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Objective:To explore and compare the reference ranges of four coagulation tests in normal pregnant women during early and late pregnancy and the influence of age.Methods:Values of four coagulation tests from 4 974 pregnant women, who gave single birth at Peking University First Hospital, Obstetrics and Gynecology Hospital of Fudan University, West China Second University Hospital, Peking University Third Hospital and Shengjing Hospital of China Medical University from February 2017 to July 2020, were measured and analyzed in this study, including prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib) and thrombin time (TT). The four normal reference ranges of coagulation during early and late pregnancy phases were expressed as P2.5- P97.5. The difference of two pregnancy phases was compared by non-parametric test of two related samples. And the difference between pregnant women of advanced and non-advanced age in the same pregnancy phase was compared by independent sample non-parametric test. Chi-square test was used to compare the incidence of pregnancy complications in different coagulation reference ranges. Results:The reference ranges of PT of normal pregnant women′s early and late pregnancy were 10.0-13.9 s and 9.6-12.3 s, the reference ranges of APTT were 22.6-35.3 s and 22.4-30.9 s, the reference ranges of Fib were 2.4-5.0 g/L and 3.0-5.7 g/L, the reference ranges of TT were 12.0-19.0 s and 11.5-18.4 s. Compared with early pregnancy, PT, APTT and TT shortened significantly, while the Fib significantly increased in late pregnancy (all P<0.001). PT, APTT and TT of advanced and non-advanced age pregnant women were significantly different (all P<0.01). Compared with the ranges of non-pregnant population, more pregnant women were included in the normal pregnant reference ranges of PT in early pregnancy and APTT in the early and late pregnancy, while the incidence of pregnancy complications had no significant differences (all P>0.05). The incidence of fetal distress was higher and the incidence of preterm birth was lower in the reference range of PT in late pregnancy. The incidence of gestational diabetes mellitus was higher in the early and late gestational Fib reference ranges, and the incidence of hypertensive disorders in pregnancy was higher in the late gestational Fib reference range (all P<0.05). Conclusions:The coagulation function of pregnant women increases significantly with the growth of pregnancy, and there is a significant difference between advanced significantly and non-advanced age pregnant women. The recommended ranges of normal pregnant women′s early and late pregnancy PT are 10.0-13.9 s and 9.6-12.3 s, the recommended ranges of APTT are 22.6-35.3 s and 22.4-30.9 s, the recommended ranges of TT are 12.0-19.0 s and 11.5-18.4 s. The appropriate ranges of normal pregnant women′s early and late pregnancy Fib still need further exploration.
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Objective:To investigate the correlation between protein C -1641A/-1654C haplotype and coagulation disorder in Chinese Han septic patients.Methods:The genotypes of protein C gene -1641A>G (rs1799809) and -1654C>T (RS1799808) in septic patients were detected by direct sequencing, and their haplotypes were analyzed and divided into two groups according to the haplotype, -1641A/-1654C (AC) carriers and non-AC haplotype carriers. At the same time, unpaired t test or Mann-Whitney U test was used to compare the differences in coagulation/fibrinolytic parameters, including partial activated thrombin time, prothrombin time, internationally standardized ratio of prothrombin time, thrombin time, fibrinogen and D-dimer levels, as well as APC levels between the two groups. Results:A total of 174 septic patients were included in this study, including 60 AC haplotype carriers and 114 non-AC haplotype carriers. Compared with non-AC haplotype carriers, AC haplotype carriers had significantly lower platelet counts, significantly longer partial activated thrombin time, and significantly decreased activated protein C levels. Other coagulation/fibrinolytic parameters including prothrombin time, internationally standardized ratio of prothrombin time, thrombin time, fibrinogen and D-dimer were not significantly different between the two groups.Conclusions:In this study, the protein C-1641A/-1654C haplotype was found to lead to decreased circulating activated protein C levels decreased platelet counts, and prolonged partial activated thrombin time in septic patients. These results suggest that the protein C-1641A/-1654C haplotype may directly affect the APC level and consequently influence the coagulation disorder of sepsis.
