Veleszületett és szerzett thrombosiskészség laboratóriumi vizsgálatának lehetőségei

Abstract

Thrombophilia can be defined as an increased, persistent tendency to hypercoagulability and venous thrombosis. The laboratory examination of thrombophilia is a costly and time-consuming process, as each defect should be separately investigated such as deficiencies of antithrombin (AT), protein C (PC), protein S (PS), FV Leiden mutation, prothrombin gene mutation. A single laboratory test for detecting multifactorial thrombophilia would be useful. It would be desirable both for patients and doctors to have a reliable global coagulation test that can differentiate patients who have or do not have hereditary thrombophilia. The Coagulation Inhibitor Potential (CIP) is a promising new global test. In the first part of the study, our aim was to adapt the manual application of the original CIP method to an optical coagulation analyser, to examine reproducibility and reliability of the CIP method and to measure the samples of the healthy subjects and the patients with hereditary thrombophilia. According to our results, CIP was found to be a suitable and reliable test to differentiate between the healthy subjects and the patients with thrombophilia. It could be possible that only those patients need to be further tested with special thrombophilia tests who have positive CIP results. By automation the CIP test would be easier, faster and more precise allowing the performance of simultaneous analyses of samples. The possible random errors of the manual laboratory activity could also be eliminated. In the second part of the study, we examined blood coagulation tests (prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen and D-dimer) of samples from uncomplicated pregnancies at gestational weeks 16, 26 and 36. In addition the CIP method was used on this samples. Our results confirm that pregnancy is associated with a progressively increasing hypercoagulable state and risk factors for venous thromboembolism. We established specific reference intervals and cut-off values for these conventional routine blood coagulation parameters for gestational weeks 16, 26 and 36. Our results could support appropriate clinical decision making.