国产血凝分析仪的检测项目及临床意义

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                    <p><img src="http://mmbiz.qpic.cn/mmbiz/A1DicCH9Vl6M5ZOUw4MDPric74wQnsRyPrJz9CP7zCvU19GI1e4iahicghpxicjDnrf6BBsCaR9lGrQjDydQvjic7mXA/0" data-ratio="0.1903807615230461" data-w="499" style="white-space: normal;"  /></p><p style="line-height: 1.75em; margin-bottom: 15px;"><span style="font-size: 18px;">  血凝分析仪主要是测试血栓和止血，对患者的止血功能是否存在缺陷有一定的了解，对此，血凝分析仪需要完成四项检测：凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）和纤维蛋白原（FIB）检测来确定，防止术中大出血而措手不及。  </span></p><p style="line-height: 1.75em; margin-bottom: 15px;"><span style="font-size: 18px;">  <strong><span style="font-size: 18px; color: rgb(84, 141, 212);">APTT</span></strong>：主要反映内源性凝血系统状况，常用于监测肝素用量。增高见于血浆因子Ⅷ、因子Ⅸ和因子XI水平减低：如血友病A、血友病B及因子XI缺乏症；降低见于高凝状态：如促凝物质进入血液及凝血因子的活性增高等情况； </span></p><p style="line-height: 1.75em; margin-bottom: 15px;"><span style="font-size: 18px;"> <strong><span style="font-size: 18px; color: rgb(84, 141, 212);"> PT</span></strong>：主要反映外源性凝血系统状况，其中INR常用于监测口服抗凝剂。延长见于先天性凝血因子ⅡⅤⅦⅩ缺乏及纤维蛋白原缺乏，后天凝血因子缺乏主要见于维生素K缺乏、严重的肝脏疾病、纤溶亢进、DIC、口服抗凝剂等；缩短见于血液高凝状态和血栓性疾病等；  </span></p><p style="line-height: 1.75em; margin-bottom: 15px;"><span style="font-size: 18px;">  <span style="font-size: 18px; color: rgb(84, 141, 212);"><strong>FIB</strong></span>：主要反映纤维蛋白原的含量。增高见于急性心肌梗死减低见于DIC消耗性低凝溶解期、原发性纤溶症、重症肝炎、肝硬化； </span></p><p style="line-height: 1.75em; margin-bottom: 15px;"><span style="font-size: 18px;">  <strong><span style="font-size: 18px; color: rgb(84, 141, 212);">TT</span></strong>：主要反映纤维蛋白原转为纤维蛋白的时间。增高见于DIC纤溶亢进期，低（无）纤维蛋白原血症，异常血红蛋白血症，血中纤维蛋白（原）降解产物（FDPs）增高；降低无临床意义。 </span></p><p style="line-height: 1.75em; margin-bottom: 15px;"><span style="font-size: 18px;">  对于目前市场上的血凝分析仪，国内国外的产品都有，仪器的结构有单通道、双通道和四通道不同，功能相同的仪器生产商在国内还是非常多的，论品牌哪个好，还是应该从具体功能、操作性、结构和服务上综合考虑。海力孚品牌血凝分析仪采用光电磁珠法为检测方法，能够消除黄疸、溶血、乳糜、浑浊、气泡等的影响，为四通道检测仪提高了检测效率，便于对患者更加及时的诊断与治疗。 </span></p><p style="line-height: 1.75em; margin-bottom: 15px;"><span style="font-size: 18px;">  血凝四项是血凝分析仪的检测项目，这四项包括：凝血酶原时间PT、活化部分凝血活酶时间APTT、纤维蛋白原FIB和凝血酶时间测定TT。它们的检测意义分别是什么呢？  </span></p><p style="line-height: 1.75em; margin-bottom: 15px;"><span style="font-size: 18px;">  凝血酶原时间PT：正常参考值为12-16秒。临床应用：凝血酶原时间是检查外源性凝血因子的一种过筛试验，是用 来证实先天性或获得性纤维蛋白原、凝血酶原、和凝血因子Ⅴ、Ⅶ、Ⅹ的缺陷或抑制物的存在，同时用于监测口服抗凝剂的用量，是监测口服抗凝剂的首选指标。