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@#To explore the effect of Ginkgo biloba extract (GBE) on anticoagulation of 4 new oral anticoagulants (NOACs), dabigatran, apixaban, rivaroxaban and edoxaban in vitro, thrombin time (TT), prothrombin time (PT), activated partial thrombin time (APTT) and the activity of coagulation factor Xa (FXa) of rat plasma were measured at different concentrations of NOACs, GBE or NOACs combined with GBE, respectively. The results showed that TT, PT and APTT were prolonged with the increase of NOACs concentration in the range of 0-500 ng/mL; that except for TT of rivaroxaban, other results showed a good linear correlation with NOACs concentration (r2= 0.78-0.98); and that FXa activity decreased with increased concentration of FXa inhibitors (apixaban, rivaroxaban and edoxaban), with a good linear correlation with concentration of FXa inhibitors in the range of 0-250 ng/mL (r2= 0.85-0.94). GBE had no significant effect on TT, PT and APTT (P>0.05) in the concentration range of 0-500 μg/mL, but FXa activity had a positive linear correlation with GBE concentration (r2= 0.840 4). TT was prolonged with increasing GBE concentration when dabigatran was combined with GBE. When the above FXa inhibitors were combined with GBE, TT shortened and FXa activity increased with rising GBE concentration. There were no significant changes in PT and APTT (P>0.05) when NOACs were combined with GBE. The study results suggest that GBE may synergize with the anticoagulant activity of dabigatran and antagonize the anticoagulant activity of FXa inhibitors, possibly due to its role in increasing FXa activity.
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Objective To investigate the clinical value of C-reactive protein (CRP) combined with prothrombin time (PT) and partially activated thromboplastin time (APTY) in the diagnosis of neonatal late-onset sepsis.Methods From January 2013 to January 2018,100 neonates with sepsis admitted to our department of neonatology in Lishui Maternal and Child Health-Care Center were collected.According to the results of blood culture,neonates with positive blood culture were classified as sepsis group A (53 cases),and neonates with negative blood culture were classified as sepsis group B (47 cases).Another 50 normal newborns born at the same period were included in the control group.The CRP,PT and APTT values of the three groups were detected and compared.The receiver-operating characteristic curves (ROC) were plotted to obtain the area under ROC curve (AUC) and the sensitivity,specificity,positive predictive value and negative predictive value.Another ROC curve was plotted to obtain the area under ROC curve (AUC) and the sensitivity,specificity,positive predictive value,and negative predictive value for a new variable,CPR + PT + APTT,which was established using a binomial logistic regression method.Results The results of CPR,PT and APTT in the control group,sepsis group A and sepsis group B all increased in turn (F=10.616,6.155,5.243,P =0.000,0.000,0.000).CPR + PT + APTT had the largest AUC (0.94),the highest sensitivity (93.42％),the highest specificity (91.66％),the highest positive predictive value (92.60％),and the highest negative predictive value (78.55％) in the four indicators.Conclusion When blood culture fails to diagnose late-onset neonatal sepsis,combined detection of CPR + PT + APTT can provide some clues for its early diagnosis,which is worthy of clinical attention.
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Abstract@#Introduction: Arterial and venous thromboses contribute to significant morbidity and mortality rate, thus an antithrombotic agent is needed for prevention and treatment of thrombosis. Ajwa dates (Phoenix dactylifera L.) reportedly contain a high level of salicylic acid which is a compound responsible for anticoagulation via antagonism of vitamin K. The present study was designed to assess coagulation activities in human plasma treated with Ajwa date extracts in vitro. Methods: Platelet-poor plasma samples from 27 donors were treated with ethanol crude date extract (ET) or aqueous crude date extract (AQ) of Ajwa dates at different concentrations to generate the following seven test groups from each donor: control (normal saline), ET-I (0.1 g/mL), ET-II (0.5 g/mL), ET-III (1.0 g/mL), AQ-I (0.1 g/ mL), AQ-II (0.5 g/mL) and AQ-III (1.0 g/mL). In vitro coagulation activities of Ajwa dates were assessed based on prothrombin time (PT, an assessment of extrinsic coagulation pathway), activated partial thromboplastin time (APTT, an assessment of the intrinsic coagulation pathway), and thrombin time (TT, an evaluation of level and function of fibrinogen). Results: A very significant prolongation of PT, APTT and TT were observed for the ET-II and ET-III groups and very significant prolongation of PT and TT was observed for the AQ-II and AQ-III groups. Significant prolongation of TT was observed in the AQ-I group. Conclusion: In conclusion, Ajwa date extracts had an anticoagulation effect on human plasma.
