Mix test (detecting endogenous anticoagulation) in the diagnosis and monitoring of treatment of coagulopathy
Blood clotting disorder is extremely dangerous and can affect the patient's life. To diagnose coagulopathy, a mix test is performed to detect endogenous anticoagulation.
1. Mix test is what test?
Mix test test is performed to mix 1:1 two plasma solutions of patients and normal people, aiming to determine prolonged clotting time in patients due to lack of clotting factors. blood or the existence of substances that inhibit the ability of blood to clot, such as specific antibodies against clotting factors, anti-Lupus antibodies.
Mix test is indicated for the following cases:
The patient's coagulation test results are abnormal for exogenous, endogenous and common coagulation pathways. Test for monitoring in the treatment of patients with circulating anticoagulants.
2. Tests of mix test
Perform a mix test including the following:
Anticoagulation. Exogenous anticoagulation. Temperature and time have no effect on endogenous anticoagulation. Temperature and time have an impact on endogenous anticoagulation.
3. Principles when testing mix test
The principle of the mix test is based on the compensatory ability of coagulation factors to find and detect the existence of circulating inhibitors, in which 50% of the coagulation factors tested have can return to normal.
Coagulation time of a 1:1 mixture of normal and patient plasma (with 1 or more coagulation factors deficient) is close to the clotting time of normal human plasma. The clotting time of a 1:1 mixture of normal and patient plasma (presence of circulating inhibitors) is approximately equal to the clotting time of patient plasma.
4. Sample collection and preservation technique for mix test
Mix test sampling technique is performed as follows:
Step 1: Use gauze, gauze to disinfect the venous area for blood collection. Take about 2ml of patient's blood and 2ml of normal's blood to make "control" plasma (in the absence of commercial control plasma); Step 2: Mix plasma with anticoagulant chemical, which is sodium citrate with a concentration of 3.2% or 3.8%, with a mixing ratio of 1:9 including 1 volume of anticoagulant and 9 volumes of plasma; Step 3: Place the mixed sample in the centrifuge and perform strong centrifugation to obtain the platelet-poor plasma solution of both normal people and patients. Specimens to perform the mix test must be stored with the following requirements:
Temperature: Equivalent to room temperature. Time: Less than 4 hours from the time of sampling. In case the test cannot be performed immediately, it is necessary to separate the plasma solution and store it cold at a temperature below -20 degrees Celsius. After that, if you want to perform the test, it is necessary to defrost for a period of 15 minutes at room temperature. The temperature is 37 degrees Celsius. After thawing the patient samples need to perform the test in about 2 hours and do not re-freeze.
5. Results, meaning and time to return test results mix test
Mix test results are the basis for doctors to access patients with prolonged PT, APTT, TT. In addition, the results of the anticoagulation test will help doctors determine whether the patient has a clotting disorder due to a deficiency of clotting factors or the existence of circulating anticoagulants. Based on that result, the doctor will order reasonable tests.
Patients with non-clotting Hemophilia A, B: Patients with suspected non-clotting inhibitors are indicated to perform other quantitative tests for inhibitors. Endogenous anticoagulation is used to monitor the presence of inhibitors in these patients. Acquired Coagulopathy: For this patient, endogenous anticoagulation plays an important role in supporting the diagnosis. To diagnose as well as monitor the treatment of coagulopathy, patients are assigned to perform a mix test to detect endogenous anticoagulation.
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