Summary
Prothrombin (factor II) was assayed in 43 patients under coumarin therapy using three one-stage methods. The three methods used were: classical one-stage method; Taipan snake venom method; Hjort’s et al. method. The substrates used were; a substrate composed of equal parts of adsorbed bovine plasma and pig serum; adsorbed bovine plasma and cephalin; factor II and VII deficient bovine plasma. Prothrombin was also assayed according to a modification of the onestage method. This modification consists in the addition of a small aliquot of human serum to the substrate containing adsorbed bovine plasma and pig serum. Reliable results were obtained with all three methods. High coefficients of correlation ‘r’ were obtained by comparing the three methods. Using the human serum-modified one-stage method, higher factor II levels were obtained as compared to the normal substrate in properly anticoagulated patients, in factor VII or factor X deficiency and in abnormal factor X (factor X Friuli) disorder. This phenomenon was noted both with rabbit brain and lung thromboplastin mixture and with human or pig brain thromboplastins. The effect was not evident in poorly anticoagulated patients, in normal subjects, and in patients with congenital hypoprothrombinemia. Using other substrates composed of equal parts of adsorbed bovine plasma and human serum instead of pig serum, no significant variations were noted between the two techniques. Only with substrates containing 2 parts of adsorbed bovine plasma and 1 part of human serum did the phenomenon become evident again.
Riassunto
La protrombina (fattore II) è stata dosata in 43 pazienti in trattamento con cumarinici utilizzando tre metodi ad uno-stadio. I tre metodi utilizzati sono: il metodo classico ad uno-stadio; il metodo del veleno del serpente Taipan; il metodo di Hjort e Coll. I substrati usati sono stati: un substrato composto di plasma bovino adsorbito e siero porcino in parti uguali; plasma bovino adsorbito e cefalina; plasma bovino privo dei fattori II e VII, rispettivamente. La protrombina è stata anche dosata secondo una modificazione del metodo ad uno-stadio. In questa modifica una aliquota di siero umano è stata aggiunta al substrato contenente plasma bovino adsorbito e siero porcino. Risultati attendibili sono stati ottenuti con tutte e tre le metodiche. Un elevato coefficiente di correlazione « r » è stato ottenuto paragonando i vari metodi tra loro. Con il metodo ad uno-stadio modificato dall’aggiunta di siero umano sono stati ottenuti livelli più elevati di fattore II rispetto al substrato basale nei soggetti adeguatamente anticoagulati, nella deficienza congenita di fattore VII o fattore X e nella anomalla del fattore X (fattore X Friuli). Questo fenomeno è stato notato tanto con tromboplastina ottenuta da cervello e polmone di coniglio quanto con quelle ottenute da cervello umano o porcino. Questo effetto non è però evidente nei soggetti non adeguatamente anticoagulati, nei soggetti normali e anche nei pazienti con ipoprotrombinemia congenita. Utilizzando altri substrati contenenti, in parti uguali, plasma bovino adsorbito e siero umano invece di siero porcino, non sono state viste variazioni significative tra le due metodiche. Solo con substrati contenenti 1 parte di siero umano e 2 parti di plasma bovino adsorbito il fenomeno è risultato ancora evidente.
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Girolami, A., Brunetti, A., Patrassi, G. et al. Dosaggio della protrombina nei pazienti in trattamento con cumarinici. studio comparativo di tre metodi ad uno-stadio. La Ricerca Clin. Lab. 4, 358–380 (1974). https://doi.org/10.1007/BF03055058
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DOI: https://doi.org/10.1007/BF03055058