Clinical Laboratory and Immunology, National Multipro le Transport Hospital So a. Clinic of Cardiology, National Multipro le Transport Hospital So a
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1 . 1, , 2, HAEMOSTASIS INDICES IN ROUTINE DIAGNOSTIC K. Ikonomova 1, V. Mincheva 2 and M. Atanasova 1 1 Clinical Laboratory and Immunology, National Multipro le Transport Hospital So a 2 Clinic of Cardiology, National Multipro le Transport Hospital So a., -. -, -,. - :, -,.,.. :,,, Summary. Haemostasis is a complex physiological mechanism responsible for stopping the bleeding in cases of vessel-wall damage while keeping the liquid state of the circulation. It can be described as a combination of two processes: blood clotting with thromb formation in particular, and brinolysis, the degradation of a formed thromb. Clinico-laboratory methods for haemostasis can be divided into several groups: methods for examination of primary and secondary haemostasis, methods for examination of coagulation inhibitors, methods for examination of brinolysis. The methods for examination of haemostasis are applied in the diagnosis of haemoragic diatheses and thrombosis as well as in monitoring anticoagulant therapy. With the introduction into the clinical practice of the new oral anticoagulants, new requirements are raised to the current laboratory methods and laboratory tests. Key words: coagulation, brinolysis, anticoagulants, laboratory methods and indices,,,,, 16, 2014, 4. -,., (in 49
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7 4., -,,, 16, 2014, 4 I XII, - PF1 + 2,, -,,,, - III, Pr C, III ( - II, IX, X, XI, XII), ( V, VIII), S ( C), Z ( X),TFPI ( ) o,, t-pa ( - PAI ( ),, 2-, TAFI ( ,, DD, :, ( - ). ( ) - (aptt)., ( - ). ( ).,. ( ).,. ( ). - - (s), (%) INR (International Normalized Ratio). - ( ) INR VIII e -. -, VIII. -.,,, [8].. 6., -. 5., - - / - ( ),,, XII, XI, IX, VIII III ( ), - VII X, V, II -,, XIII ( - II, IX, X, XI, XII), C ( V, VIII), S ( C), Z ( X), TFPI ( ), tpa ( ), -, PAI-1 ( 1), PAI-2 ( 2), 2-, 2-, TAFI ( - - ) 55
8 ,. -., ù., , [1]., -, [3]. - : Pr C Pr S, III - t-pa, -, PAI -,, -,. - 4, - -, III, DD,,, -, DD..,,,, -., DD. -,, X, Y, D,, DD. 6., ,,,,,,,,,, - -,, -,,,, t-pa, -, PAI,,, III, HC II, Pr C/S, TFPI. - Pr C Pr S, III, V,, ( - ), ( ),,, -. -, [11].. PF 1 + 2,, -,,,, III, Pr C,.. -,,,,, - II, V, VII, VIII, X, XIII,.. -,, DD,,,,. - : -, - ( 56.,...
9 7.,, - : (. 15 ) (. 5 ) ( -, - ) III. II, IX, X, XI,XII. 1,5-2, ,,,, ( ),, -.,., - II, VII, IX, X, protein C, protein S, INR. INR 2-4. INR ,,,,.., -,,, -,,,, DD III),,, [5]. :,,, [2].,,,,.,,. -,, ,. -.., ,....., 2007., 16, 2014, 4 57
10 3. Bertina, R. M. The role of procoagulants and anticoagulants in the development of venous thromboembolism. Thromb. Res., 123, 2009, Suppl. 4, Boisclair, M. D., D. A. Lane t J. T. Wilde. A comparative evaluation of assays for markers of activated coagulation and/ or brinolysis: thrombin antithrombin complex, D-dimer and brinogen/ brin fragment E. Br. J. Haematol., 74, 2008, 4, Borensztajn, K. et C. A. Spek. Blood coagulation factor Xa as an emerging drug target. Exp. Opin Ther. Targets, 15, 2011, 3, C e s a r i, M., M. Pahor et R. A. Incalzi. Plasminogen activator inhibitor-1 (PAI-1): A key factor linking brinolysis and age-related subclinical and clinical conditions. Cardiovasc. Therap., 28, 5, C o x, S. Coagulation factors-attributes and future directions. Thromb. Haemost., 102, 2009, 3, Favaloro, E. J. et G. Lippi. Laboratory testing of anticoagulants: the present and the future. - Pathology, 43, 2011, 7, K e m p t o n, C. L. et al. Platelet heterogeneity: variation in coagulation complexes on platelet subpopulations. Arterioscler. Thromb. Vasc. Biol., 25, 2005, 4, Kranjc, A. et D. Kikelj. Inhibitors of the blood coagulation enzymes. Curr. Med. Chem., 11, 2004, 19, L e v i, M. DIC: Which laboratory tests are most useful. - Elsevier, 25, 2011, 1, Lippi, G., E. J. Favaloro et M. Franchini et G. C. Guidi. Milestones and perspectives in coagulation and hemostasis. Semin. Thromb. Hemost., 35, 2009, 1, Mann, K. G. et al. Models of blood coagulation. - Blood Cells Mol. Dis., 36, 2006, 2, M o r e l, O. et al. Platelet microparticles and vascular cells interactions: a checkpoint between the haemostatic and thrombotic responses. Platelets, 19, 2008, 1, Panteleev, M. A., M. V. Ovanesov et D. A. Kireev. Spatial propagation and localization of blood coagulation are regulated by intrinsic and protein C pathways, respectively. Biophys. J., 90, 2006, 5, P i a z z a G., J. Fanikos et M. Zayaruzny. Blood coagulation, brinolysis and cellular haemostasis. Thromb. Haemost., 102, 2009, 3, P r e i s s n e r, K. T. Physiology of blood coagulation and brinolysis. Hamostaseologie, 28, 2008, 5, Riddel, J. P. et al. Theories of blood coagulation. J. Pediatr. Oncol. Nurs, 24, 2007, 3, : ikonomovak@yahoo.com 1431,... 1./ ,...
Keywords: anti-coagulants, factor Xa, QSAR, Thrombosis. Introduction
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