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Objective@#To analyze the clinical test results of D-dimer and coagulation indicators in pregnant patients with hypertensive disorder, and to explore the diagnostic value of D-dimer and coagulation index.@*Methods@#From January 2016 to December 2017, 50 pregnant women with hypertensive disorder (observation group) and 50 healthy pregnant women(control group) who underwent antenatal examination in the Traditional Chinese Medicine Hospital of Yiwu were selected.The plasma D-dimer, coagulation parameters (prothrombin time, activated partial thromboplastin time, thrombin time) were compared between the two groups.According to the condition of hypertensive disorder complicating pregnancy, the observation group was divided into three subgroups: simple gestational hypertension group, mild preeclampsia group and severe preeclampsia group.Pearson correlation coefficient analysis was used to analyze the correlation between plasma D-dimer, coagulation parameters and hypertensive disorder complicating pregnancy.@*Results@#In the observation group, the D-dimer level[(413.15±127.62)μg/L] was higher than that in the control group[(284.29±97.86)μg/L](t=5.666, P<0.05). The prothrombin time[(10.12±1.07)s], activated partial thrombin time[(25.16±3.32)s], and thrombin time[(20.87±2.52)s] in the observation group were all shorter than those in the control group[(12.54±1.93)s, (31.84±5.87)s, (24.26±3.27)s](t=7.754, 7.004, 5.806, all P<0.05). The differences of D-dimer level, prothrombin time, activated partial thrombin time and thrombin time among the simple gestational hypertension group, mild preeclampsia group and severe preeclampsia group were statistically significant(F=4.710, 4.297, 4.411, 4.979, all P<0.05). The level of D-dimer was positively correlated with hypertensive disorder complicating pregnancy(r=0.725), while prothrombin time, activated partial thromboplastin time and thrombin time were negatively correlated with hypertensive disorder during pregnancy(r=-0.713, -0.704, -0.719).@*Conclusion@#The blood of patients with hypertensive disorder complicating pregnancy is generally in hypercoagulable state of D-dimer.The detection of coagulation index can be used as an auxiliary diagnostic index for hypertensive disorder complicating pregnancy.
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Objective@#To study the effects of ticagrelor on clinical efficacy, coagulation function and platelet aggregation in patients with coronary heart disease.@*Methods@#From January 2017 to December 2017, 78 patients in the Department of Cardiology of the First People's Hospital of Huzhou were randomly selected in this study.All patients were treated with interventional therapy.According to the different drug used in the interventional therapy, the patients were divided into the observation group and the control group, with 39 cases in each group.The patients in the control group were given clopidogrel during interventional therapy, and the patients in the observation group were given ticagrelor during interventional therapy.The coagulation function and platelet aggregation rate of the patients before and after treatment were observed, and the clinical efficacy and satisfaction rate of the patients were observed.@*Results@#After treatment, the prothrombin time, activated partial thromboplastin time, thrombin time and fibrinogen level were (12.48±1.01)s, (31.91±2.53)s, (17.06±1.03)s and (4.21±1.09)μg/L, respectively, which were significantly better than those in the control group(t=18.980, 17.092, 15.993, 11.762, all P<0.05). The total effective rate and satisfaction rate of the observation group were 89.745% and 97.44%, respectively, which were significantly higher than those of the control group, and the differences were statisticall significant(χ2=9.983, 8.973, all P<0.05).@*Conclusion@#The clinical efficacy of ticagrelor in the interventional treatment of coronary heart disease is significant, which can significantly improve the coagulation function.
