Capillary fraglity test毛细血管脆性试验.docVIP

Capillary fragility (resistance) test: This test is used to determine the presence of vascular disorder, a circle 2.5 cm in diameter, the upper edge of which is 4 cm below the crease of the elbow, is drawn on the inner aspect of the forearm, pressure midway between the systolic and diastolic blood pressure is applied using sphygmomanometer above the elbow for 15 minutes, and a count of petechiae within the circle is made: 10, normal; 10–20, marginal; more than 20, abnormal. Assays for primary Haemostasis Bleeding time Von Willebrand factor: Antigen determination Activity Platelet count Platelet aggregation Activation markers (b-TG, PF4, GP V) Specialised tests for platelet function Laboratory investigation of platelets and platelet function: A number of simple tests are employed to assess the platelet dysfunction and thrombocytopenia: Blood count and blood film examination: Peripheral blood platelet count and skin bleeding time are the first-line tests for platelet function. If the results of these two tests are within the normal limits, it is unlikely that a clinically important platelet defect is responsible for the bleeding tendency. Additional information may be obtained by inspecting a fresh blood film which may show abnormalities of platelet size or morphology which can be diagnostic importance. If the screening tests suggest a disorder of platelet function, further investigations are organized. Drugs and certain foods may affect the platelet function tests (look for the table below) and the patient must be asked to refrain from taking such substances for at least seven days before the test. Platelet function tests can be divided into five main groups: Adhesion tests Aggregation tests Assessment for the granular contents and the release reaction Investigation of the prostaglandin pathway Test for platelet coagulant activity. Blood count film Low platelet count Normal platelet count 1- Bleeding time 1- Bone marrow examin