Francis C W, Malone J E, Marder V J
Am J Clin Pathol. 1985 Dec;84(6):724-9. doi: 10.1093/ajcp/84.6.724.
A chromogenic prothrombin time (CPT) has been compared with the standard prothrombin time (PT) or activated partial thromboplastin time (aPTT) in evaluating the hemostatic abnormality in patients with specific clotting factor deficiencies or liver disease and in patients receiving anticoagulant or fibrinolytic therapy. As expected, the CPT was sensitive to deficiencies of Factors II, V, X, and VII but was unaffected by deficiencies of Factors XII, XI, IX, or VIII. Due to the presence of polybrene in the thromboplastin formulation, the CPT was insensitive to heparin concentrations below 1 unit/mL. However, the assay result prolonged progressively between 1 and 10 units of heparin/mL, indicating that the CPT can be used to assay heparin concentrations within this range. Among patients with liver disease or who were receiving warfarin or fibrinolytic therapy, there was good correlation between the prolongation of the PT and the CPT. The results demonstrate that the CPT was sensitive to the commonly encountered clinical abnormalities in which the PT is prolonged and could be applied for monitoring oral anti-coagulant therapy. However, prolongation of the PT to a given value in different clinical conditions was associated with different degrees of prolongation of the CPT. This differential effect may reflect an abnormality in fibrinogen conversion to fibrin, which prolongs the PT but not the CPT and may also be contributed to by the differential sensitivity of the PT and CPT to specific factor deficiencies. The simplicity and reproducibility of the CPT warrant its further assessment, but correlation with the PT in a variety of clinical conditions is needed before clinical application can be undertaken.
在评估特定凝血因子缺乏或肝病患者以及接受抗凝或纤维蛋白溶解治疗的患者的止血异常情况时，已将发色底物法凝血酶原时间（CPT）与标准凝血酶原时间（PT）或活化部分凝血活酶时间（aPTT）进行了比较。正如预期的那样，CPT对因子II、V、X和VII的缺乏敏感，但不受因子XII、XI、IX或VIII缺乏的影响。由于凝血活酶制剂中存在鱼精蛋白，CPT对低于1单位/毫升的肝素浓度不敏感。然而，在肝素浓度为1至10单位/毫升之间时，检测结果逐渐延长，这表明CPT可用于检测该范围内的肝素浓度。在肝病患者或接受华法林或纤维蛋白溶解治疗的患者中，PT延长与CPT延长之间存在良好的相关性。结果表明，CPT对PT延长的常见临床异常情况敏感，可用于监测口服抗凝治疗。然而，在不同临床情况下，PT延长至给定值与CPT的不同程度延长相关。这种差异效应可能反映了纤维蛋白原转化为纤维蛋白的异常，这会延长PT但不会延长CPT，也可能是由于PT和CPT对特定因子缺乏的敏感性差异所致。CPT的简单性和可重复性值得进一步评估，但在临床应用之前，需要在各种临床情况下与PT进行相关性研究。
