title: [Interpretation of hemostatic and fibrinolytic markers].
abstract: Blood dose not normally coagulate in the blood vessels covered with endothelial cells, because these cells contain some substances responsible for antithrombotic action such as thrombomodulin, heparin-like substance, prostacyclin, nitric oxide and tissue plasminogen activator. Most important role of blood coagulation is hemostasis. Blood can coagulate in two ways: intrinsic coagulation pathway and extrinsic coagulation pathway that is activated by negatively charged substances and FVIIa-tissue-factor (TF) complex, respectively. Prothrombin time(PT) can represent extrinsic pathway, while activated partial thromboplastin time (APTT) can represent intrinsic pathway. PT is prolonged in such diseases as vitamin K deficiency, hepatic failure and warfarin intake, while APTT is prolonged such diseases as hemophilia A & B, von Willebrand disease and lupus anticoagulant. Cross mixing test is very useful to assess prolonged clotting time. FDP means fibrin/fibrinogen degradation products and D-dimer is the smallest products of fibrin degradation. These markers are often used to diagnose disseminated intravascular coagulation (DIC) and deep vein thrombosis (DVT). Thrombin-antithrombin complex (TAT) and plasmin-alpha2 plasmin inhibitor (PIC) can be used to evaluate the extent of coagulation and fibrinolysis activation, respectively. These two markers is essential for classify the pathophysiology of DIC: DIC with suppressed fibrinolysis, enhanced fibrinolysis or balanced fibrinolysis. In conclusion, exact interpretation of hemostatic and fibrinolytic markers is one of the most important abilities in clinical situation.
authors.affiliation: Department of Internal Medicine (III), Kanazawa University School of Medicine, Kanazawa 920-8641, Japan. hasakura@med3.m.kanazawa-u.ac.jp
authors.forename: Hidesaku
authors.initials: H
authors.lastname: Asakura
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage; D001562:Benzimidazoles / Q000008:administration & dosage; D015415:Biomarkers; D001778:Blood Coagulation Disorders / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology / Q000517:prevention & control; D001779:Blood Coagulation Factors; D001792:Blood Platelets; D000069604:Dabigatran; D005338:Fibrin Fibrinogen Degradation Products; D005342:Fibrinolysis; D006487:Hemostasis; D006801:Humans; D010314:Partial Thromboplastin Time; D010960:Plasminogen Activators; D011517:Prothrombin Time; D018180:Thrombomodulin; D014859:Warfarin / Q000008:administration & dosage; D015091:beta-Alanine / Q000008:administration & dosage / Q000031:analogs & derivatives
chemical_list: D000925:Anticoagulants; D001562:Benzimidazoles; D015415:Biomarkers; D001779:Blood Coagulation Factors; D005338:Fibrin Fibrinogen Degradation Products; D018180:Thrombomodulin; D015091:beta-Alanine; D014859:Warfarin; D010960:Plasminogen Activators; D000069604:Dabigatran