Uchiba Mitsuhiro, Ando Yukio
Department of Blood Transfusion and Cell Therapy, Kumamoto University Hospital, Kumamoto 860-8556, Japan.
Rinsho Byori. 2009 Oct;57(10):1004-12.
Prothrombin time (PT) and activated partial thromboplastin time (APTT) are basic laboratory tests for diagnosis of bleeding diseases such as congenital hemophilia. In addition, abnormally prolonged clotting times are observed in patients who have inhibitors. Lupus anticoagulant and inhibitors against coagulation factors are two clinically important inhibitors. However, non-specific inhibitors are also observed. Differential diagnosis of these inhibitors is important. Clotting times are also prolonged by artifactitious factors, such as contamination of heparin. Mixing tests are relatively easy and useful methods which potentially differentiate these abnormalities. This article is summarized the causes of prolongation of clotting times and the usefulness of mixing tests for differentiation of the abnormalities.
凝血酶原时间（PT）和活化部分凝血活酶时间（APTT）是诊断诸如先天性血友病等出血性疾病的基本实验室检查。此外，在有抑制剂的患者中观察到凝血时间异常延长。狼疮抗凝物和针对凝血因子的抑制剂是两种临床上重要的抑制剂。然而，也观察到非特异性抑制剂。对这些抑制剂进行鉴别诊断很重要。凝血时间也会因人为因素而延长，例如肝素污染。混合试验是相对简单且有用的方法，有可能区分这些异常情况。本文总结了凝血时间延长的原因以及混合试验在鉴别这些异常情况方面的作用。
