What are the effects of high thromboplastin time

A high APTT may indicate abnormal coagulation function, mainly affecting increased bleeding risk, coagulation factor deficiency, anticoagulant interference, liver disease or vitamin K deficiency, genetic coagulation disorders, etc.

1. Increased risk of bleeding:

The most direct consequence of prolonged APTT is an increased tendency towards spontaneous bleeding. Minor collisions may cause subcutaneous bruising, prolonged gum bleeding during brushing, and increased menstrual flow in women. In severe cases, critical situations such as gastrointestinal bleeding, intra-articular hemorrhage, or intracranial hemorrhage may occur. Avoid vigorous exercise and external injuries in daily life.

2. Coagulation factor deficiency:

is commonly found in coagulation factor VIII, IX, and XI deficiencies, with hemophilia A/B accounting for the majority. Patients with coagulation factor activity lower than 30% of the normal value may experience APTT prolongation and need to be diagnosed through coagulation factor activity testing. Alternative therapy is the main intervention method, but caution should be taken against the production of inhibitors.

3. Anticoagulant interference: During heparin treatment, APTT should be maintained at 1.5-2.5 times the normal value. Pathological antiphospholipid antibodies such as lupus anticoagulants can lead to prolonged pseudo APTT, which in turn increases the risk of thrombosis in these patients. It is necessary to combine anti Xa activity detection and dilution test identification, and if necessary, perform antiphospholipid antibody spectrum screening.

4. Liver disease or vitamin K deficiency: In severe liver disease, the ability of the liver to synthesize coagulation factors decreases, and the reduction of vitamin K-dependent factors II, VII, IX, and X can lead to the simultaneous prolongation of APTT and PT. Obstructive jaundice or long-term use of antibiotics may lead to vitamin K deficiency, which can be improved by supplementing with vitamin K.

5. Hereditary coagulation disorder:

Patients with von Willebrand disease (vWD) may experience prolonged APTT and prolonged bleeding time due to abnormal vWF factor affecting the stability of factor VIII. Although APTT is significantly prolonged in rare genetic diseases such as factor XII deficiency, there is actually no tendency for bleeding. Genetic testing can provide a clear diagnosis.

It was found that APTT prolongation should be further examined through tests such as coagulation factor activity, coagulation factor activity, and mixed plasma correction test. Mild abnormalities without bleeding symptoms can be observed, but repeated nosebleeds, hematuria, or postoperative bleeding require specialized medical attention. Avoid medications such as aspirin that affect platelets in daily life, consume green leafy vegetables rich in vitamin K, and use a soft bristled toothbrush to reduce mucosal damage. Regular monitoring of coagulation function is particularly important for patients undergoing long-term anticoagulant therapy. If sudden headaches, abdominal pain, or joint swelling occur, immediate medical attention should be sought to rule out internal bleeding.