Author/Editor		Mlakar, Uroš; Preložnik-Zupan, Irena; Strauch, Rika
Title		Ocena primarne hemostaze z analizatorjem trombocitne funkcije PFA-100
Translated title		Evaluation of primary haemostasis with platelet function analyser PFA-100
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 73, št. 6
Publication year		2004
Volume		str. 485-8
Language		slo
Abstract		Background. Laboratory evaluation is indicated when a disorder of primary haemostasis is suspected by a personal or family history of easy bruising nose bleed.s, menorrhagia or postoperative bleeding, especially following dental extraction or tonsillectomy. The traditional procedures to diagnose defect in primary haemostasis are bleeding time, measurement of von Willebrand factor and platelet aggregometry. The most widely used screening test is bleeding time. Despite attempts at standardisation, the bleeding time remains poorly reproducible and is relatively insensitive to platelet function defects. Recently, a new test method, the platelet function analyser (PFA-100) has been introduced for the investigation of primary haemostasis. PFA-100 measures the ability of platelets activated in a high-shear environment to occlude an aperture in membrane treated with collagen and epinephrine and/or collagen and ADP. The time taken for flow across the membrane to stop (closure time) is recorded. Conclusions. This article highlights the benefits and limitations of the clinical utility of the PFA-100. Because of its simplicity and excellent sensitivity the PFA-100 is useful mainly as a screening test for von Willebrand disease, hereditary and acquired platelet-dysfunctions including acetylsalicylic acidinduced abnormadities. Recently the PFA-100 has been shown to be. of value in monitoring antiplatelet therapy and in monitoring desmopressin treatment in von Willebrand disease.
Summary		Izhodišča. Za laboratorijsko diagnostiko motnje primarne hemostaze se odločimo pri nagnjenosti k podplutbam, pripogostih krvavitvah iz nosu, menoragiji ali pooperativni krvavitvi, zlasti po izruvanju zob ali tonzilektomiji. Običajno se za ugotavljanje motenj v primarni hemostazi uporabljajo čas krvavitve (ČK), merjenje von Willebrandovega faktorja (vWF) in agregometrija. Kot presejalni test za ugotavljanje motnje primarne hemostaze se je do nedavnega uporabljal predvsem ČK. Občutljivost testa za ugotavljanje motnje funkcije trombocitov in ponovljivost testa je slaba. Uvedba merjenja zapiralnega časa (ZČ) z analizatorjem PFA-100 odpravlja mnoge slabosti, ki spremljajo določanje ČK. Z ZČ merimo nastanek trombocitnega strdka, ki zamaši odprtino v membrani, skozi katero teče kri. Strdek nastane zaradi delovanja velikih strižnih sil na trombocite in prisotnih agonistov na membrani. Uporabi se lahko testna celica, ki ima na membrani kolagen in adrenalin in/ali celica s kolagenom in ADP. Analizator izmeri čas, ki je potreben, da nastali trombocitni strdek ustavi pretok krvi skozi membrano. Zaključki. V članku obravnavamo prednosti in omejitve klinične uporabe analizatorja PFA-100. Zaradi enostavne izvedbe in dobre občutljivosti je ZČ primerna presejalna preiskava za ugotavljanje von Willebrandove bolezni, prirojenih napak trombocitov in pridobljene okvare funkcije trombocitov zaradi bolezni in zdravil (acetilsalicilna kislina). Test lahko uporabljamo tudi za vodenje zdravljenja von Willebrandove bolezni z dezmopresinom. Omogoča tudi spremljanje zdravljenja z antiagregacijskimi zdravili.
Descriptors		PLATELET FUNCTION TESTS BLOOD PLATELET DISORDERS PLATELET AGGREGATION BLEEDING TIME