Görög P, Kovacs I B
Thrombosis Unit, St. Bartholomew's Hospital, West Smithfield, London, UK.
Thromb Res. 1991 Dec 1;64(5):611-9.
A broad-based, dynamic model of intrinsic coagulation is described. Non-anticoagulated whole blood was perfused through polyethylene tubing under standard conditions, and coagulation (cessation of flow) was monitored by pressure changes. The dynamic coagulation test (DCT) is a sequel to the shear-induced haemostasis, a platelet function test routinely performed prior to coagulation. DCT has two important advantages over stagnant overall clotting tests: i./DCT reflects platelet coagulant activities; selective activation by adenosine diphosphate or shear-stress or inhibition of platelets by prostacyclin greatly enhanced or prolonged dynamic coagulation, respectively. Furthermore, activation of platelets by plasminogen activators (streptokinase, t-PA) was manifested in a significantly shortened coagulation. ii./ DCT allows the rapid assessment of fibrin crosslinking, the mechanical stability of the clot formed. Antibody against factor XIIIa greatly prolonged the time until completion of clotting. In patients taking oral anticoagulant (n = 54), strong correlations were observed between DCT, the prothrombin time (INR) and the thrombelastograph measurements. It is concluded that this simple assay could be useful in the overall screening for coagulation abnormalities.
本文描述了一种基础广泛的内源性凝血动态模型。在标准条件下，将未抗凝的全血通过聚乙烯管进行灌注，并通过压力变化监测凝血情况（血流停止）。动态凝血试验（DCT）是剪切诱导止血的后续试验，剪切诱导止血是一种在凝血之前常规进行的血小板功能试验。与静态全凝试验相比，DCT有两个重要优点：i./DCT反映血小板的促凝活性；二磷酸腺苷或剪切应力的选择性激活或前列环素对血小板的抑制分别极大地增强或延长了动态凝血。此外，纤溶酶原激活剂（链激酶、组织型纤溶酶原激活剂）对血小板的激活表现为凝血显著缩短。ii./DCT可以快速评估纤维蛋白交联情况，即所形成凝块的机械稳定性。抗因子XIIIa抗体大大延长了凝血完成所需的时间。在服用口服抗凝剂的患者（n = 54）中，观察到DCT、凝血酶原时间（INR）和血栓弹力图测量值之间存在强相关性。得出的结论是，这种简单的检测方法可能有助于对凝血异常进行全面筛查。
