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1 診断 治療 技術講座 2018; 29 4 : APTT 波形解析 APTT waveform Hideo WADA Key words: APTT, waveform, hemophilia, anticoagulant therapy NIH / activated partial thromboplastin time: APTT APTT f 1a APTT 1 st derivative 2 2 nd derivative 2 APTT APTT 1 st derivative velocity: v 1b 2 nd derivative acceleration: a 1c APTT 2 biphasic pattern: bp Tel: Fax: wadahide@clin.medic.mie-u.ac.jp , 3 a v 1/2 1/2f 3 1a 1v 1-1/2f 1 2a 1 2 2a 2 2v 1/2 2-1/2f 4 1 3a 1 2 3a 2 3v d 1 st derivative 2 nd derivative VIII FVIII lupus anticoagulant: LA APTT Instrumentation Laboratory IL IL ACL-TOP 29 4
2 414 1 APTT a f 1 b First derivative v 2 c Second derivative a 3 3 APTT 2a c A B LA APTT APTT bp APTT 4 APTT 3 bp APTT 1a 1v 1-1/2f 3 2a 2v LA LA APTT FVIII APTT r= a 1 2a 2 r= APTT 2a 1 2a 2 APTT FVIII APTT FVIII 5
3 415 2 a b c d APTT 4 4 APTT 2d 2a 2v 1a 1v 1/2 1-1/2f 2 3v 3a 2 direct oral anticoagulant DOAC 2a 2v 1a 1v 1/2 1-1/2f DOAC 3 DOAC APTT DOAC APTT APTT Xa 6 Xa APTT r<0.2 deep vein thrombosis: DVT DVT APTT 29 4
4 416 1 FVIII APTT APTT P P= Y= X P< Y= X P< Y= X P= Y= X P= Y= X P=0.013 Y= X P= Y= X P= Y= X 1/ P= Y= X 1/ P= Y= X APTT P= Y= X P= Y= X APTT: activated partial thromboplastin time 6 3 APTT a DVT b DVT cd 5
5 417 4 APTT a b 1 c MB: **P<0.001 *P< APTT DVT major bleeding: MB MB 1v 1 3a 1 2v 1v 3a 1 2v APTT 5 APTT 1 1a 1 1v A B LA Xa disseminated intravascular coagulation: DIC 5a b 1 2a 1 A B DIC Xa 5c 2v Xa 5d 1 3a 1 A B LA Xa DIC 5e 3v A B LA Xa DIC 29 4
6 418 2 APTT s HH HHH BBB mabs/ H HHH HHH BBB 2 mabs/ H HH HHH HHH BBB HHH BBB mabs/ HHH HHH /2 1/2 mabs HHH BBB 1/ HH HHH BBB mabs: m-absorbance H p<0.05 HH p<00.1 HHH p<00.1 B p<0.05 BB p<00.1 BBB p< f 2a 1 2v 1 6 thromboelastgram: TEG thrombin generation test: TGT TEG TGT VIII APTT FVIII APTT 7 APTT APTT 7 1 APTT 2 APTT APTT VIII 3 APTT DOAC 4 APTT LA 5 APTT 6 COI
7 419 5 APTT HV HA A HB B Inhibitor FVIII apl + warfarin Anti-Xa Xa PW TP DIC *p<0.05 **p<0.01 ***p<
8 420 1 Toh CH, Giles AR: Waveform analysis of clotting test optical profiles in the diagnosis and management of disseminated intravascular coagulation (DIC). Clin Lab Haematol 24: , Matsumoto T, Nogami K, Shima M: A combined approach using global coagulation assays quickly differentiates coagulation disorders with prolonged aptt and low levels of FVIII activity. Int J Hematol 105: , Matsumoto T, Wada H, Fujimoto N, Toyoda J, Abe Y MR, Ohishi K, Yamashita Y, Ikejiri M, Hasegawa K, Suzuki K, Imai H, Nakatani K, Katayama N: An evaluation of the activated partial thromboplastin time waveform. Clin Appl Thromb Hemost 24: , Katayama H, Matsumoto T, Wada H, Fujimoto N, Toyoda J, Abe Y, Ohishi K, Yamashita Y, Ikejiri M, Habe K, Katayama N: An evaluation of hemostatic abnormalities in patients with hemophilia according to the activated partial thromboplastin time waveform. Clin Appl Thromb Hemost Matsumoto T, Nogami K, Tabuchi Y, Yada K, Ogiwara K, Kurono H, Arai N, Shima M: Clot waveform analysis using CS-2000i distinguishes between very low and absent levels of factor VIII activity in patients with severe haemophilia A. Haemophilia 23: e427 e435, Hasegawa M, Wada H, Tone S, Yamaguchi T, Wakabayashi H, Ikejiri M, Watanabe M, Fujimoto N, Matsumoto T, Ohishi K, Yamashita Y, Katayama N, Sudo A: Monitoring of hemostatic abnormalities in major orthopedic surgery patients treated with edoxaban by APTT waveform. Int J Lab Hematol 40: 49 55, Nogami K, Matsumoto T, Tabuchi Y, Soeda T, Arai N, Kitazawa T, Shima M: Modified clot waveform analysis to measure plasma coagulation potential in the presence of the anti-factor IXa/factor X bispecific antibody emicizumab. J Thromb Haemost 16: , 2018.
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2015; 26 6 : 658-668 自己免疫性出血病 FXIII/13 診断ガイド Guidance on Diagnostic Criteria for Autoimmune Hemorrhaphilia FXIII/13(AHFXIII/13) FXIII/13 659 Contents 1 660 2 660 3 660 4 661 5 661 6 661 7 661 8 661 9 662
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Study of Health Monitoring of Vehicle Structure by Using Feature Extraction based on Discrete Wavelet Transform Akihisa TABATA *4, Yoshio AOKI, Kazutaka ANDO and Masataka KATO Department of Precision Machinery
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無水エタノールによる硬化療法および鼻粘膜癒着処置を施行したオスラー病による難治性鼻出血の１例
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Basic examination of an automated coagulation analyzer, Coapresta 2000, and introduction to 24-hour emergency service Yuji Oikawa, Nobuaki Matsumoto, Yukiko Seki and Makoto Suzuki Recently, in addition
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