005-01-01
影响因子：
7.5
通讯作者：
Manco-Johnson, MJ
中科院分区：
文献类型：
--
作者：
Goldenberg, NA;Hathaway, WE;Manco-Johnson, MJ
导言：全球凝血检测可以反映个体的净止血余额，并有助于血栓前病变和出血风险评估。材料和方法：在凝块形成和溶解(CloFAL)试验中，将含有微量钙、组织因子和组织型纤溶酶原激活剂的缓冲反应物溶液加入96孔板上的血浆样品中，在自动温度调节(37℃)分光光度计中。凝块的形成和溶解以3h内吸光度的连续变化来监测。测量包括最大吸光度(MA)、达到最大吸光度的时间(T-1)和吸光度下降第一阶段的完成时间(T-2)和曲线下面积(AUC)，由此可以计算凝血指数(CI)和各种纤维蛋白溶解指数(FI)。结果与结论：MA、T-1和CI主要受纤维蛋白原和促凝因素的影响。FI可通过抑制纤溶酶原或凝血酶激活的纤溶抑制物的激活而改变。与健康成人相比，足月新生儿的CI中位数显著降低，而FI显著增加(CI：58%比115%，FI：210%比90%；P<；0.001)。相比之下，与成人相比，健康孕妇的中位数CI显著增加，FI显著降低(CI：239%比115%，FI：59%比90%；P<；0.001)。CloFAL全球检测对凝血和纤溶系统中的几个关键成分以及止血过程中的生理变化具有分析敏感性。(C)2005爱思唯尔有限公司。保留所有权利。
Introduction: Global clotting assays may reflect an individual's net hemostatic balance and could contribute to prothrombotic and hemorrhagic risk assessment. In this research, a global assay that measures both coagulation and fibrinolytic capacities was developed and investigated.Materials and methods: In the Clot Formation and Lysis (CloFAL) assay, a buffered reactant solution containing trace amounts of calcium, tissue factor, and tissue-type plasminogen activator is added to plasma samples on a 96-well microplate in an automated, thermo-regulated (37 degrees C) spectro photometer. Clot formation and lysis are monitored as continuous changes in absorbance over the course of 3 h. Measurements include maximum amplitude (MA), times to maximum absorbance (T-1) and completion of the first phase of decline in absorbance (T-2), and area under the curve (AUC), from which a coagulation index (CI) and various fibrinotytic indices (FI) may be calculated.Results and conclusions: MA, T-1, and CI were principally influenced by fibrinogen and procoagulant factors. FI was found to be altered by inhibiting activation of plasminogen or thrombin activatable fibrinolytic inhibitor. Median CI was significantly decreased, while FI was markedly increased, in term neonates as compared to healthy adults (CI: 58% vs. 115%, FI: 210% vs. 90%; P < 0.001 for each). By contrast, median Cl was notably increased, and FI decreased, in healthy pregnant women when compared to adults (CI: 239% vs. 115%, FI: 59% vs. 90%; P < 0.001 for each). The CloFAL global assay is analytically sensitive to several key components in the coagulation and fibrinolytic systems, as well as to physiologic alterations in hemostasis. (c) 2005 Elsevier Ltd. All rights reserved.