Curnow J L, Morel-Kopp M-C, Roddie C, Aboud M, Ward C M
Northern Blood Research Centre, University of Sydney, Sydney, Australia.
J Thromb Haemost. 2007 Mar;5(3):528-34. doi: 10.1111/j.1538-7836.2007.02362.x. Epub 2006 Dec 13.
Routinely available coagulation assays are not capable of detecting clinically defined hypercoagulable states. A number of global coagulation assays have been developed with the potential to evaluate hypercoagulability, which predisposes to the common clinical events of arterial and venous thromboembolism (VTE).
We hypothesized that the overall hemostatic potential (OHP) assay would show abnormal fibrin generation and lysis in patients with clinically defined hypercoagulable states.
We used the OHP assay as described by Blombäck and colleagues [1,2] in 161 clinically hypercoagulable patients with arterial or VTE, pregnancy complications or autoimmune disease. Eighty patients had associated antiphospholipid antibodies (APLA). Ninety-eight normal plasma donors were tested for comparison.
We derived three new assay parameters for correlation with hypercoagulable states: the maximum optical density, maximum slope, and delay in onset of fibrin generation. We found significantly different assay results for all patients' parameters examined when compared with controls, indicating both increased fibrin generation and reduced fibrinolysis in hypercoagulable patients. The findings were similar whether samples were collected in association with an acute thrombotic event or not. Estimated assay sensitivity for detection of a clinically defined hypercoagulable state was 96%.
The OHP assay is a simple, inexpensive global test that is useful for assessing patients with hypercoagulable states including APLA. OHP results are significantly abnormal in hypercoagulable groups compared with controls, indicating that both increased fibrin generation and reduced fibrinolysis contribute to hypercoagulable states. The assay may ultimately assist in tailoring clinical management to patients' individual requirements.
常规可用的凝血检测方法无法检测出临床定义的高凝状态。已开发出多种整体凝血检测方法，有可能评估易导致动脉和静脉血栓栓塞（VTE）这一常见临床事件的高凝性。
我们假设整体止血潜能（OHP）检测会在临床定义的高凝状态患者中显示出异常的纤维蛋白生成和溶解。
我们采用了布隆贝克及其同事描述的OHP检测方法[1,2]，对161例患有动脉或VTE、妊娠并发症或自身免疫性疾病的临床高凝患者进行检测。80例患者伴有抗磷脂抗体（APLA）。对98名正常血浆捐献者进行检测以作比较。
我们得出了三个与高凝状态相关的新检测参数：最大光密度、最大斜率以及纤维蛋白生成开始的延迟时间。与对照组相比，我们发现所有检测的患者参数的检测结果存在显著差异，表明高凝患者的纤维蛋白生成增加且纤维蛋白溶解减少。无论样本是否与急性血栓形成事件相关联，结果均相似。检测临床定义的高凝状态的估计检测灵敏度为96%。
OHP检测是一种简单、廉价的整体检测方法，可用于评估包括APLA在内的高凝状态患者。与对照组相比，高凝组的OHP结果显著异常，表明纤维蛋白生成增加和纤维蛋白溶解减少均导致高凝状态。该检测最终可能有助于根据患者的个体需求调整临床管理。
