activated partial thromboplastin time
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Author(s):  
М.С. Успенская ◽  
М.Г. Ляпина ◽  
М.Д. Калугина

Введение. Актуальность темы исследования обусловлена проблемой борьбы с тромбозами и тромбоэмболиями безопасными для организма методами. Во многих растениях обнаружены антикоагулянты разной природы (гепариноподобные, пептиды). Цель исследования - изучение возможности проявления синергических эффектов на антикоагулянтную и фибринолитическую активность крови и процессы полимеризации фибрина экстракта из корней пиона «Иван Горожанкин» в сравнительном аспекте с действием экстракта из корней пиона «молочноцветковый». Методика. Объектом исследования служили корни пионов «Иван Горожанкин» и «молочноцветковый», произрастающих в Ботаническом саду МГУ. Пион «Иван Горожанкин» был создан скрещиванием пиона «молочноцветкового» и «лекарственного» Разработаны методы получения экстрактов из корней различных пионов. При различных разведениях экстрактов (0.1, 1, 5%) определены антикоагулянтная активность по тестам, характеризующим внутренний, внешний и общий пути свертывания крови, а также степень полимеризации фибрина плазмы крови крыс. Для сравнения был использован стандартный препарат низкомолекулярного гепарина (LMWH) животного происхождения фирмы «Celsus» (США). Проведены выделение и очистка активного начала (гепариноидов) из сухих препаратов и измерены их активности. Pезультаты. Показано, что экстракты из обоих препаратов пионов обладали антикоагулянтной и суммарной фибринолитической активностью на нестабилизированном фибрине, но в разной степени. В экстрактах из корней пиона «Иван Горожанкин» отмечались преимущественные синергические эффекты, а именно превышение антикоагулянтной активности на 20-30%, суммарной фибринолитической - на 18% по сравнению с таковыми, отмечаемыми в экстрактах из корней пиона «молочноцветковый». Подобные результаты выявлены и при изучении степени полимеризации фибрина под влиянием очищенных препаратов из пионов. Рассмотрены возможные механизмы активирующего действия экстракта из пиона «Иван Горожанкин» на антикоагулянтные свойства плазмы, суммарную фибринолитическую активность и степень полимеризации фибрина. Это связано с блокадой активности тромбина и факторов внутреннего механизма свертывания крови. При этом антикоагулянтный эффект от применения экстракта из пиона «Иван Горожанкин» по тесту APTT (activated partial thromboplastin time) превышал на 20-30% ту же активность, выявленную у пиона «молочноцветковый», которая соответствовала антикоагулянтной активности препарата сравнения LMWH. В экстракте из пиона «Иван Горожанкин» впервые обнаружено наличие антикоагулянтного гепариноподобного вещества. Заключение. Впервые установлена способность экстракта из корней пиона «Иван Горожанкин» проявлять синергические антикоагулянтные и фибриндеполимеризационные эффекты, превышающие таковые у экстракта из пиона «молочноветковый». На основе полученных данных возникает необходимость исследования пиона «Иван Горожанкин» в качестве антитромботического, а возможно, и антиатеросклеротического агента. Introduction. The research topic is relevant due to the problem of safely combating thrombosis and thromboembolism. Anticoagulants of various kinds, e.g., heparin-like and peptides, have been found in many plants. Aim. To investigate the possibility of synergistic effects on the blood anticoagulant and fibrinolytic activity and on processes of fibrin polymerization by an extract from the roots of the «Ivan Gorozhankin» peony compared with the root extract from «Paeonia lactiflora». Methods. The focus of the study was the roots of the “Ivan Gorozhankin” peony and the Paeonia lactiflora growing in the Botanical Garden of the Moscow State University. The “Ivan Gorozhankin” peony was created by crossing P. lactiflora and the “medicinal” peony. Methods for obtaining extracts from the roots of various peonies have been developed. In 1%, 3%, and 5% dilutions of the extracts, the anticoagulant activity was determined according to tests characterizing the internal, external and general blood coagulation pathways, as well as by the degree of polymerization of rat blood plasma fibrin. For comparison, we used a standard preparation of low molecular weight heparin (LMWH) of animal origin (Celsus, USA). Isolation and purification of the active substances, heparinoids, were isolated from dry preparations and purified, and their activities were measured. Results. Extracts from both peony preparations had anticoagulant and total fibrinolytic activity on unstabilized fibrin, but to different extents. In the extracts from the roots of the “Ivan Gorozhankin” peony, preferential synergistic effects were noted, namely, the anticoagulant activity was higher by 20-30%, and the total fibrinolytic activity was higher by 18% compared to those of extracts from Paeonia lactiflora roots. Similar results were obtained when studying the degree of fibrin polymerization as influenced by purified peony preparations. Possible mechanisms of the activating action of the «Ivan Gorozhankin» peony extract on the anticoagulant properties of plasma, the total fibrinolytic activity, and the degree of fibrin polymerization are considered. This action is due to the inhibition of thrombin activity and factors of the internal mechanism of blood coagulation. According to the activated partial thromboplastin time (APTT) test, the anticoagulant effect of extracts from the «Ivan Gorozhankin» peony exceeded by 20-30% the activity of Paeonia lactiflora extract, which corresponded to the anticoagulant activity of the LMWH comparator drug. Using the described biochemical methods, the presence of an anticoagulant heparin-like substance in an extract from the peony «Ivan Gorozhankin» has been discovered. Conclusion. For the first time, the ability of an extract from the roots of the «Ivan Gorozhankin» peony to exhibit synergistic anticoagulant and fibrin-depolymerization effects was demonstrated. These effects exceeded those of the Paeonia lactiflora extract. Based on these data, it appears necessary to study the «Ivan Gorozhankin» peony as an antithrombotic, and possibly as an anti-atherosclerotic agent.


