A Novel Assessment of Factor VIII Activity by Template Matching Utilizing Weighted Average Parameters from Comprehensive Clot Waveform Analysis.
A Novel Assessment of Factor VIII Activity by Template Matching Utilizing Weighted Average Parameters from Comprehensive Clot Waveform Analysis.
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利用综合血块波形分析的加权平均参数，通过模板匹配对因子 VIII 活性进行新颖评估。
DOI：
10.1055/s-0040-1715838
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Nogami K.
中科院分区：
文献类型：
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作者：
Shimonishi N;Ogiwara K;Oda Y;Kawabe T;Okazaki S;Shima M;Nogami K.
背景基于活化部分凝血活酶时间（aPTT）的凝块波形分析用于评估纤维蛋白凝块形成的综合动态。此外，该技术可有效用于快速评估 A 型血友病 (HA) 患者在各种临床环境中的 (F)VIII 因子促凝血活性。我们定义了一种基于 aPTT 波形的加权平均参数的新算法，以设计用于评估 FVIII 活性 (FVIII:C) 的模板匹配程序。方法由 aPTT 试剂 (Coagpia APTT-N) 触发的原始凝块波形的一阶导数用于确定各种缺乏凝血因子的血浆中不同最大高度百分比下波形包围的面积的加权平均值。将基于 50 个加权平均相关参数制备的模板与 78 个 aPTT 延长的血浆进行比较。结果具有延长的 aPTT 的各种缺乏凝血因子的血浆的原始非平滑波形表现出多种形状。加权平均值是在对不同基线进行调整后计算的，并且该模式似乎受特定凝血因子缺乏的控制。加权平均相关参数包括基线楔形（r2= 0.998）和纵横比（r2= 0.998）与FVIII:C水平高度相关。基于从 158 个样本获得的加权平均相关波形参数的模板匹配分析表明，在 aPTT 延长的血浆 (n= 78) 中，敏感性为 97.2%，特异性为 83.3%。 结论 这种基于 aPTT 波形加权平均值和模板匹配的新算法可能支持判断 HA 的临床实用性，并可能有助于在缺乏特定凝血因子的情况下对患者进行临床管理化验。
BackgroundActivated partial thromboplastin time (aPTT)-based clot waveform analysis is used to evaluate the comprehensive dynamics of fibrin clot formation. In addition, the technique can be usefully utilized for the rapid assessment of factor (F)VIII procoagulant activity in various clinical settings in patients with hemophilia A (HA). We defined a novel algorithm based on the weighted average parameters from aPTT-based waveforms to devise a template-matching procedure for assessing FVIII activity (FVIII:C).MethodsThe first derivatives of original clot waveforms triggered by the aPTT reagent (Coagpia APTT-N) were used to determine weighted averages of areas surrounded by the waveform at different percentages of maximum height in various clotting factor-deficient plasmas. Prepared templates based on 50 weighted average-related parameters were compared with 78 aPTT-prolonged plasmas.ResultsOriginal nonsmoothed waveforms of the various clotting factor-deficient plasmas with prolonged aPTTs demonstrated a variety of shapes. The weighted averages were calculated after adjustments for different baselines, and the patterns seemed to be governed by the specific clotting factor deficiency. The weighted average-related parameters including baseline wedge (r2= 0.998) and aspect ratio (r2= 0.998) were highly correlated with FVIII:C levels. Template-matching analyses based on weighted average-related waveform parameters obtained from 158 samples demonstrated that the sensitivity was 97.2% and specificity was 83.3% in aPTT-prolonged plasmas (n= 78).ConclusionThis novel algorithm based on weighted averages of aPTT-based waveforms together with template-matching may support clinical usefulness for judging of HA and may aid clinical management in the patients in the absence of specific clotting factor assays.