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Objective@#To investigate the changes of coagulation indexes in normal pregnant women in early and late pregnancy.@*Methods@#The coagulation indexes in early and late pregnancy including activated partial thromboplastin time (APTT), APTT ratio, prothrombin time (PT), PT ratio, prothrombin activity, international normalized ratio, fibrinogen (Fib) and thrombin time (TT) were retrospectively collected from 196 normal pregnant women delivered in Peking University First Hospital from August 2013 to September 2014. Differences in these indexes before and after the seventh gestational week of early pregnancy and in early and late pregnancy were compared. In addition, the normal reference values were calculated. Paired t test and sum-rank test were used for statistical analysis. The reference values were presented with P2.5-P97.5.@*Results@#In early pregnancy, some coagulation indexes after the seventh weeks were shorter than those before, such as APTT [30.3 (26.1-35.5) vs 32.1 (27.9-36.8) s, Z=25.850, P<0.001] and TT [13.8 (12.2-16.0) vs 14.5 (12.3-16.4) s, Z=16.720, P<0.001], but Fib [3.3 (2.5-4.3) vs 2.9 (2.2-3.8) g/L, Z=43.180, P<0.001] became higher. APTT [(27.5±1.6) vs (31.4±2.4) s, t=24.736, P<0.001], PT [(9.7±0.5) vs (11.0±0.8) s, t=18.647, P<0.001] and TT [(13.3±0.8) vs (14.2±1.0) s, t=9.255, P<0.001] were significantly shorter, while Fib [(4.4±0.5) vs (3.1±0.4) g/L, t=-29.152, P<0.001] was higher in late pregnancy than in early pregnancy. The reference values of APTT, PT, Fib and TT in early pregnancy were 26.5-36.0 s, 9.4-12.4 s, 2.4-4.0 g/L and 12.3-16.4 s, and those in late pregnancy were 25.0-31.2 s, 8.8-10.6 s, 3.4-5.4 g/L and 12.0-14.9 s, respectively.@*Conclusions@#The coagulation indexes of pregnant women change significantly since the beginning of early pregnancy. APTT, PT and TT are shorter, while Fib is higher in late pregnancy than in early pregnancy.
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Objective@#To analyze the phenotype and genotype of a pedigree affected with congenital dysfibrinogenemia.@*Methods@#Liver and kidney functions of the proband and her relatives were determined. Coagulation tests including prothrombin time (PT), activated partial thromboplastin time (APTT) and thrombin time(TT), fibrin(ogen) degradation products (FDPs), D-dimer(D-D) and the calibration experiment of protamine sulfate of against plasma TT were detected in the proband and her predigree members. The activity and antigen of fibrinogen (Fg) in plasma were measured by Clauss method and immunonephelometry method, respectively. All of the exons and exons-intron boundaries of the three fibrinogen genes (FGA, FGB and FGG) were subjected to PCR amplification and Sanger sequencing. Potential influence of the suspected mutations were analyzed with bioinformatics software including PolyPhen-2, SIFT and Mutation Taster.@*Results@#The proband had normal PT, APTT, FDPs, D-D and prolonged TT (31.8 s). The activity of fibrinogen (Fg) in plasma was significantly decreased but the antigen was normal. Genetic analysis revealed a heterozygous c. 92G>A (p.Gly31Glu) mutation in exon 2 of the FGA gene. Family studies revealed that the mother carried the same mutation. Bioinformatic analysis suggested that the mutation may affect the function of Fg Protein.@*Conclusion@#The dysfibrinogenemia was probably caused by the novel Gly31Glu mutation of the FGA gene.
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Objective To investigate the changes of coagulation indexes in normal pregnant women in early and late pregnancy.Methods The coagulation indexes in early and late pregnancy including activated partial thromboplastin time (APTT),APTT ratio,prothrombin time (PT),PT ratio,prothrombin activity,international normalized ratio,fibrinogen (Fib) and thrombin time (TT) were retrospectively collected from 196 normal pregnant women delivered in Peking University First Hospital from August 2013 to September 2014.Differences in these indexes before and after the seventh gestational week of early pregnancy and in early and late pregnancy were compared.In addition,the normal reference values were calculated.Paired t test and sum-rank test were used for statistical analysis.The reference values were presented with P2.5-P97.5.Results In early pregnancy,some coagulation indexes after the seventh weeks were shorter than those before,such as APTT [30.3 (26.1-35.5) vs 32.1 (27.9-36.8) s,Z=25.850,P＜0.001] and TT [13.8 (12.2-16.0) vs 14.5 (12.3-16.4) s,Z=16.720,P＜0.001],but Fib [3.3 (2.5-4.3) vs 2.9 (2.2-3.8) g/L,Z=43.180,P＜0.001] became higher.APTT [(27.5± 1.6) vs (31.4±2.4) s,t=24.736,P＜0.001],PT [(9.7±0.5) vs (11.0±0.8) s,t=1 8.647,P＜0.001] and TT [(13.3 ±0.8) vs (14.2±1.0) s,t=9.255,P＜0.001] were significantly shorter,while Fib [(4.4±0.5) vs (3.1 ±0.4) g/L,t=-29.152,P＜0.001] was higher in late pregnancy than in early pregnancy.The reference values ofAPTT,PT,Fib and TT in early pregnancy were 26.5-36.0 s,9.4-12.4 s,2.4-4.0 g/L and 12.3-16.4 s,and those in late pregnancy were 25.0-31.2 s,8.8-10.6 s,3.4-5.4 g/L and 12.0-14.9 s,respectively.Conclusions The coagulation indexes of pregnant women change significantly since the beginning of early pregnancy.APTT,PT and TT are shorter,while Fib is higher in late pregnancy than in early pregnancy.
