*Blood Coagulation Tests ; *Hemophilia A ; *Child

OBJECTIVE: To compare the plasma components of frozen plasma (FP) and fresh frozen plasma (FFP). METHODS: Twenty samples of FP and 20 samples of FFP from Beijing Red Cross Blood Center were randomly selected. Immediately after plasma melting, 12 plasma components including coagulation factor, fibrinolytic system and anticoagulation protein were detected, including activated partial thromboplastin time (APTT), prothrombin time (PT), coagulation factor Ⅷ (FⅧ) activity, coagulation factor Ⅴ (FⅤ) activity, fibrinogen(FIB) level, ADAMTS-13 activity, von Willebrand factor(vWF) activity, D-dimer (D-dimer, DD), fibrin degradation products (FDP), antithrombin (AT), protein C (PC), and protein S (PS). All these coagulation components between the two types of plasma were compared and analyzed. RESULTS: Compared with FFP, APTT in FP was significantly prolonged(t=3.428, P<0.01), and PT was also significantly prolonged(z=-2.140, P<0.05), and FⅧ activity was decreased (t=-3.372, P<0.01), but all in the reference range, and PS activity was decreased(t=-2.458，P＜0.05), there was no statistical difference in the other part between two types of plasma(P>0.05). CONCLUSION FP can substitute FFP in the treatment of some diseases, although it is lack of some coagulation factors and anticoagulation protein.
Beijing ; Blood Coagulation ; Blood Coagulation Factors ; Blood Coagulation Tests ; Humans ; Plasma

The purpose of this study was to investigate the influence of blood coagulation reagents stored for different time on test results of the specimens prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and fibrinogen (Fib). A total of 21 patient plasma specimens was taken and measured for homeostasis by Sysmex CA7000 automated blood coagulation analyzer and supporting reagent. The PT, APTT, TT and Fib of specimens were measured with the reagents stored in Sysmex CA7000 for different time. The differences of PT, APTT, TT and Fib were analyzed between values measured of the reagents stored for 0 hour and different time (TS:12, 24, 36,48, 60, 72 h; DA:24, 48, 72, 96, 120 h; TT:2, 4, 6, 8, 10, 12 h; TR:4, 8, 12, 16, 20, 24 h; OVB:1, 2, 3, 4, 5 ,6 h), respectively. The results showed that when coagulation reagent TS were stored for more than 48 h , DA 96 h, TT 10 h, TR 16 h and OVB 4 h, the values of PT, APTT, TT and Fib of samples were statistically different from the values measured with fresh coagulation reagent (P < 0.01), respectively. Compared 0 h with TS stored for 48-72, DA 96-120, TT 10-12, TR 16-24 and OVB 4-6 h, the percentage difference of PT, APTT, TT and Fib is in -2.6% ∼ 10.8%, -3.44% ∼ 4.8%, -3.9% ∼ 5.52%, -10.8% ∼ 3.3% and -17.2% ∼ 0.5%, the PT and Fib changes were more significant. Accordingly, the result of PT, APTT and TT had a uptrend as the reagent stored in Sysmex CA7000 analyzer for a long time, while Fib downtrend. It is concluded that the reagents showed be timely replaced when the plasma coagulation test is performed so as to obtain accurate results of examination.
Blood Coagulation ; Blood Coagulation Tests ; Blood Preservation ; methods ; Fibrinogen ; Hemostasis ; Humans ; Indicators and Reagents

OBJECTIVEThrough researching preoperative coagulation function in the case of ABO-identical blood insufficient for emergency rescue transfusion according to recommended programs of special emergency rescue transfusion was carried out, the relationship between volume of blood products and coagulation function was analyzed.

