血栓弹力图TEG技术

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1、®®THETEGTHROMBELASTOGRAPHHEMOSTASISANALYZERTheTEGsystemiscomprisedofananalyzerandsoftwarewhichtogetherprovideacompletepictureoftheformationanddissolutionoftheclot,showingthebalanceorimbalanceofthetwosystems.WhatcanTEGanalysismeasure?Consistentwithadvancesintheunderstandingofhemostasis,TEGtechnolo

2、gyanalyzesplateletfunction.BecausetheTEGanalyzermonitorstheelasticityofclottingblood,thesystemissensitivetoalltheinteractingcellularandplasmaticcomponentssuchascoagulationandfibrinolyticfactors,activators,andinhibitorsthatmayaffecttherateorstructureofaclottingsampleanditsbreakdown.TheTEGanalyzerm

3、easuresthemechanicalpropertiesofthedevelopingclot:•Thetimeuntilinitialfibrinformation;•Thekineticsoftheinitialfibrinclottoreachmaximumstrength;and,•Thestrengthandstabilityofthefibrinclotanditsabilitytodotheworkofhemostasis,thatis,tomechanicallyimpedehemorrhagewithoutpermittinginappropriatethrombo

4、sis.THETEGANALYZERTECHNOLOGYTheTEGanalyzerhasasamplecupthatoscillatesconstantlyatasetspeedthroughanarcof4°45'.Eachrotationlaststenseconds.Awholebloodsampleof360ulisplacedintothecup,andastationarypinattachedtoatorsionwireisimmersedintotheblood.Whenthefirstfibrinforms,itbeginstobindthecupandpin,cau

5、singthepintooscillateinphasewiththeclot.Theaccelerationofthemovementofthepinisafunctionofthekineticsofclotdevelopment.Thetorqueoftherotatingcupistransmittedtotheimmersedpinonlyafterfibrin-plateletbondinghaslinkedthecupandpintogether.Thestrengthofthesefibrin-plateletbondsaffectsthemagnitudeofthepi

6、nmotion,suchthatstrongclotsmovethepindirectlyinphasewiththecupmotion.Thus,themagnitudeoftheoutputisdirectlyrelatedtothestrengthoftheformedclot.Astheclotretractsorlyses,thesebondsarebrokenandthetransferofcupmotionisdiminished.Therotationmovementofthepinisconvertedbyamechanical-electricaltransducer

7、toanelectricalsignalwhichcanbemonitoredbyacomputer.Theresultinghemostasisprofileisameasureofthetimeittakesforthefirstfibrinstrandtobeformed,thekineticsofclotformation,thestrengthoftheclot(inshearelasticityunitsofdyn/cm