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Objective To analyze the clinical test results of D-dimer and coagulation indicators in pregnant patients with hypertensive disorder , and to explore the diagnostic value of D-dimer and coagulation index. Methods From January 2016 to December 2017,50 pregnant women with hypertensive disorder (observation group) and 50 healthy pregnant women ( control group ) who underwent antenatal examination in the Traditional Chinese Medicine Hospital of Yiwu were selected.The plasma D-dimer,coagulation parameters (prothrombin time,activated partial thromboplastin time ,thrombin time) were compared between the two groups.According to the condition of hypertensive disorder complicating pregnancy , the observation group was divided into three subgroups : simple gestational hypertension group,mild preeclampsia group and severe preeclampsia group.Pearson correlation coefficient analysis was used to analyze the correlation between plasma D-dimer, coagulation parameters and hypertensive disorder complicating pregnancy.Results In the observation group ,the D-dimer level[(413.15 ±127.62)μg／L] was higher than that in the control group [(284.29 ±97.86) μg／L] ( t＝5.666,P＜0.05).The prothrombin time [(10.12 ±1.07)s],activated partial thrombin time [(25.16 ±3.32) s],and thrombin time [(20.87 ±2.52) s] in the observation group were all shorter than those in the control group [(12.54 ±1.93)s,(31.84 ±5.87)s,(24.26 ± 3.27)s] (t＝7.754,7.004,5.806,all P＜0.05).The differences of D-dimer level,prothrombin time,activated partial thrombin time and thrombin time among the simple gestational hypertension group ,mild preeclampsia group and severe preeclampsia group were statistically significant (F＝4.710,4.297,4.411,4.979,all P＜0.05).The level of D-dimer was positively correlated with hypertensive disorder complicating pregnancy (r＝0.725),while prothrom-bin time,activated partial thromboplastin time and thrombin time were negatively correlated with hypertensive disorder during pregnancy(r＝-0.713,-0.704,-0.719).Conclusion The blood of patients with hypertensive disorder complicating pregnancy is generally in hypercoagulable state of D-dimer.The detection of coagulation index can be used as an auxiliary diagnostic index for hypertensive disorder complicating pregnancy .
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Objective To study the effects of ticagrelor on clinical efficacy ,coagulation function and platelet aggregation in patients with coronary heart disease.Methods From January 2017 to December 2017,78 patients in the Department of Cardiology of the First People＇s Hospital of Huzhou were randomly selected in this study.All patients were treated with interventional therapy.According to the different drug used in the interventional therapy ,the patients were divided into the observation group and the control group ,with 39 cases in each group.The patients in the control group were given clopidogrel during interventional therapy ,and the patients in the observation group were given ticagrelor during interventional therapy.The coagulation function and platelet aggregation rate of the patients before and after treatment were observed ,and the clinical efficacy and satisfaction rate of the patients were observed.Results After treatment,the prothrombin time,activated partial thromboplastin time ,thrombin time and fibrinogen level were (12.48 ±1.01) s, (31.91 ±2.53) s, (17.06 ±1.03 ) s and ( 4.21 ±1.09 ) μg／L, respectively, which were significantly better than those in the control group ( t＝18.980,17.092,15.993,11.762,all P＜0.05).The total effective rate and satisfaction rate of the observation group were 89.745% and 97.44%,respectively,which were significantly higher than those of the control group ,and the differences were statisticall significant (χ2 ＝9.983,8.973, all P＜0.05).Conclusion The clinical efficacy of ticagrelor in the interventional treatment of coronary heart disease is significant,which can significantly improve the coagulation function.