METHODSThe surgical cases of blood transfusion more than 1 600 ml during operation were collected in our hospitals from Aug 2015 to Dec 2016（n=218）, these cases were divided into the normal coagulation group（Group A） and abnormal coagulation group（Group B）, and the patients of emergency rescue transfusion O type blood group（Group C）. The basic information of cases, the infused volume of red blood cell（RBC）, virus-inactivated frozen plasma（VIFP）, fresh frozen plasma（FFP）, cryoprecipitate（C）and platelets（P）, prothrombin time（PT）, activated partial thromboplastin time（APTT）, fibrinogen（FIB）and international normalized ratio（INR）were analyzed, the relationship between volume of blood transfusion and coagulation function were also analysed. At the same time, the efficiency and safety index were compared before and after transfusion. These indexes, such as hemoglobin（Hb）, indirect bilirubin（IBiL）, direct antiglobulin test（DAT）and irregular antibody were determined at the time-paints of 24 h, 3 d and 7 d after blood transfusion.

RESULTSThe differences of age and blood type between group A and B was not statistically significant（P>0.05）. Proportion of A and AB type，transfusion volume of RBC, FFP, C and Plt all were significantly higher in group C （P<0.05）. PT, APTT, FIB and INR in group B and C were significantly different（P<0.05）, which related with the transfusion volume of RBC, FFP and C（P<0.05）. DAT and irregular antibody in every group was all negative before transfusion, No any new irregular antibodies had been detected after transfusion. Hb after blood transfusion was not statistically different before and after transfusion in group C, the IBiL level also was not significantly increased after blood transfusion（P > 0.05）. All those showed that emergency rescue transfusion was safe and effective.

CONCLUSIONPreoperative coagulation function is one of factors inflnencing blood products transfusion volume during operation, which also is the basis for evaluating bleeding and blood transfusion. Emergency O type blood and ABO-matched blood transfusions show the same efficiency and safety.

Viscoelastic coagulation tests provide simultaneous measurements of multiple aspects of whole-blood coagulation, including interactions between the plasma components and cellular components of the coagulation cascade. This can be carried out immediately using a point of care technique. Viscoelastic tests could predict the patient's outcome, including mortality, and detect coagulopathy more sensitively, resulted in reduced blood loss. The transfusion strategy based on the viscoelastic parameters rather than a conventional coagulation test has been shown to reduce the transfusion requirements. Although there are concerns about the reliability and accuracy of this method, viscoelastic tests, including ROTEM, would be a useful method to guide patient blood management strategies.
Blood Coagulation Disorders ; Blood Coagulation Tests ; Blood Transfusion ; Humans ; Methods ; Mortality ; Plasma ; Point-of-Care Systems ; Thrombelastography

