Применение проточных систем в лабораторной диагностике для интегральной оценки системы гемостаза

Одна из важнейших задач лабораторной диагностики нарушений работы в системе гемостаза - оценка риска тромбозов и кровотечений. Для этой цели плохо подходят узкоспециализированные тесты, направленные на выявление патологий отдельных звеньев или отдельных маркеров: дефицитов антигемофильных факторов - VIII, IX, XI, уровня D-димеров, тромбоцитарные тесты на активацию АДФ серотонином и агрегацию в присутствии ацетилсалициловой кислоты. Перспективным подходом считаются интегральные тесты, имитирующие процессы гемостаза in vivo, - тромбоэластография, тромбодинамика, генерация тромбина. При их создании ставится задача оценки риска тромбоза или кровотечения при сочетании дефектов гемостаза различной природы, а также скрининг и мониторинг лекарственной терапии. Один из подходов при создании интегральных тестов - применение проточных систем - микрокамер, в которых над активатором гемостаза формируется поток плазмы или цельной крови, а рост тромба регистрируется оптически. Существуют коммерчески доступные образцы таких устройств, накапливается опыт их применения в клинике, однако каких-либо единых стандартов и клинических рекомендаций в этой области пока нет. В данном обзоре рассмотрены примеры применения проточных камер для диагностики, описаны существующие проблемы при их использовании и те возможности, которые они могут предоставить клиницисту.

интегральные тесты гемостаза, микрофлюидика, функциональные тесты, тромбоз

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