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[新型冠状病毒肺炎相关血栓形成风险的管理:止血实验室的作用是什么?]

[Management of the thrombotic risk associated with COVID-19: what is the role of the hemostasis laboratory?].

作者信息

Hardy Michael, Douxfils Jonathan, Dogné Jean-Michel, Lessire Sarah, Chatelain Bernard, Testa Sophie, Gouin-Thibault Isabelle, Gruel Yves, Lecompte Thomas, Mullier François

机构信息

Laboratoire d'hématologie, Namur Thrombosis and Hemostasis Center (NTHC), Université catholique de Louvain, CHU UCL Namur, Yvoir, Belgique, Service d'anesthésiologie, Namur Thrombosis and Hemostasis Center (NTHC), Université catholique de Louvain, CHU UCL Namur, Yvoir, Belgique.

Département de pharmacie, Namur Thrombosis and Hemostasis Center (NTHC), Université de Namur, Namur, Belgique, Qualiblood s.a., Namur, Belgique.

出版信息

Ann Biol Clin (Paris). 2020 Oct 1;78(5):471-481. doi: 10.1684/abc.2020.1581.

Abstract

COVID-19 is associated with disturbances of hemostasis in the laboratory and an increased thrombotic risk. Routine laboratory tests - activated partial thromboplastin time (aPTT), prothrombin time, Clauss fibrinogen and D-dimers levels measurement - are used for the evaluation of the thrombotic risk and the monitoring of hemostasis, but are subject to several drawbacks that may affect the reliability and clinical relevance of the delivered results. Another challenge for the hemostasis laboratory is the monitoring of heparin treatment. For instance, the issue of the monitoring of unfractionated heparin remains debated, the more so when there is a tremendous inflammatory response. This brief review considers the role of laboratory tests of hemostasis in the management of COVID-19 and discusses their main limitations to be kept in mind.

摘要

新冠病毒病(COVID-19)与实验室检查中止血功能紊乱及血栓形成风险增加有关。常规实验室检查——活化部分凝血活酶时间(aPTT)、凝血酶原时间、Clauss纤维蛋白原及D-二聚体水平测定——用于评估血栓形成风险及监测止血功能,但存在一些缺点,可能影响所提供结果的可靠性和临床相关性。止血实验室面临的另一个挑战是肝素治疗的监测。例如,普通肝素监测问题仍存在争议,在存在强烈炎症反应时更是如此。本简要综述探讨了止血功能实验室检查在COVID-19管理中的作用,并讨论了需要牢记的主要局限性。

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