OBJECTIVE: To investigate the correlation and consistency between thromboelastography (TEG) and routine tests, platelets count in different coagulation states (hypercoagulable, low coagulation, and normal coagulation) and to evaluate the clinical value of TEG, routine bloot test and Plt count. METHODS: The clinical data of 409 patients performed the TEG, coaglation 4 test and blood routine test in third Xiangya Hosptial of Central Sonth University from January 2015 to December 2017 were analyzed retrospectively. The TEG main parameters such as the activation time of clothing factor (R), the formation rate of blood clots (K), the maximal α-angle (Angle) and maximal amplitude (MA) were compared with prothrombin time (PT), activated partial thromboplastin time (APTT), fibrin (Fib), thrombin time (TT) in blood routine test as well as platelet (Plt) counts by using the person correlation, Kappa consistency and paired chi-square test in different coagulation states, at the same time the guiding rote of these 2 detection mathods for clinical application of blood was compared. RESULTS: R value positively correlated with PT, the correlation coefficient (r) under low, high and normal coagulation status was 0.376, 0.316 and 0.276 respectively (P<0.05); the Kruskal-Wallis test of pairwise comparison showed no statistical difference (P>0.05); the consistency of R with PT under low, high and normal coagalation status was 0.208, 0.227 and 0.131, respectively. The R value positively correlated with APTT, r value under low, high and normal coagulation status was 0.418, 0.258 and 0.458 respectively (P<0.05); the Kruskal Walls test of pairwise comparion showed that there was no difference between value of low and normal coagulation status (P>0.05), while there was difference between r value of low and high coagulation status (P<0.05), the consistences of R value with APTT under low, high and normal coagulatiom status was 0.338, 0.291 and 0.161, with statistical difference (P<0.05). K value negatively correlated with Fib, r value under low, high and mornal coagulation status was -0.611, -0.411 and 0.311 respectively (P<0.05); the Kruskal-Wallis test of pairwise comparison all showed that statistical difference (P<0.05); the consistencey of K value with Fib was 0.432, 0.481 and 0.323 respectively under low, high and normal coagulation states. K value negatively correlated with plt count, r value under low, high and normal coagulation status was -0.278, -0.238 and -0.278 respectively (P<0.05); the consistency of K value with Fib level under low,high and normal coagulation status was 0.401, 0.312 and 0.279 respectively(P<0.05). Angle postively correlated with Fib level, r value under low, high and normal coagulation status was 0.638, 0.538 and 0.438 respectively (P<0.05); the Kruskal-Wallis test of pairwise comparison showed the statistical difference (P<0.05); the consistency of Angle with under low,high and normal coagulation status Fib was 0.323, 0.357 and 0.288 respectively(P<0.05). MA value positively correlated with Fib level (r=0.351, 0.381 and 0.211, P<0.05); the Kruskal-Wallis test of pairwise comparison showed that there was no difference of r value under low- and high-coagulation states (P>0.05), while there were differences of r values under low- and high-coagulation states with normal coagulation (P<0.05); the consistency of MA with Fib level under 3 kinds of coagulation states was 0.510, 0.467 and 0.427 respectively (P<0.05). MA value positively correlated with Plt count (r=0.478, 0.515 and 0.378) respectively under 3 kinds of coagulation states; the Kruskal-Wallis test of pairuse comparison both showed the statistical difference (P<0.05); the consistency of MA with Plt count under 3 kinds of coagulation status was 0.581, 0.461 and 0.350 (P<0.05). CONCLUSION The TEG correlates with results of blood coagulation test and Plt detection; the correlation and consistecy of TEG with routine blood coagalation test and Plt detection are different under different status. Therefore, for patients who possibly had pathologic hyper- and hypo-coagulation, the TEG detection should be performed, so as to dynamically monitor the blood coagulation in vivo, guide the rational use of drugs and blood transfusion, reduce the risk of embolion and blood transfusion.
Blood Coagulation ; Blood Coagulation Tests ; Humans ; Platelet Count ; Retrospective Studies ; Thrombelastography

OBJECTIVE: To analyze the level of coagulation function indexes in patients with lymphoplasmacytic lymphoma (LPL) and its clinical significance. METHODS: The clinical data of 32 patients with initial LPL (LPL group) and physical examination data of 25 healthy persons (control group) who underwent physical examination in our hospital during the same period were collected. The differences of platelet (Plt), D-Dimer (D-D), fibrinogen (Fib), thrombin time (TT), prothrombin time (PT) and activated partial thrombin time (APTT) between the two groups were compared. RESULTS: The Plt count in LPL group [ (137.06±40.14)×10/L] was significantly lower than that in control group [ (215.07±33.25)×10/L], D-D [ (1.01±0.16) mg/L, PT [ (13.01±1.37) s] and APTT [ (40.96±7.24) s] in LPL group were significantly higher than those in control group [ (0.37±0.09) mg/L, (11.96±0.87) s, (25.07±5.13) s] (P＜0.01); there was no significant difference in TT and Fib levels between the two groups (P＞0.05). There was no significant difference in Plt, D-D, Fib, AP, TT and APTT among LPL patients secreting different types of immunoglobulin (Ig) (P＞0.05). After treatment, the coagulation function of LPL patients returned to normal, and no death cases occurred due to hemorrhage or thrombosis. CONCLUSION LPL patients have hypercoagulable state blood and abnormal coagulation function, but which not closely relates to with the type of Ig secreted by patients.
Adult ; Blood Coagulation ; Blood Coagulation Tests ; Humans ; Lymphoma ; Partial Thromboplastin Time ; Prothrombin Time ; Thrombosis