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Objective To observe the clinical curative effect of warfarin therapy on atrial fibrillation complicated with cerebral embolism,and its influence on D－dimer.Methods From January 2013 to March 2016,80 cases of atrial fibrillation complicated with cerebral embolism in Shanxi Cardiovascular Disease Hospital were selected in the study.By using the random number table method,the patients were divided into two groups,with 40 cases in each group.The control group was given aspirin therapy,the observation group was given warfarin treatment.The treatment effect,D －dimer level,blood coagulation function index,cerebral embolism recurrence rate and mortality were compared between the two groups.Results The total effective rate of the observation group was 95.0%,which of the control group was 90.0%,there was no statistically significant difference between the two groups (χ2＝0.721,P＞0.721).After treatment,the D－dimer,prothrombin time (PT),activated partial clotting enzyme live time (APTT), thrombin time (TT)in the observation group were (162.85 ±60.53)μg/L,(20.54 ±4.03)s,(42.84 ±8.47 )s, (22.59 ±4.84)s,respectively,which in the control group 1were (245.41±83.24)μg/L,(16.39 ±3.41)s,(34.23 ± 7.59 )s,(17.98 ±4.27 )s,respectively,the differences between the two groups were statistically significant (t ＝5.073,4.972,4.788,4.972,all P ＜0.05 ).The recurrence rate of cerebral embolism in the observation group (7.5%)was significantly lower than that in the control group (25.0%)(χ2＝4.501,P＜0.05 ).The mortality of the observation group (2.5%)was slightly lower than that of the control group (5.0%),but there was no statistically significant difference (χ2＝0.346,P＞0.346).Conclusion Warfarin therapy in the treatment of atrial fibrillation complicated with cerebral embolism has significant clinical effect,it has anticoagulant effect,and can reduce the D－dimer level,improve patients'anticoagulant function,effectively prevent the cerebral embolism happen again,and improve the prognosis.
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Objective To observe the clinical efficacy of acupuncture plus oral administration ofLuohua Zizhu tablets in treating hemafecia in stageⅠ internal hemorrhoid.Method A total of 116 patients with hemafecia in stageⅠ internal hemorrhoid were randomized into a treatment group and a control group, 58 cases each. The treatment group was intervened by acupuncture plus oral administration ofLuohua Zizhu tablets, while the control group was treated with oral administration ofLuohua Zizhu tablets alone. The hemafecia score, hemorrhoid congestion score, and laboratory indexes (platelet and thrombin time) were observed before and after the treatment. The clinical efficacies of the two groups were also compared.Result The total effective rate was 93.1％ in the treatment group versus 84.5％ in the control group, and the between-group difference was statistically significant (P<0.05). Respectively after 3 d, 5 d and 7 d treatment, the hemafecia and hemorrhoid congestion scores were significantly different from the scores before the treatment in both groups (P<0.05). There were significant differences in comparing the hemafecia and hemorrhoid congestion scores between the two groups respectively after 3 d, 5 d and 7 d treatment (P<0.05). The laboratory indexes showed significant changes after the treatment in both groups (P<0.05). After the intervention, the laboratory indexes of the treatment group were significantly different from those of the control group (P<0.05).Conclusion Acupuncture plus oral administration ofLuohua Zizhu tablets is an effective method in treating hemafecia in stageⅠ internal hemorrhoid.
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Objective:To investigate the clinical effect of dexamethasone combined with urokinase on the tuberculous pleurisy.Methods:From August 2013 to May 2016,190 cases of tuberculous pleurisy patients in our hospital were selected.All the patients were randomly divided into the observation group and control group with of 95 patients in each group,both groups were treated with anti tuberculosis treatment,the control group was given urokinase treatment,the observation group was given dexamethasone combined with urokinase treatment,both groups were treated for 1 month.After treatment,the total effective rate,incidence of adverse reactions,total drainage time of pleural effusion,total amount of pleural effusion,thrombin time and prothrombin time of two groups were compared.Results:All patients were well tolerated with injection during the treatment and there was no severe complication after treatment;the total effective rates in the observation group and the control group were 88.4％ and 72.6％,which was significantly higher in the observation group than that of the control group (P＜0.05).The total drainage time and total amount of pleural effusion in pleural effusion in the observation group were 7.56± 2.44 d and 2867.33± 456.10 mL,the control group were 9.44± 2.89 d and 1989.92± 444.20 mL,the total drainage time in the observation group was significantly shorter than that of the control group,and the total amount of pleural effusion was significantly higher than that of the control group(P＜0.05).After treatment,the pleural effusion thrombin time and prothrombin time in both groups were significantly higher than those before treatment (P＜0.05),which were higher in the observation group than those of the control group (P＜0.05).Conclusion:Dexamethasone combined with urokinase could prolong the thrombin time and prothrombin time,shorten the time of drainage of pleural effusion,increase the pleural effusion amount,with good safety and clinical effect in the treatment of tuberculous pleurisy.
