Wielders S, Mukherjee M, Michiels J, Rijkers D T, Cambus J P, Knebel R W, Kakkar V, Hemker H C, Béguin S
Department of Biochemistry, Medical Faculty and Cardiovascular Research Institute, Maastricht University, The Netherlands.
Thromb Haemost. 1997 Apr;77(4):629-36.
The area under the thrombin generation curve (the endogenous thrombin potential; ETP) has been proposed as a parameter for plasma-based hypercoagulability and to monitor anticoagulant treatment. We present an ETP assay for the routine laboratory using a centrifugal analyser. Throughput is 30 samples/h, within and between run imprecision is 4-5.6%. Suitable substrates were developed for the ranges of 10-500% and 2-100% of normal. Independent of tissue factor concentration (if > 4 pM), the normal value of the extrinsic ETP is 384.8 +/- 51.7 nM.min. The intrinsic ETP, triggered by ellagic acid, is 414 +/- 41 nM.min. The ETP is decreased to 15 and 35% of normal by oral anticoagulation (INR 2.5-4.0) and by heparin administration (APTT 1.5-2.5 x control). The ETP is increased in untreated subjects with congenital antithrombin deficiency and in women using oral contraceptives. In deep vein thrombosis (phlebographically confirmed), it is increased by 29.4% (extrinsic) and 53% (intrinsic). In (angiographically assessed) coronary artery disease the increase is by 10% and 17% respectively.
凝血酶生成曲线下面积（内源性凝血酶潜能；ETP）已被提议作为基于血浆的高凝状态参数及监测抗凝治疗的指标。我们介绍一种使用离心分析仪的用于常规实验室的ETP检测方法。通量为每小时30个样本，批内和批间不精密度为4 - 5.6%。针对正常水平的10 - 500%和2 - 100%范围开发了合适的底物。与组织因子浓度无关（如果>4 pM），外源性ETP的正常值为384.8±51.7 nM·min。由鞣花酸触发的内源性ETP为414±41 nM·min。口服抗凝治疗（国际标准化比值2.5 - 4.0）和给予肝素（活化部分凝血活酶时间为对照值的1.5 - 2.5倍）可使ETP分别降至正常水平的15%和35%。在未治疗的先天性抗凝血酶缺乏患者及使用口服避孕药的女性中ETP升高。在（经静脉造影证实的）深静脉血栓形成中，外源性ETP升高29.4%，内源性ETP升高53%。在（经血管造影评估的）冠状动脉疾病中，外源性和内源性ETP分别升高10%和17%。
