What is the clinical significance of prolonged thrombin time

Prolonged thrombin time usually indicates coagulation dysfunction, which may be related to factors such as abnormal fibrinogen, interference from heparin like substances, use of anticoagulant drugs, hyperfibrinolysis, or disseminated intravascular coagulation.

1. Abnormal fibrinogen:

Decreased fibrinogen content or functional defects are common causes. Hereditary hypofibrinogenemia, cirrhosis, and other diseases lead to reduced synthesis, while abnormal fibrinogen affects the formation of fibrin oligomers. Laboratory testing should be combined with fibrinogen quantification and functional testing.

2. Heparin interference:

Treatment with heparin or heparin like substances in the body can inhibit thrombin activity. After extracorporeal circulation, patients with severe liver disease or systemic mastocytosis may experience an increase in endogenous heparin like substances, which needs to be confirmed through toluidine blue correction test.

3. Effects of anticoagulant drugs:

Direct oral administration of anticoagulant drugs such as dabigatran etexilate can specifically inhibit thrombin. When warfarin overdose leads to vitamin K-dependent coagulation factor deficiency, thrombin time may be secondary prolonged. The collection of medication history is crucial for identification. 4. Fibrinolytic hyperfunction: Primary fibrinolysis or fibrinolysis secondary to DIC can degrade fibrinogen, producing fibrin degradation products that interfere with coagulation. Clinically, there is continuous bleeding from the wound, and D-dimer and FDP testing are needed to assist in diagnosis.

5. DIC consumptive coagulation:

Diffuse intravascular coagulation is characterized by excessive consumption of coagulation factors, accompanied by thrombocytopenia and fibrinogen decline in the middle stage. Obstetric emergencies, severe infections, or malignant tumors are common causes that require urgent intervention.

It was found that the prolongation of thrombin time requires the completion of tests such as coagulation four items and platelet count. Avoid intense exercise and trauma, increase intake of vitamin K rich foods such as spinach and animal liver. Patients undergoing anticoagulant therapy should regularly monitor their coagulation function and seek medical attention immediately if there is a tendency for spontaneous bleeding. When abnormal results occur in special populations such as the elderly and pregnant women, it is recommended to conduct comprehensive evaluations such as thromboelastography.