Toh C H, Giles A R
Roald Dahl Haemostasis and Thrombosis Centre, Royal Liverpool University Hospital, Liverpool, UK.
Clin Lab Haematol. 2002 Dec;24(6):321-7. doi: 10.1046/j.1365-2257.2002.00457.x.
Transmittance waveform charts the changes in light transmittance on standard coagulation assays, such as the prothrombin time (PT) and activated partial thromboplastin time (APTT). Analysis and characterization of these data on photo-optical coagulation analysers provides additional qualitative and quantitative information to that obtained using the clotting time alone. The most thoroughly evaluated clinical application is that of the biphasic APTT waveform with disseminated intravascular coagulation (DIC). The degree of waveform abnormality correlates directly with the severity of haemostatic dysfunction and allows for both the prediction and monitoring from non-overt to overt DIC. As its performance is simple and rapid, this provides the means for targeting therapeutic intervention to an earlier stage of DIC. The recent identification that the mechanism underlying the biphasic waveform is a complex that exists in vivo between C reactive protein with very low density lipoprotein, provides potentially important insights into the molecular pathogenesis of DIC. Thus, in addition to the immediate clinical utility in diagnostic practice, it has important applications as a research tool. Preliminary experience in the application of this technology to the diagnosis and management of the haemophilias and the lupus anticoagulant syndrome has also provided evidence of the power and utility of waveform analysis in essentially simple clotting assays.
透光率波形图描绘了标准凝血检测（如凝血酶原时间（PT）和活化部分凝血活酶时间（APTT））中透光率的变化。在光光学凝血分析仪上对这些数据进行分析和表征，可提供比仅使用凝血时间所获得的更多定性和定量信息。评估最为全面的临床应用是双相APTT波形在弥散性血管内凝血（DIC）中的应用。波形异常程度与止血功能障碍的严重程度直接相关，可用于预测和监测从非显性到显性的DIC。由于其操作简单快速，这为在DIC早期阶段进行靶向治疗干预提供了手段。最近发现双相波形的潜在机制是体内存在的一种由极低密度脂蛋白与C反应蛋白组成的复合物，这为DIC的分子发病机制提供了潜在的重要见解。因此，除了在诊断实践中的直接临床应用外，它作为一种研究工具也有重要应用。将该技术应用于血友病和狼疮抗凝综合征的诊断和管理的初步经验，也证明了在基本简单的凝血检测中波形分析的作用和实用性。
