各位高手，Russel's viper venom (RVV)有什么作用，在凝血实验方面有何用途？谢谢
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解决时间 2021-02-24 03:10
- 提问者网友：最美的风景
- 2021-02-23 19:57
各位高手，Russel's viper venom (RVV)有什么作用，在凝血实验方面有何用途？谢谢
最佳答案
- 五星知识达人网友：一把行者刀
- 2021-02-23 21:27
Dilute Russell's viper venom time (dRVVT) is a laboratory test often used for detection of lupus anticoagulant (LA)
Mechanism
This in vitro diagnostic test is based on the ability of the venom of the Russell's viper to induce thrombosis. The coagulant in the venom directly activates factor X, which turns prothrombin into thrombin in the presence of factor V and phospholipid. In the dRVVT assay, low, rate-limiting concentrations of both Russell's viper venom and phospholipid are used to give a clotting time of 23 to 27 seconds. This makes the test sensitive to the presence of lupus anticoagulants, since these antibodies interfere with the clot-promoting role of phospholipid in vitro. A prolonged clotting time of 30 seconds or greater that does not correct with the addition of an equal volume of normal plasma suggests the presence of a lupus anticoagulant. An abnormal result for the initial dRVVT assay should be followed by a dRVVT confirmatory test. In this test, the inhibitory effect of lupus anticoagulants on phospholipids in the dRVVT can be overcome by adding an excess of phospholipid to the assay. The clotting times of both the initial dRVVT assay and confirmatory test are normalized and then used to determine a ratio of time without phospholipid excess to time with phospholipid excess. In general, a ratio of greater than 1.2 is considered a positive result and implies that the patient may have antiphospholipid antibodies. The dRVVT test is more sensitive than the aPTT test for the detection of lupus anticoagulant, because it is not influenced by deficiencies or inhibitors of clotting factors VIII, IX or XI.
Use in diagnosis
The dRVVT is one component of a workup of a suspected antiphospholipid antibody, the other component being the serological testing for anticardiolipin antibodies and anti-β2 glycoprotein-I antibodies using ELISA technology. The Sapporo criteria require at least one of the above laboratory tests to be positive and the patient to have at least one clinical manifestation of antiphospholipid syndrome such as vascular thrombosis or fetal mortality/morbidity in order to diagnose the antiphospholipid syndrome (also known as Hughes syndrome). Positive laboratory test results should be seen on two separate occasions at least twelve weeks apart in order for diagnosis. Antiphospholipid antibody syndrome is an important marker for recurrent thrombosis, and often warrants indefinite anticoagulant (blood thinner) therapy.
Mechanism
This in vitro diagnostic test is based on the ability of the venom of the Russell's viper to induce thrombosis. The coagulant in the venom directly activates factor X, which turns prothrombin into thrombin in the presence of factor V and phospholipid. In the dRVVT assay, low, rate-limiting concentrations of both Russell's viper venom and phospholipid are used to give a clotting time of 23 to 27 seconds. This makes the test sensitive to the presence of lupus anticoagulants, since these antibodies interfere with the clot-promoting role of phospholipid in vitro. A prolonged clotting time of 30 seconds or greater that does not correct with the addition of an equal volume of normal plasma suggests the presence of a lupus anticoagulant. An abnormal result for the initial dRVVT assay should be followed by a dRVVT confirmatory test. In this test, the inhibitory effect of lupus anticoagulants on phospholipids in the dRVVT can be overcome by adding an excess of phospholipid to the assay. The clotting times of both the initial dRVVT assay and confirmatory test are normalized and then used to determine a ratio of time without phospholipid excess to time with phospholipid excess. In general, a ratio of greater than 1.2 is considered a positive result and implies that the patient may have antiphospholipid antibodies. The dRVVT test is more sensitive than the aPTT test for the detection of lupus anticoagulant, because it is not influenced by deficiencies or inhibitors of clotting factors VIII, IX or XI.
Use in diagnosis
The dRVVT is one component of a workup of a suspected antiphospholipid antibody, the other component being the serological testing for anticardiolipin antibodies and anti-β2 glycoprotein-I antibodies using ELISA technology. The Sapporo criteria require at least one of the above laboratory tests to be positive and the patient to have at least one clinical manifestation of antiphospholipid syndrome such as vascular thrombosis or fetal mortality/morbidity in order to diagnose the antiphospholipid syndrome (also known as Hughes syndrome). Positive laboratory test results should be seen on two separate occasions at least twelve weeks apart in order for diagnosis. Antiphospholipid antibody syndrome is an important marker for recurrent thrombosis, and often warrants indefinite anticoagulant (blood thinner) therapy.
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- 1楼网友：渡鹤影
- 2021-02-23 22:26
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