据报道，在口服抗凝剂的过程中，维持PT在正常对照的1-2倍最为适宜。  </span></p><p style="line-height: 1.75em; margin-bottom: 15px;"><span style="font-size: 18px;">  活化部分凝血活酶时间APTT：正常参考值为24-36秒。临床应用：活化部分凝血活酶时间是检查内源性凝血因子的一 种过筛试验，是用来证实先天性或获得性凝血因子Ⅷ、Ⅸ、Ⅺ的缺陷或是否存在它们相应的抑制物，同时，APTT也可用来凝血因子Ⅻ、激肽释放酶原和高分子量激肽释放酶原是否缺乏，由于APTT的高度敏感性和肝素的作用途径主要是内源性凝血途径，所以APTT成为监测普通肝素首选指标。 </span></p><p style="line-height: 1.75em; margin-bottom: 15px;"><span style="font-size: 18px;">纤维蛋白原FIB：正常参考值为2—4g/L</span></p><p style="line-height: 1.75em; margin-bottom: 15px;"><span style="font-size: 18px;">临床应用：</span></p><p style="line-height: 1.75em; margin-bottom: 15px;"><span style="font-size: 18px;">纤维蛋白原即凝血因子Ⅰ，是凝</span><span style="font-size: 18px;">血过程中的主要蛋白质，FIB 增高除了生理情况下的应激反应和妊娠晚期外，主要出现在急性感染、烧伤、动脉粥样硬化、急性心肌梗死、自身免疫性疾病、多发性骨髓瘤、糖尿病、妊高症及急性肾炎、尿毒症等，FIB减少主要见于DIC、原发性先溶亢进、重症肝炎、矸硬化和溶栓治疗时。 凝血酶原时间、活化部分凝血活酶时间、纤维蛋白原三者同时检测已被临床用于筛查病人凝血机制是否正常，特别是心胸外科、骨科、妇产科等手术前检查病人的凝血功能尤为重要。</span></p><p style="line-height: 1.75em; margin-bottom: 15px;"><span style="font-size: 18px;"> </span><span style="font-size: 18px; line-height: 1.75em;"> 凝血酶时间测定TT：凝血酶时间延长：见于肝素增多或类肝素抗凝物质存在、如SLE、肝病、肾病等，低（无）纤维蛋白血症、异常纤维蛋白原血症、纤维蛋白原降解产物（FDP）增多、如DIC、原发性纤溶等。凝血酶时间缩短：见于血标本有微小凝块或钙离子存在时。  </span></p><p style="line-height: 1.75em; margin-bottom: 15px;"><span style="font-size: 18px;">  血凝分析仪四项检测是凝血分析中的必检项目，它们的诊断分析具有重要的意义。</span></p><p style=""><img src="http://mmbiz.qpic.cn/mmbiz/rz7R73cuHRrv6jdOCoJeZmYwvEAIoHpY0a7yJL2egiaEokLTpwkIsIRTzTFUic09aEThKHS4hrEcSqU0lAS3tu5g/0" data-ratio="0.14959016393442623" data-w="488" src="http://mmbiz.qpic.cn/mmbiz/rz7R73cuHRrv6jdOCoJeZmYwvEAIoHpY0a7yJL2egiaEokLTpwkIsIRTzTFUic09aEThKHS4hrEcSqU0lAS3tu5g/0" style="word-wrap: break-word !important; box-sizing: border-box !important; width: auto !important; visibility: visible !important;"  /></p><p style=""><legend style="padding: 0px; max-width: 100%; white-space: normal; color: rgb(51, 51, 51); font-family: 宋体; font-size: 14px; line-height: 24px; orphans: 2; widows: 2; margin: 0px; word-wrap: break-word !important; box-sizing: border-box !important;"><span style="max-width: 100%; margin: 0px; padding: 0px; font-family: arial, helvetica, sans-serif; word-wrap: break-word !important; box-sizing: border-box !important;"><strong style="max-width: 100%; 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