2021 ◽  
pp. 20-24
Author(s):  
M. M. Markova ◽  
O. S. Polunina ◽  
D. G. Tarasov ◽  
M. A. Kiseleva ◽  
E. A. Polunina

The aim of the study. To analyze the indicators of hemostasis with adherence to treatment in patients operated on for mitral valve prosthetics with mechanical bicuspid prostheses in dynamics after 6, 12 and 60 months.Materials and methods. The study included 260 patients who underwent surgery for prosthetics with mechanical prostheses. Patients’ adherence to treatment was assessed using the Morisky – Green test. The following hemostasis parameters were analyzed: international normalized ratio (INR), activated partial thromboplastin time (APTT), D-dimer, fibrinogen and soluble fibrin-monomer complexes.Results of the study and conclusion. At all stages of the postoperative period, the hemostasis indicators of compliant patients corresponded to the reference values for people receiving anticoagulants, in non-compliant patients, these indicators did not reach the recommended values for patients on anticoagulant therapy. The presence of correlations between compliance and hemostasis indicators is evidenced by the results of correlation analysis. In most cases, the maximum strength of the relationship between compliance and hemostasis indicators was observed after 12 months of follow-up. A noticeable strength of interrelations was traced between compliance and levels of APTT, INR and fibrinogen.


2021 ◽  
Vol 10 (24) ◽  
pp. 5987
Author(s):  
Hideo Wada ◽  
Yuhuko Ichikawa ◽  
Minoru Ezaki ◽  
Katsuya Shiraki ◽  
Isao Moritani ◽  
...  

Background: Although platelets, which contain large amounts of phospholipids, play an important role in blood coagulation, there is still no routine assay to examine the effects of platelets in blood coagulation. Methods: Hemostatic abnormalities in patients with thrombocytopenia, including those with idiopathic thrombocytopenic purpura (ITP), were examined using clot wave analysis (CWA)–small-amount tissue-factor-induced FIX activation (sTF/FIXa) and thrombin time (TT). Results: Although there were no marked differences in the three parameters of activated partial thromboplastin time (APTT) between normal healthy volunteers and typical patients with ITP, the peak heights of the CWA-sTF/FIXa were markedly low in patients with ITP. The three peak times of the CWA-sTF/FIXa in patients with a platelet count of ≤8.0 × 1010/L were significantly longer than those in patients with a platelet count > 8.0 × 1010/L and the peak heights of the CWA-sTF/FIXa in patients with a platelet count of ≤8.0 × 1010/L were significantly lower than those in patients with >8.0 × 1010/L. The peak heights of the CWA-APTT in patients with ITP were significantly lower than in patients with other types of thrombocytopenia. The three peak heights of the CWA-sTF/FIXa in ITP patients were significantly lower than those in patients with other types of thrombocytopenia. The CWA-TT showed lower peak heights and longer peak times in patients with ITP in comparison to patients with other types of thrombocytopenia. Conclusions: The CWA-sTF/FIXa and CWA-TT results showed that blood coagulation is enhanced by platelets and that the blood coagulation ability in ITP patients was low in comparison to healthy volunteers and patients with other types of thrombocytopenia.


PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261429
Author(s):  
Ekaterina M. Koltsova ◽  
Maria A. Sorokina ◽  
Alexandra S. Pisaryuk ◽  
Nikita M. Povalyaev ◽  
Anastasia A. Ignatova ◽  
...  

Background Coagulation system is heavily involved into the process of infective endocarditis (IE) vegetation formation and can facilitate further embolization. In this study we aimed to assess the coagulation and platelet state in IE implementing a wide range of standard and global laboratory assays. We also aim to determine whether prothrombotic genetic polymorphisms play any role in embolization and mortality in IE patients. Methods 37 patients with IE were enrolled into the study. Coagulation was assessed using standard coagulation assays (activated partial thromboplastin time (APTT), prothrombin, fibrinogen, D-dimer concentrations) and integral assays (thromboelastography (TEG) and thrombodynamics (TD)). Platelet functional activity was estimated by flow cytometry. Single nuclear polymorphisms of coagulation system genes were studied. Results Fibrinogen concentration and fibrinogen-dependent parameters of TEG and TD were increased in patients indicating systemic inflammation. In majority of patients clot growth rate in thrombodynamics was significantly shifted towards hypercoagulation in consistency with D-dimers elevation. However, in some patients prothrombin, thromboelastography and thrombodynamics were shifted towards hypocoagulation. Resting platelets were characterized by glycoprotein IIb-IIIa activation and degranulation. In patients with fatal IE, we observed a significant decrease in fibrinogen and thrombodynamics. In patients with embolism, we observed a significant decrease in the TEG R parameter. No association of embolism or mortality with genetic polymorphisms was found in our cohort. Conclusions Our findings suggest that coagulation in patients with infective endocarditis is characterized by general hypercoagulability and platelet pre-activation. Some patients, however, have hypocoagulant coagulation profile, which presumably can indicate progressing of hypercoagulation into consumption coagulopathy.


Author(s):  
Anjaly M. V. ◽  
Sindhu K. R. ◽  
Usha N. P. ◽  
Ajithkumar S. ◽  
Justin Davis K

Coagulatory abnormalities are common in renal dysfunction in humans. The studies on coagulatory abnormalities in renal failure in dogs are limited. The present paper deals with coagulation profile in acute and chronic kidney disease in dogs. The haemostatic defects observed in acute renal dysfunction included thrombocytopaenia, prolonged capillary bleeding time (CBT), elevated D-Dimer and hypoantithrombinemia which indicated a hypercoagulable state. Prolongation of prothrombin time (PT), activated partial thromboplastin time (aPTT), elevated D-Dimer concentration and hypoantithrombinemia in chronic kidney disease indicated the presence of hypocoagulable state


2021 ◽  
Vol 11 (6-S) ◽  
pp. 114-122
Author(s):  
Tahia Jafar Abdo Alhakam Eshag ◽  
Maye M. Merghani ◽  
Nihad Elsadig Babiker

