Kukosha kwekiriniki
Zvinoreva zvakafanana nenguva yekugwamba kweropa, asi zvine hunhu hwakanyanya. Nzira zhinji dzekuongorora APTT dziri kushandiswa parizvino dzinogona kunge dzisina kujairika kana plasma coagulation factor iri pasi pe15% kusvika 30% yehuwandu hweropa hwakajairika.
(1) Kuwedzerwa kwenguva yeAPTT: mhedzisiro yeAPTT yakareba nemasekonzi gumi kupfuura yeyakajairika. APTT ndiyo bvunzo yakavimbika yekuongorora kushomeka kwe endogenous coagulation factor uye inonyanya kushandiswa kuwana hemophilia isina kusimba. Kunyangwe factor Ⅷ: C levels ichigona kuonekwa pasi pe25% ye hemophilia A, kunzwa kune subclinical hemophilia (factor Ⅷ>25%) uye vatakuri ve hemophilia kwakashata. Mhedzisiro yakareba inoonekwawo mu factor Ⅸ (hemophilia B), Ⅺ uye Ⅶ kushomeka; kana zvinhu zvinorwisa ropa zvakaita se coagulation factor inhibitors kana heparin levels zvikawedzera, prothrombin, fibrinogen uye factor V, X kushomeka zvinogona kuwedzerwa, asi kunzwa kwacho kwakaderera zvishoma; Kuwedzerwa kwenguva yeAPTT kunogona kuonekwawo mune vamwe varwere vane chirwere chechiropa, DIC, uye huwandu hwakawanda hweropa rakachengetwa.
(2) Kupfupika kweAPTT: kunoonekwa muDIC, mamiriro ekudzivirira ropa asati asvika uye chirwere cheropa rakadzikira.
(3) Kuongororwa kwekurapwa kweheparin: APTT inonyanya kunzwisiswa nehuwandu hweheparin muropa, saka inhamba yekutarisa inoshandiswa zvakanyanya murabhoritari parizvino. Panguva ino, zvinofanira kucherechedzwa kuti mhedzisiro yekuyerwa kweAPTT inofanira kunge iine hukama hwakafanana nehuwandu hweheparin muropa murabhoritari, zvikasadaro haifanirwe kushandiswa. Kazhinji, panguva yekurapwa kweheparin, zvinokurudzirwa kuchengetedza APTT iri pa1.5 kusvika 3.0 nguva kupfuura yekudzora kwakajairika.
Kuongorora mhedzisiro
Pakurapa, APTT nePT zvinowanzo shandiswa senzira yekuongorora mashandiro eropa. Zvichienderana nemhedzisiro yekuyera, pane mamiriro ezvinhu mana anotevera:
(1) Zvese APTT nePT zvakajairika: Kunze kwevanhu vakagwinya, zvinongoonekwa chete mukushaya nhaka uye kwechipiri FXIII. Zvirwere zvinowanikwa zvinowanzoonekwa muzvirwere zvakakomba zvechiropa, bundu rechiropa, malignant lymphoma, leukemia, anti-factor XIII antibody, autoimmune anemia uye pernicious anemia.
(2) APTT yakareba kwenguva refu nePT yakajairika: Zvizhinji zvezvirwere zvekubuda ropa zvinokonzerwa nekusagadzikana munzira yekugwinya kweropa. Zvakadai sekushaya ropa A, B, uye kushomeka kwefactor Ⅺ; kune ma antibodies e-anti-factor Ⅷ, Ⅸ, Ⅺ muropa rinotenderera.
(3) APTT yakajairika ine PT yakareba: matambudziko mazhinji ekubuda ropa anokonzerwa nekukanganisika munzira yekuvharika kweropa, senge kushomeka kwemajini uye kushomeka kwechinhu chinowanikwa VII. Mabhakitiriya anowanikwa anowanzo kuwanikwa muzvirwere zvechiropa, DIC, ma antibodies e-anti-factor VII mukutenderera kweropa uye mishonga inorwisa kuvharika kweropa nemuromo.
(4) Zvese APTT nePT zvinotora nguva refu: zvirwere zvakawanda zvekubuda ropa zvinokonzerwa nekusakwana munzira yekugwamba kweropa, zvakaita sekushaya majini neakawanikwa factor X, V, II neI. Zvinowanikwa zvinonyanya kuonekwa muchirwere chechiropa neDIC, uye zvinhu X neII zvinogona kuderedzwa kana mishonga inorwisa kupwanya ropa ikashandiswa. Pamusoro pezvo, kana paine anti-factor X, anti-factor V uye anti-factor II antibodies muropa, zvinotora nguva refu zvinoenderana. Kana heparin ikashandiswa mukiriniki, ese APTTT nePT anotora nguva refu zvinoenderana.