Die vorliegende Arbeit untersucht in einer Population von 132 gesunden Probanden die Hämostase mittels Calibrated Automated Thrombogram (CAT) und Rotationsthromboelastometrie (ROTEM). CAT wurde im plätchenarmen Plasma mit einer tissue factor (TF) von 1 und 5 pM durchgeführt. Lag time, Thrombin peak, Time to thrombin peak und das endogene Thrombin Potential (ETP) wurden ermittelt. ROTEM wurde ohne Aktivator durchgeführt (NATEM) und die Daten für Gerinnungszeit (clotting time, CT), Gerinnselbildungszeit, Alpha Winkel und maximale Gerinnselfestigkeit (MCF) mit den Daten der Thrombingenerierung korreliert. Es zeigte sich eine positive aber nicht lineare Korrelation bezüglich Alter versus lag time und time to peak, sowie eine annähernd lineare Korrelation bezüglich Alter versus thrombin peak und ETP. Für ROTEM konnte eine positive Korrelation bezüglich Alter versus MCF und Alpha Winkel, aber eine negative Korrelation bezüglich Alter versus CT dargestellt werden. In der Gegenüberstellung beider Assays korrelierten Thrombin peak und ETP (aktiviert mit einer TF Konzentration von 5 pM) signifikant mit dem Alpha Winkel und der MCF. Alle signifikanten Korrelationen zeigten lediglich eine moderate Regressionssteigung. / Published data on thrombin generation variables and their correlation with thromboelastometry in the healthy population are scarce. This study aimed at assessing thrombin generation in adults and its correlation to classical rotational thromboelastometry (ROTEM). Methods: Thrombin generation was
measured in platelet-poor plasma from healthy volunteers using the calibrated automated thrombogram (CAT) with 1 and 5 pmol/l tissue factor final concentration. Lag time, thrombin peak, time to thrombin peak and endogenous thrombin potential (ETP) were analyzed. ROTEM was performed without activator (NATEM) and data for clotting time, alpha angle, clot formation time and maximum clot firmness were correlated with
those of thrombin generation. Results: Altogether 132 persons (72 men, 60 women; median age: 48.0 years) were included. There was a positive non-linear correlation for age versus lag time (p < 0.001) and time to peak
(p = 0.001), and almost linear correlation for age versus thrombin peak (p = 0.024) and ETP (p = 0.001), although with a moderate regression
slope. Regarding ROTEM, there was a positive correlation between age and maximum clot firmness and alpha angle (p = 0.001), but a negative correlation between age and clotting time (p = 0.039). Comparing both assays, thrombin peak and ETP measured with a final tissue factor concentration of 5 pmol/l correlated significantly with alpha angle and maximum clot firmness. Conclusion: The age-related changes in CAT and ROTEM variables among adults are not linear. There is a significant correlation, although with a moderate slope, between data from CAT measured with 5 pmol/l tissue factor and ROTEM.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa.de:bsz:15-qucosa-207426 |
| Date | 21 July 2016 |
| Creators | Schneider, Tobias |
| Contributors | Universität Leipzig, Medizinische Fakultät, PD Dr. med Sirak Petros, Prof. Dr. med. Gabriele Siegert, Prof. Dr. med Joachim Thiery |
| Publisher | Universitätsbibliothek Leipzig |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | deu |
| Detected Language | English |
| Type | doc-type:doctoralThesis |
| Format | application/pdf |
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