What does prolonged APTT mean for the four coagulation factors

Prolonged APTT in the four coagulation factors usually indicates abnormal coagulation function in the body, which may be caused by factors such as lack of coagulation factors, presence of anticoagulant substances, or vascular hemophilia. APTT, also known as activated partial thromboplastin time, is an important indicator for evaluating the function of endogenous coagulation pathways.

1. Coagulation factor deficiency

APTT prolongation is most common in coagulation factor VIII, IX, and XI deficiency. Hemophilia A patients with hereditary deficiency of factor VIII and hemophilia B patients with deficiency of factor IX can both lead to significant prolongation of APTT. Acquired coagulation factor deficiency can be seen in severe liver disease, vitamin K deficiency, and other conditions, often accompanied by prolonged PT. Treatment requires supplementation of corresponding coagulation factors or infusion of fresh frozen plasma. Medications can be selected from human coagulation factor VIII injection, recombinant human coagulation factor IX for injection, etc.

2. Anticoagulant interference

When heparin anticoagulant substances are present in the body, APTT will be significantly prolonged. Commonly used in patients treated with unfractionated heparin or lupus anticoagulants produced by autoimmune diseases such as systemic lupus erythematosus. It needs to be identified through heparinase test, dilution test, etc. Treatment should stop using heparin or use plasma exchange to clear antibodies. If necessary, immunosuppressants such as methylprednisolone succinate sodium for injection should be used.

3. Von Willebrand disease

Von Willebrand factor deficiency can lead to impaired platelet adhesion function, accompanied by decreased factor VIII activity, manifested as prolonged APTT. Patients often have a tendency towards skin and mucosal bleeding, which can be diagnosed through vWF antigen testing. The preferred treatment is acetic acid vasopressin injection, and in severe bleeding, plasma products containing vWF need to be infused.

4. Diffuse intravascular coagulation

DIC may exhibit APTT prolongation in the early stage due to excessive consumption of coagulation factors, accompanied by symptoms such as thrombocytopenia and fibrinogen reduction. To treat the primary disease and supplement coagulation factors, drugs such as injectable thrombin and human fibrinogen can be chosen.

5. Specimen factors

Improper proportion of anticoagulants during blood collection, hemolysis or prolonged storage of specimens, and other non disease factors can also lead to pseudoprolongation of APTT. It is necessary to re standardize blood collection and re examination to eliminate interference from testing.

It was found that APTT prolongation should be judged comprehensively based on other coagulation indicators and clinical manifestations. Mild prolongation without bleeding symptoms can be monitored regularly. If the prolongation exceeds 1.5 times the normal value or is accompanied by bleeding tendency, timely medical attention should be sought. Daily exercise and trauma should be avoided, aspirin and other antiplatelet drugs should be used with caution, and a balanced diet should be maintained to ensure vitamin K intake. When bleeding occurs, immediate compression should be applied to stop the bleeding and medical treatment should be sought.