Aiach M, Gaussem P
Faculté de Pharmacie de l'Université René-Descartes, Paris.
Ann Pharm Fr. 1996;54(1):21-4.
The exploration of coagulation in biological practice implies simple routine tests. A normal bleeding time associated with a normal platelet count allows to exclude any primary haemostasis abnormality. A prolonged bleeding time is most frequently the result of a thrombocytopenia, the etiology of which remains to be determined. A prolonged bleeding time is also observed in von Willebrand disease and in thrombopathia. Such diagnosis requires appropriate investigation. The exploration of the coagulation cascade includes prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen level. A congenital or acquired deficiency in one or more coagulation factors should be distinguished from a lupus anticoagulant or from the occurrence of an antibody against a coagulation factor. Indeed, a prolonged APTT is not always related to a bleeding risk. Only the identification of the coagulation abnormality can predict the bleeding or thrombotic risk during surgery. In each case, an appropriate preventive therapy should be prescribed.
在生物学实践中对凝血功能的检测涉及简单的常规检查。出血时间正常且血小板计数正常可排除任何原发性止血异常。出血时间延长最常见的原因是血小板减少症，其病因仍有待确定。在血管性血友病和血小板病中也会观察到出血时间延长。此类诊断需要进行适当的检查。对凝血级联反应的检测包括凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）和纤维蛋白原水平。应将一种或多种凝血因子的先天性或后天性缺乏与狼疮抗凝物或针对凝血因子的抗体的出现区分开来。实际上，APTT延长并不总是与出血风险相关。只有确定凝血异常才能预测手术期间的出血或血栓形成风险。在每种情况下，都应开出适当的预防性治疗方案。