OBJECTIVE: To analyze and compare the effects of leukapheresis on hemostatic function in patients with hyperleukocytic leukemia. METHODS: A total of 139 patients with AML, ALL and CML who underwent leukapheresis from June 2009 to February 2020 and did coagulation test before and after operation were included in this study. The clearance efficiency of each group and the difference among three groups were evaluated, as well as hemostatic function including platelet counts, coagulation indicators, CDSS score and incidence of adverse events. The difference of hemostatic function caused by leukapheresis in different leukemia patients were compared. RESULTS: After leukapheresis, the WBC counts were decreased significantly in the three groups of patients (P<0.001), and the clearance efficiency was highest in ALL patients. However, the platelet counts also were decreased significantly (AML:P＜0.001, ALL: P＜0.001, CML: P＜0.01) in the three groups of patients, particularly for acute leukemia patients with a positive correlation with WBC clearance efficiency(r=0.284). After leukapheresis, fibrinogen decreased, PT and APTT prolonged. For acute leukemia patients, higher CDSS score was related to an elevated incidence of bleeding events (P<0.05). CONCLUSION Leukapheresis is an effective method to decrease the leukemic burden, but it is necessary to monitor the impact on hemostatic function. It is recommended to assess the CDSS socre for acute leukemia patients, in order to identify the predictive value for bleedings.
Acute Disease ; Blood Coagulation ; Blood Coagulation Tests ; Hemorrhage ; Hemostatics ; Humans ; Leukapheresis/methods* ; Leukemia, Myeloid, Acute/therapy*

OBJECTIVE: To analyze the results of activated partial thromboplastin time (APTT) mixing test in coagulation factor Ⅷ inhibitor-positive hemophilia patients, so as to increase the value of APTT mixing test in the screen of factor Ⅷ inhibitor. METHODS: Eighty plasmas samples with different titers of coagulation factor Ⅷ inhibitors had been collected and diluted for routine immediate APTT mixing test and at 37 ℃ 2 hours incubation APTT mixing test. Fifteen samples were selected for immediate and normal temperature incubation for 15 min, 30min, 1 hour, 2 hours and 37 ℃ for 30 min, 1 hour, 2 hours APTT mixing test. RESULTS: The results of APTT mixing test were significantly correlated with the titers of coagulation factor Ⅷ inhibitors. The ROC curve result showed that the best diagnostic cut-off value for 2 hours incubation APTT mixing test at 37 ℃ to determine the presence or absence of coagulation factor Ⅷ inhibitors was 43.8 s (sensitivity and specificity was 85.90% and 100%, respectively), while the best diagnostic cut-off value for distinguishing high-titer and low-titer Ⅷ inhibitors was 52.4 s (sensitivity and specificity was 98.18% and 95.65%, respectively). The critical coagulation factor Ⅷ inhibitor titer that could not be corrected by immediate APTT was 5.14 BU/ml, while that could not be corrected by 37 ℃ 2 hours incubation APTT was 1.31 BU/ml. Paired samples t -test was performed on the APTT mixing test results at different times and temperatures, and the differences were statistically significant (P < 0.05). CONCLUSIONS The APTT mixing test can be used as a screening index for coagulation factor Ⅷ inhibitors. APTT mixing test result shows a significant time-temperature dependence with lower titers of coagulation factor Ⅷ inhibitor. Patients with hemophilia who cannot be corrected by immediate APTT mixing test should be alert to the possibility of high titer of coagulation factor Ⅷ.
Humans ; Factor VIII ; Hemophilia A/diagnosis* ; Blood Coagulation Tests/methods* ; Partial Thromboplastin Time ; Blood Coagulation Factors

Blood Coagulation Tests ; Coagulation Protein Disorders ; blood ; physiopathology ; Female ; Humans ; Young Adult