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Objective To study the differences of coagulation indices on the first day of birth in newborns with different gestational ages.Method Premature infants born in our hospital between January 2014 and December 2015 were enrolled in this study as the observational group,and they were divided into early preterm group,moderate preterm group,and late preterm group according to their gestational ages.Healthy full-term infants born during the same period were selected as the control group by 3:1 The clinicaldata and coagulation indices of the infants and their mothers in each group were compared.Result There were 44,50,71,and 52 cases in the early preterm,moderate preterm,late preterm,and control group,respectively.The prothrombin time (PT),activated partial thromboplastin time (APTT),and thrombin time (TT) of the premature infants in the early preterm group,moderate preterm group,and late preterm group were all longer than those of the control group [PT:(16.1 ±4.3) s,(16.8 ±4.9) s,(15.8 ±4.8) s,vs.(13.0±1.3)s;APTT:(88.3±38.1) s,(93.5±37.7) s,(91.0±32.3) s,vs.(66.0±17.8) s;TT:(25.4 ±4.6) s,(25.1 ±5.5) s,(25.0 ±3.3) s,vs.(24.0 ±3.3) s;all P＜0.05].The fibrinogen level of the premature newborns in three groups were all lower than that of the full-term infants in the control group [(1.11 ± 0.46) g/L,(1.12 ± 0.44) g/L,(1.12 ± 0.45) g/L vs.(1.28 ± 0.37) g/L,P ＜ 0.05].The differences of all the indices among the three groups of premature infants were all not statistically significant (P ＞ 0.05).The comparison of the coagulation indices of the mothers of the newborns from all four groups showed no significant differences (P ＞ 0.05).Conclusion Compared with full-term infants,preterm infants showed significantly poorer coagulation function on the first day of birth.However,there were no significant differences in coagulation indices among preterm infants of different gestational ages.
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Objective To investigate the influencing factors on thrombin time (TT) assay to ensure the accuracy of the detection results.Methods Totally 3 out-and in-patients from January to July 2015 with normal results of prothrombin time (PT),activated partial clotting enzyme live time (APTT) and fibrinogen (FIB) were selected,whose detection results were not satisfactory.The specimen underwent re-centrifugation,and then Beckman ACL TOP700 automatic coagulation analyzer was used to detect four coagulation indexes.The detection results were compared with those before re-centrifugation,and the differences between the results were analyzed statically.Results The values of PT,APTT and FIB of the three patients before and after re-centrifugation were (10.8,11.5,9.7 s),(29.5,32.7,25.2 s),(2.49,3.12,2.85 g/L) and (10.9,11.3,10.0 s),(30.4,31.5,25.9 s),(2.31,3.28,2.67 g/L) respectively,and the differences between the results were not significant (with t ranging from 0.627 to 1.719 and P＞0.05).The values of TT of the three patients before and after re-centrifugation were (66.51,127.3,89.62 s) and (12.2,15.7,13.8 s) respectively,and there were obvious differences between the values (with t ranging from 51.743 to 79.167 and P＜0.001).Conclusion Insufficient centrifugation has high influences on the detection result of TT except other coagulation indexes,and re-centrifugation is necessary for the accuracy of TT value to eliminate misdiagnosis.
