Ukubaluleka kweklinikhi
Ngokusisiseko inentsingiselo efanayo nexesha lokujiya, kodwa inovakalelo oluphezulu. Uninzi lweendlela zokumisela i-APTT ezisetyenziswayo ngoku zinokuba zingaqhelekanga xa i-plasma coagulation factor ingaphantsi kwe-15% ukuya kwi-30% yenqanaba eliqhelekileyo.
(1) Ukwandiswa kwe-APTT: isiphumo se-APTT sinde ngemizuzwana eli-10 kuneso solawulo oluqhelekileyo. I-APTT lolona vavanyo lokuvavanya oluthembekileyo lokusilela kwe-endogenous coagulation factor kwaye isetyenziselwa kakhulu ukufumanisa i-hemophilia encinci. Nangona amanqanaba e-factor Ⅷ: C anokufunyanwa ngaphantsi kwe-25% ye-hemophilia A, uvakalelo kwi-subclinical hemophilia (factor Ⅷ>25%) kunye nabathwali be-hemophilia alulunganga. Iziphumo ezinde zikwabonwa nakwi-factor Ⅸ (hemophilia B), Ⅺ kunye ne-Ⅶ; xa izinto ezilwa ne-coagulant egazini ezifana ne-coagulation factor inhibitors okanye amanqanaba e-heparin enyuka, i-prothrombin, i-fibrinogen kunye ne-factor V, ukungabikho kwe-X nako kunokwandiswa, kodwa uvakalelo luphantsi kancinci; Ukwandiswa kwe-APTT kunokubonwa nakwezinye izigulana ezinesifo sesibindi, i-DIC, kunye negazi elininzi eligciniweyo.
(2) Ukufinyezwa kwe-APTT: kubonakala kwi-DIC, imeko yangaphambi kokubetheka kwegazi kunye nesifo sokubetheka kwegazi.
(3) Ukubeka esweni unyango lwe-heparin: I-APTT inovelwano kakhulu kuxinzelelo lwe-plasma heparin, ngoko ke luphawu lokubeka esweni elebhu olusetyenziswa kakhulu okwangoku. Okwangoku, kufuneka kuqatshelwe ukuba isiphumo sokulinganisa i-APTT kufuneka sibe nolwalamano oluchanekileyo noxinzelelo lwe-plasma ye-heparin kuluhlu lonyango, kungenjalo akufanele isetyenziswe. Ngokubanzi, ngexesha lonyango lwe-heparin, kuyacetyiswa ukuba i-APTT ihlale ikwi-1.5 ukuya kwi-3.0 amaxesha kunolawulo oluqhelekileyo.
Uhlalutyo lweziphumo
Ngokwezonyango, i-APTT kunye ne-PT zihlala zisetyenziswa njengovavanyo lokuhlola ukusebenza kokujiya kwegazi. Ngokweziphumo zokulinganisa, kukho iimeko ezine ezilandelayo:
(1) Zombini i-APTT kunye ne-PT ziqhelekile: Ngaphandle kwabantu abaqhelekileyo, kubonakala kuphela kwi-genetic and secondary FXIII deficiency. Ezo zifunyenweyo ziqhelekile kwisifo sesibindi esibi, i-liver tumor, i-malignant lymphoma, i-leukemia, i-anti-factor XIII antibody, i-autoimmune anemia kunye ne-pernicious anemia.
(2) I-APTT ende ene-PT eqhelekileyo: Uninzi lweengxaki zokopha zibangelwa ziziphene kwindlela yokujiya kwangaphakathi. Ezifana nokunqongophala kwe-hemophilia A, B, kunye ne-factor Ⅺ; kukho ii-anti-factor Ⅷ, Ⅸ, Ⅺ antibodies kumjikelezo wegazi.
(3) I-APTT eqhelekileyo ene-PT ende: uninzi lweengxaki zokopha ezibangelwa ziziphene kwindlela yokujiya kwegazi yangaphandle, ezifana nokusilela kwe-genetic kunye ne-acquired factor VII. Ezo zifunyenweyo zixhaphakile kwisifo sesibindi, i-DIC, ii-anti-factor VII antibodies ekujikelezeni kwegazi kunye nee-anticoagulants zomlomo.
(4) Zombini i-APTT kunye ne-PT zihlala ixesha elide: uninzi lweengxaki zokopha ezibangelwa ziziphene kwindlela eqhelekileyo yokujiya kwegazi, ezifana nokusilela kwe-genetic kunye ne-acquired factor X, V, II kunye ne-I. Ezo zifunyenweyo zibonakala kakhulu kwisifo sesibindi kunye ne-DIC, kwaye izinto X kunye ne-II zinokuncitshiswa xa kusetyenziswa ii-anticoagulants zomlomo. Ukongeza, xa kukho ii-anti-factor X, anti-factor V kunye nee-anti-factor II antibodies kumjikelezo wegazi, nazo ziyandiswa ngokufanelekileyo. Xa i-heparin isetyenziswa ngokwezonyango, zombini i-APTTT kunye ne-PT ziyandiswa ngokufanelekileyo.