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Cardiac marker POCT status quo(三)

Feb 16, 2018

The overall evaluation of coagulation function

The so-called overall evaluation, refers to such equipment is different from the previous single detection of some aggregates and activity of the method, usually records the blood from coagulation to fibrinolysis of the whole process, so a more comprehensive manner to provide all aspects of the patient's coagulation function Information, has formed a unique POCT categories. At present, there are mainly two kinds of such POCT in the country, which are all based on the viscoelastic change during blood coagulation. Thromboelastogram, the so-called TEG (Thrombelastography, Haemoscope, IL, USA). The curve can directly reflect the coagulation and fibrinolysis of whole blood as the agglutination strength increases and decreases. According to the author's clinical experience in recent years, this method is more standardized than platelet aggregation rate, does not require cumbersome specimen processing, with good reproducibility, the performance evaluation has another statement. Analysis of platelet function on the time there are strict requirements, in principle, should be completed within 2 hours after blood collection in order to reflect the actual level of coagulation in vivo, non-anticoagulant new blood anticoagulant results more reliable than citric acid. TEG and platelet aggregation rate of the overall detection time roughly the same, if further increase its detection speed will bring greater convenience to clinical, RapidTEG recently introduced detection has been greatly improved, but also provide ACT. There is a difference between the results of TEG in measuring arteriovenous blood, the stronger of blood coagulation of arterial blood reflected by TEG, and the gender difference. TEG is widely used in cardiac surgery, liver transplantation, trauma and obstetrics to detect coagulation and fibrinolysis, especially for the prediction of bleeding. Although some scholars prefer traditional clotting tests to be more sensitive and specific, it can not be denied that TEG better reflects coagulation and fibrinolysis than conventional clotting parameters and is closer to the actual situation of coagulation in the body. It suggests bleeding tendency It may be more clinically valuable than a reduction in clotting function that is lacking in single clotting factor or expresses over time. The perfect development of 60 years makes the application of TEG to guide the transfusion of blood components in surgery more and more mature. Unfortunately, no transfusion-related international standards or guidelines have yet been formed, which provides room for our research and application.

Sonoclot (SCT, Sienco, USA) has also been used as a bedside diagnosis in China for a long time. Unlike TEG, Sonoclot uses ultrasonic testing to detect the thrombus's viscoelasticity. This difference brings about a difference in reproducibility. In addition to predicting bleeding, Sonoclot is also used for assessing platelet function, but few are used to guide blood transfusions.

POCT is a subsector of IVDs that provide quick, quick diagnosis of patient outcomes with ease and speed. China's POCT market is still not yet meet the huge blue ocean market demand, domestic enterprises have just begun the import substitution, the current domestic leader in POCT Nanjing Foundation Egg Biotechnology Co., Ltd. has achieved POCT product sales at home and abroad.

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