Tripodi A, Mannucci P M, Chantarangkul V, Bottasso B, Arbini A A, Della Bella S, Scorza R
Angelo Bianchi Bonomi Haemophilia and Thrombosis Centre, Institute of Internal Medicine, Milano, Italy.
Br J Haematol. 1993 Aug;84(4):670-4. doi: 10.1111/j.1365-2141.1993.tb03144.x.
Hypercoagulability can be defined as a condition of procoagulant imbalance due to heightened enzymatic activation of coagulation zymogens, but with no laboratory evidence of fibrin deposition nor clinical signs of thrombosis. The imbalance can be detected by measuring the plasma levels of prothrombin fragment 1 + 2 (F1 + 2), fibrinopeptide A (FPA) and thrombin-antithrombin III (TAT) complexes. The aims of this study were to establish the frequency of existence and biochemical pattern of hypercoagulability in patients with cancer and autoimmune disorders, clinical conditions associated with an increased risk of thrombosis, and to ascertain the most sensitive method for its diagnosis. In approximately one-fourth of the patients hypercoagulability was identified by finding high levels of FPA F1 + 2 or TAT unaccompanied by signs of fibrin deposition (expressed by normal levels of D-dimer). In a smaller proportion of patients (approximately 10%), the concomitant presence of high levels of D-dimer indicated that the activation of the coagulation cascade had gone beyond the stage of heightened enzymatic activity to the point of cross-linked fibrin deposition. Of the markers used to detect hypercoagulability. FPA seems to be the most sensitive, being significantly increased in all clinical conditions studied.
高凝状态可定义为由于凝血酶原酶原的酶促活化增强导致的促凝失衡状态，但无纤维蛋白沉积的实验室证据或血栓形成的临床体征。这种失衡可通过检测血浆凝血酶原片段1 + 2（F1 + 2）、纤维蛋白肽A（FPA）和凝血酶 - 抗凝血酶III（TAT）复合物的水平来检测。本研究的目的是确定癌症和自身免疫性疾病患者（与血栓形成风险增加相关的临床病症）中高凝状态的存在频率和生化模式，并确定其最敏感的诊断方法。在大约四分之一的患者中，通过发现高水平的FPA、F1 + 2或TAT且无纤维蛋白沉积迹象（以正常水平的D - 二聚体表示）来确定高凝状态。在较小比例的患者中（约10%），高水平D - 二聚体的同时存在表明凝血级联反应的激活已超出酶活性增强阶段，达到交联纤维蛋白沉积阶段。在用于检测高凝状态的标志物中，FPA似乎是最敏感的，在所有研究的临床病症中均显著升高。