Background: Coagulation, also known as blood clotting, is the process by which blood convert from a liquid to a gel, forming a blood clot. It referred to haemostasis, the stopping of blood loss from a damaged vessel, followed by repair. Material and methods: This was cross sectional study conducted at the albawasla medical laboratory, Khartoum, Sudan during the period August to November, 2021 and to evaluate the effect of time and hemolysis on prothrombin time and activated partial thromboplastin time tests. 50 samples (case group) were collected from the patients attending police teaching hospital   and requested to the PT and APTT test in addition to that,50 apparently healthy donors with no history of any coagulation problems or any chronic disease were selected as control group. Three ml of venous blood samples were collected in container with Tri Sodium Citrate anticoagulant. The coagulation tests (PT and APTT) were performed using semiautomatic device (coagulometer machine MI). Results:  The result of this study revealed that; when compared the measurement of PT and APTT immediately and after one hour there was insignificant differences (p. v.>0.05).  also when compared the measurement of PT and APTT between hemolyzed and non-hemolyzed samples there was significant differences ( p. v.<0.05)  in addition when compared case and control for the PT and APTT immediately,  after one hour, hemolyzed and non-hemolyzed sample there was significant differences ( p. v.<0.05) except the APTT hemolyzed samples  and  insignificant differences with age and gender ( p. v.>0.05).  For the correlation there was significant correlation in the case group for the PT and APTT immediately, after one hour, and hemolyzed samples. Conclusion: In the cases group results showed insignificant differences in the results of PT and APTT between immediate sample and after 1 hour in and significant differences in the results of PT and APTT between hemolyzed and non-hemolyzed samples, also there was insignificant differences between age and gender, immediately, after one hr. and hemolyzed sample in PT and APTT. Keywords:  Homeostasis,  hemolyzed  sample, PT and APTT


2021 ◽  
Vol 16 (5) ◽  
Author(s):  
Johanes Nugroho ◽  
Ardyan Wardhana ◽  
Dita Aulia Rachmi ◽  
Eka Prasetya Budi Mulia ◽  
Maya Qurota A'yun ◽  
...  

Context: COVID-19 severe manifestations must be detected as soon as possible. One of the essential poor characteristics is the involvement of coagulopathy. Simple coagulation parameters, including prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (aPTT), and platelet, are widely accessible in many health centers. Objectives: This meta-analysis aimed to determine the association between simple coagulation profiles and COVID-19 in-hospital mortality. Method: We systematically searched five databases for studies measuring simple coagulation parameters in COVID-19 on admission. The random-effects and inverse-variance weighting were used in the study, which used a standardized-mean difference of coagulation profile values. The odds ratios were computed using the Mantel-Haenszel formula for dichotomous variables. Results: This meta-analysis comprised a total of 30 studies (9,175 patients). In our meta-analysis, we found that non-survivors had a lower platelet count [SMD = -0.56 (95% CI: -0.79 to -0.33), P < 0.01; OR = 3.00 (95% CI: 1.66 to 5.41), P < 0.01], prolonged PT [SMD = 1.22 (95%CI: 0.71 to 1.72), P < 0.01; OR = 1.86 (95%CI: 1.43 to 2.43), P < 0.01], prolonged aPTT [SMD = 0.24 (95%CI: -0.04 to 0.52), P = 0.99], and increased INR [SMD = 2.21 (95%CI: 0.10 to 4.31), P = 0.04] than survivors. Conclusions: In COVID-19 patients, abnormal simple coagulation parameters on admission, such as platelet, PT, and INR, were associated with mortality outcomes.


2021 ◽  
Vol 2 (24) ◽  

BACKGROUND Factor XI deficiency, also known as hemophilia C, is a rare inherited bleeding disorder that may leave routine coagulation parameters within normal range. Depending on the mutation subtype, prolonged activated partial thromboplastin time may occasionally be found. The disease has an autosomal transmission, with an estimated prevalence in the general population of approximately 1 in 1 million. Heterozygosis accounts for partial deficits, but the tendency to bleed is unrelated to the measured activity of factor XI. Diagnosis usually follows unexpected hemorrhages occurring spontaneously or after trauma or surgical procedures. OBSERVATIONS Few cases have been reported in the neurosurgical literature, all occurring spontaneously or after head trauma. Owing to its subtle features, the true incidence of the disease is probably underestimated. The authors report a case of a patient with previously undiagnosed factor XI deficiency who underwent uncomplicated resection of a fourth-ventricle papilloma and experienced delayed, severe hemorrhagic complications. LESSONS The known association between choroid plexus tumors and intracranial bleeding raised differential diagnosis issues. This report may serve to help to investigate delayed hemorrhages after cranial surgery.


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