Ukubaluleka komtholampilo
Ngokuyisisekelo inencazelo efanayo nesikhathi sokujiya, kodwa ngokuzwela okuphezulu. Iningi lezindlela zokunquma ze-APTT ezisetshenziswayo njengamanje zingaba ezingavamile lapho i-plasma coagulation factor ingaphansi kuka-15% kuya ku-30% wezinga elijwayelekile.
(1) Ukwelulwa kwe-APTT: umphumela we-APTT ubude ngemizuzwana eyi-10 kunowokulawula okuvamile. I-APTT iyisivivinyo sokuhlola esithembeke kakhulu sokuntuleka kwe-endogenous coagulation factor futhi isetshenziswa kakhulu ukuthola i-hemophilia encane. Nakuba amazinga e-factor Ⅷ: C angatholakala ngaphansi kwama-25% e-hemophilia A, ukuzwela kwi-subclinical hemophilia (factor Ⅷ>25%) kanye nabathwali be-hemophilia kubi. Imiphumela ende ibonakala futhi ekushodeni kwe-factor Ⅸ (hemophilia B), Ⅺ kanye ne-Ⅶ; lapho izinto ezilwa nokuqina kwegazi ezifana nezithiyo ze-coagulation factor noma amazinga e-heparin ekhuphuka, i-prothrombin, i-fibrinogen kanye ne-factor V, ukuntuleka kwe-X nakho kungandiswa isikhathi eside, kodwa ukuzwela kubi kancane; Ukwelulwa kwe-APTT kungabonakala nakwezinye iziguli ezinesifo sesibindi, i-DIC, kanye nenani elikhulu legazi eligciniwe.
(2) Ukufinyezwa kwe-APTT: kubonakala ku-DIC, isimo sangaphambi kokuvinjelwa kwegazi kanye nesifo sokuvinjelwa kwegazi.
(3) Ukuqapha ukwelashwa kwe-heparin: I-APTT ibucayi kakhulu ekugxilweni kwe-heparin ye-plasma, ngakho-ke iyinkomba yokuqapha yelabhorethri esetshenziswa kabanzi njengamanje. Okwamanje, kufanele kuqashelwe ukuthi umphumela wokulinganisa we-APTT kumele ube nobudlelwano obuqondile nokugxilwa kwe-heparin ye-plasma ebangeni lokwelapha, ngaphandle kwalokho akufanele isetshenziswe. Ngokuvamile, ngesikhathi sokwelashwa kwe-heparin, kuyalulekwa ukugcina i-APTT iphindwe izikhathi eziyi-1.5 kuya kwezingu-3.0 kunezokulawula okuvamile.
Ukuhlaziywa kwemiphumela
Ngokwezokwelapha, i-APTT kanye ne-PT zivame ukusetshenziswa njengezivivinyo zokuhlola ukusebenza kokujiya kwegazi. Ngokwemiphumela yokulinganisa, kunezimo ezine ezilandelayo:
(1) Kokubili i-APTT ne-PT kujwayelekile: Ngaphandle kwabantu abavamile, kubonakala kuphela ekusweleni kwe-FXIII okuzuzwe njengefa kanye nokwesibili. Okutholakalayo kuvame kakhulu ezifweni zesibindi ezinzima, isimila sesibindi, i-malignant lymphoma, i-leukemia, i-anti-factor XIII antibody, i-autoimmune anemia kanye ne-pernicious anemia.
(2) I-APTT ende ene-PT evamile: Iningi lezinkinga zokopha libangelwa ukukhubazeka endleleni yokujiya kwangaphakathi. Njengokuntuleka kwe-hemophilia A, B, kanye ne-factor Ⅺ; kukhona ama-anti-factor Ⅷ, Ⅸ, Ⅺ antibodies ekujikelezeni kwegazi.
(3) I-APTT evamile ene-PT ende: izinkinga eziningi zokopha ezibangelwa ukukhubazeka endleleni yokujiya kwangaphandle, njengokuntuleka kwezakhi zofuzo kanye nokuntuleka kwe-factor VII. Ezitholakalayo zivame kakhulu ezifweni zesibindi, i-DIC, ama-anti-factor VII antibodies ekujikelezeni kwegazi kanye nama-anticoagulants omlomo.
(4) Kokubili i-APTT ne-PT zithatha isikhathi eside: izinkinga eziningi zokopha ezibangelwa ukukhubazeka endleleni evamile yokujiya kwegazi, njengokuntuleka kwezakhi zofuzo kanye ne-acquired factor X, V, II kanye ne-I. Ezitholakalayo zibonakala kakhulu ezifweni zesibindi kanye ne-DIC, futhi izici X kanye ne-II zingancishiswa uma kusetshenziswa ama-anticoagulant omlomo. Ngaphezu kwalokho, uma kukhona ama-anti-factor X, anti-factor V kanye nama-anti-factor II antibodies ekujikelezeni kwegazi, nawo athatha isikhathi eside ngokufanele. Uma i-heparin isetshenziswa ngokwezokwelapha, zombili i-APTTTT kanye ne-PT zithatha isikhathi eside ngokufanele.