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凝血酶原时间诊断的演变模式及其在心血管受损和 COVID-19 患者中的临床相关性日益增加。

Evolving Paradigm of Prothrombin Time Diagnostics with Its Growing Clinical Relevance towards Cardio-Compromised and COVID-19 Affected Population.

机构信息

Design Program, Indian Institute of Technology, Kanpur 208016, India.

Microsystems Fabrication Laboratory, Indian Institute of Technology, Kanpur 208016, India.

出版信息

Sensors (Basel). 2021 Apr 9;21(8):2636. doi: 10.3390/s21082636.

Abstract

Prothrombin time (PT) is a significant coagulation (hemostasis) biomarker used to diagnose several thromboembolic and hemorrhagic complications based on its direct correlation with the physiological blood clotting time. Among the entire set of PT dependents, candidates with cardiovascular ailments are the major set of the population requiring lifelong anticoagulation therapy and supervised PT administration. Additionally, the increasing incidence of COVID affected by complications in coagulation dynamics has been strikingly evident. Prolonged PT along with sepsis-induced coagulopathy (SIC score > 3) has been found to be very common in critical COVID or CAC-affected cases. Considering the growing significance of an efficient point-of-care PT assaying platform to counter the increasing fatalities associated with cardio-compromised and coagulation aberrations propping up from CAC cases, the following review discusses the evolution of lab-based PT to point of care (PoC) PT assays. Recent advances in the field of PoC PT devices utilizing optics, acoustics, and mechanical and electrochemical methods in microsensors to detect blood coagulation are further elaborated. Thus, the following review holistically aims to motivate the future PT assay designers/researchers by detailing the relevance of PT and associated protocols for cardio compromised and COVID affected along with the intricacies of previously engineered PoC PT diagnostics.

摘要

凝血酶原时间(PT)是一种重要的凝血(止血)生物标志物,可根据其与生理凝血时间的直接相关性,用于诊断多种血栓栓塞和出血性并发症。在整个 PT 依赖者中,患有心血管疾病的患者是需要终身抗凝治疗和监督 PT 管理的主要人群。此外,受凝血动力学并发症影响的 COVID 发病率的增加已经非常明显。在重症 COVID 或 CAC 影响的病例中,发现延长的 PT 与脓毒症诱导的凝血障碍(SIC 评分>3)非常常见。考虑到高效的即时护理 PT 检测平台对于应对与 CAC 病例中出现的心脏受损和凝血异常相关的死亡率不断上升的重要性日益增加,以下综述讨论了从实验室基于的 PT 到即时护理(PoC)PT 检测的演变。进一步详细阐述了利用微传感器中的光学、声学和机械电化学方法在 PoC PT 设备中的最新进展。因此,以下综述全面旨在通过详细说明与心脏受损和 COVID 相关的 PT 及其相关方案的相关性以及之前设计的 PoC PT 诊断的复杂性,为未来的 PT 检测设计人员/研究人员提供动力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e5c/8068903/722b287cd240/sensors-21-02636-g001.jpg

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