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Objective To investigate the effect of stress level on blood coagulation and fracture healing in fracture patients.Methods The clinical data of 50 fracture patients (fracture group) and 50 healthy volunteers (control group) were analyzed retrospectively.The oxidative stress indexes [superoxide dismutase (SOD) and malondialdehyde (MDA)] and blood coagulation indexes [plasma fibrinogen (Fib),activated partial thromboplastin time (APTT),thronbin time (TT),and prothrombin time (PT)] were compared between the 2 groups.Correlation between stress level and coagulation indexes in the fracture patients was analyzed by Spearman correlation coefficient.The correlation between stress level and the progress of fracture healing in fracture patients was analyzed.Results There were no significant differences in APTT,TT,PT or other blood coagulation indexes between the 2 groups (P ＞ 0.05).The fracture group had a significantly lower SOD level but significantly higher MDA and Fib levels than the control group (P ＜ 0.05).Spearman analysis showed that the SOD level was negatively correlated to the Fib level (P ＜ 0.05) while the MDA level was positively correlated to the Fib level in the fracture group (P ＜ 0.05).The MDA level was negatively correlated to the process of fracture healing (P ＜ 0.05) while the SOD level was positively correlated to the process of fracture healing in the fracture group (P ＜ 0.05).Conclusions Traumatic fracture can cause stress reaction.It should be kept in mind that the severity of stress reaction is closely related to the Fib level and the process of fracture healing.
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Objective To evaluate the performance of diluted thrombin time (dTT) assay for detecting Dabigatran levels and observe whether this assay may meet the requirements of clinical laboratory.Methods According to EP15-A2,EP6-A,EP7-A and C-24 documents of the Clinical and Laboratory Standards Institute (CLSI),the precision,trueness,analytical measurement range,carryover rate and anti-biological interference of dTT assay were evaluated and the stability of specimen for dTT assay was observed.Results Both the within-day and between-day coefficient of variation (CV) of dTT assay for detecting Dabigatran levels were consistent with manufacturer's stated CV.Compared with target values of Dabigatran,the relative bias of 3 levels of proficiency test materials from College of American Pathologists (CAP) were less than 10％.The results meet linear verification when Dabigatran concentration was between 30.92 and 249.13 ng/mL.The carryover rate was-0.84％.There was no interference for Dabigatran levels by dTT assay for detecting Dabigatran when Hb≤3 g/L,triglyceride≤873 mg/dL,heparin≤2.2 IU/mL and FDP≤29 mg/L.The results of stability showed that plasma specimens for dTT could not be stored at room temperature more than 4 hours,at 4 ℃ more than 4 days,at-20 ℃ exceed 1 month,while at-80℃ the plasma specimens could be stored at least 6 months for dTT assay.Conclusion The precision,trueness,analytical measurement range,carryover rate,anti-biological interference of dTT assay may meet the requirement of clinical laboratory.The stability of the specimen can fulfill the clinical requirements.
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Background: Atrial fibrillation (AF) generates a hypercoagulable state with an increased thrombin generation and raised levels of thrombin-antithrombin complexes, which results in a high risk of stroke and thromboembolism. Aim: To evaluate the anticoagulant effect of rivaroxaban by anti-Xa factor activity and its correlation with thrombin-antithrombin complexes, thrombin generation and prothrombin time in patients newly diagnosed with non-valvular AF. Patients and Methods: Prospective study in patients with indication of anticoagulation. Demographic variables, cardiovascular risk factors, CHA2DS2-VASc and HAS-BLED scores were recorded. Blood samples were taken at baseline, at 3 and 24 hours after the administration of the drug and at 30 days. Rivaroxaban levels, anti-Xa activity, prothrombin time, thrombin generation and plasma levels of thrombin-antithrombin complexes were determined. Results: We studied 20 patients aged 76.3 ± 8.0 years (60% female) with a CHA2DS2-VASc score > 2 points. The anti-Xa factor activity correlated with rivaroxaban plasma levels at 3 hours (r = 0.61, p < 0.01), at 24 hours (r = 0.85, p < 0.01) and at 30 days (r = 0.99, p < 0.01), with prothrombin time at 3 hours (r = -0.86, p = 0.019) and at 30 days (r = -0.63, p = 0.02) and with a sustained decrease in thrombin generation at 30 days of follow-up (r = -0.74, p < 0.01). There was no correlation with thrombin-antithrombin complexes (r = -0.02, p = 0.83). Conclusions: Rivaroxaban consistently inhibited the mild pro-coagulant state found in newly diagnosed non-valvular AF patients through the first 24 hours and this effect was maintained at 30 days. Plasma levels of the drug correlated with anti-Xa factor activity, thrombin generation and prothrombin time