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Activated Parteial Thromboplastin Time

The document discusses the activated partial thromboplastin time (APTT) test, which is used to screen for abnormalities in the intrinsic pathway of coagulation. The APTT test measures the clotting time of citrated plasma after the addition of activators of the intrinsic pathway. Prolonged APTT may indicate deficiencies in coagulation factors VIII, IX, XI, XII, or common pathway factors, or may be caused by conditions like disseminated intravascular coagulation, liver disease, heparin therapy, or inherited coagulation disorders. The document also compares the APTT and prothrombin time (PT) tests.

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251 views3 pages

Activated Parteial Thromboplastin Time

The document discusses the activated partial thromboplastin time (APTT) test, which is used to screen for abnormalities in the intrinsic pathway of coagulation. The APTT test measures the clotting time of citrated plasma after the addition of activators of the intrinsic pathway. Prolonged APTT may indicate deficiencies in coagulation factors VIII, IX, XI, XII, or common pathway factors, or may be caused by conditions like disseminated intravascular coagulation, liver disease, heparin therapy, or inherited coagulation disorders. The document also compares the APTT and prothrombin time (PT) tests.

Uploaded by

meshan797
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Practical Hematology 3 Lab5

Activated Partial Thromboplastin Time(APTT)


a. Clinical significance:
The activated partial thromboplastin time(APTT):is used as a general
screening test for the detection of coagulation abnormalities in the
intrinsic pathway. APTT is sensitive to deficiencies or abnormalities of
factors VIII,IX,XI,XII,X,V,II and I.APTT is the most widely used
method for monitoring intravenous heparin anticoagulation therapy.
b. Principle:
In presence of Calcium ions cephaloplastin activates coagulation factors
of intrinsic pathway in plasma leading to clot formation. Clotting time is
proportional to the concentration of factors VIII, IX,XI and XII as well as
common pathway factors II,V and X.
c. Sample required:
Citrated plasma
Nine parts of freshly drawn venous blood are collected into one part of tri-
sodium citrate3.2%. immediately without delay, centrifuge the blood at
3000rpm for 15 minutes. This will provide platelet poor plasma and transfer
the plasma into plastic tube or siliconized glass tube. Do not disturb the
buffy coat while collecting supernatant plasma. The test should be
performed within 2 hours of collecting the blood.
d. Materials required:
 Pipettes and Tips.
 Plastic test tube and racks
 Timer
 Water bath
 Centrifuge
e. Materials provided:
APTT Reagent 1, APTT Reagent 2 and Tri sodium citrate.
f. Procedure:
Bring contents of the vial to room temperature and then swirl gently to mix
to a homogenized suspension. Keep the reagents at 37 C⁰ for 10 min prior to
use.
1. Pipette into a clean and dry plastic tube 0.1 ml of citrated plasma.

Dr.Marwah Ba Jubair Coagulation test


Practical Hematology 3 Lab5

2. Pipette 0.1ml of pre-warmed reagent 2(APTT reagent) in to the test tube.


3. Mix well and incubate exactly for 3 min at 37C⁰(activation time)
4. After that add 0.1 ml of pre-warmed R1(cacl2) into test tube.
5. Mix and start stop watch.
6. Hold the tube in the water bath and tilt the mixture back and forth,
looking for clot formation. When a clot forms stop the stop watch and
record the result.
g. Reference value:
APTT :21----38 seconds.
h. APTT ratio: is used to monitor the use of unfractionated heparin.
APTT of the patient seconds
APTT ratio= APTT of normal plasma ( pool % )∈ seconds

Normal APTT ratio upto1.1


i. Main causes of a prolonged APTT test are:
A prolonged PTT means that clotting is taking longer to occur than
normal and may be due to a variety of causes.
1. DIC(Disseminated intravascular coagulation).
2. Deficiency of clotting factor: prothrombin,V,VIII,IX,X,XI or XII due to
vitamin K deficiency, liver disease ,heparin or warfarin anticoagulant ,or
less commonly an inherited coagulation disorder.

Dr.Marwah Ba Jubair Coagulation test


Practical Hematology 3 Lab5

What are the differences between PT and APTT?


APTT PT
 APTT measures the intrinsic and PT measures extrinsic and
Common pathway. Common pathway.
 Normal value :≤ 38 sec Normal value:≤ 15 sec.
 More steps (longer cascade) Less steps (shorter cascade).
 Slower, but more efficient Faster, but less efficient.
 Preparation: surface activator and Ca++ preparation: tissue extract and
Added to citrated plasma. Ca++added to citrated plasma.
 Factors of intrinsic pathway: Factors of extrinsic pathway:
XII,IX.VIII and XI. III and VII.
 Prolonged in: Prolonged in:
 Heparin Vit K deficiency
 Hemophilia Warfarin
 Liver disease Liver disease
 APS(anti phospholipid antibody syndrome) Factor deficiency
 Warfarin Heparin
 DIC DIC
 VWD APS(antiphospholipid syndrome)

Dr.Marwah Ba Jubair Coagulation test

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