persmedРоссийский журнал персонализированной медициныRussian Journal for Personalized Medicine2782-38062782-3814ФОНД АЛМАЗОВА10.18705/2782-3806-2022-2-3-119-128persmed-62Research ArticleЛАБОРАТОРНАЯ ДИАГНОСТИКАLABORATORY MEDICINEТЕСТ ГЕНЕРАЦИИ ТРОМБИНА КАК ИНТЕГРАЛЬНЫЙ АНАЛИЗ СИСТЕМЫ ГЕМОСТАЗА: ТЕХНИЧЕСКИЕ ВОЗМОЖНОСТИ И ПРИМЕНЕНИЕ В КЛИНИКО-ЛАБОРАТОРНОЙ ПРАКТИКЕTHROMBIN GENERATION TEST AS AN INTEGRAL ANALYSIS OF THE HEMOSTASIS SYSTEM: TECHNICAL CAPABILITIES AND APPLICATION IN LABORATORY PRACTICEМельничниковаО. С.MelnichnikovaO. S.

Мельничникова Ольга Сергеевна, к.м.н., старший научный сотрудник НИГ кардиоонкологии

ул. Аккуратова, д. 2, Санкт-Петербург, 197341

Melnichnikova Olga S., PhD, Senior Researcher, Research Group of Cardio-Oncology

Akkuratova str., 2, Saint Petersburg, 197341

olga4403@gmail.comЖиленковаЮ. И.ZhilenkovaY. I.

Жиленкова Юлия Исмаиловна, к.м.н., доцент кафедры лабораторной медицины и  генетики

ул. Аккуратова, д. 2, Санкт-Петербург, 197341

Zhilenkova Yulia I., PhD., Assistant Professor, Laboratory Medicine and Genetics Department

Akkuratova str., 2, Saint Petersburg, 197341

ЗолотоваЕ. А.ZolotovaE. A.

Золотова Екатерина Алексеевна, младший научный сотрудник НИГ кардиоонкологии

ул. Аккуратова, д. 2, Санкт-Петербург, 197341

Zolotova Ekaterina A., Junior Researcher, Research Group of Cardio-Oncology

Akkuratova str., 2, Saint Petersburg, 197341

ПищуловК. А.PishchulovK. A.

Пищулов Константин Анатольевич, младший научный сотрудник НИГ кардиоонкологии

ул. Аккуратова, д. 2, Санкт-Петербург, 197341

Pishchulov Konstantin A., Junior Researcher, Research Group of Cardio-Oncology

Akkuratova str., 2, Saint Petersburg, 197341

СироткинаО. В.SirotkinaO. V.

Сироткина Ольга Васильевна, д.б.н., главный научный сотрудник НИГ кардиоонкологии НЦМУ «Центр персонализированной медицины», профессор кафедры лабораторной медицины и генетики

ул. Аккуратова, д. 2, Санкт-Петербург, 197341

Sirotkina Olga V., D.Sc., Chief Researcher, Research Group of Cardio-oncology, professor of Department of Laboratory Medicine and Genetics

Akkuratova str., 2, Saint Petersburg, 197341

СимаковаМ. А.SimakovaM. A.

Симакова Мария Александровна, к.м.н., старший научный сотрудник НИГ кардиоонкологии

ул. Аккуратова, д. 2, Санкт-Петербург, 197341

Simakova Maria A., PhD., Head, Senior Researcher, Research Group of Cardio-Oncology

Akkuratova str., 2, Saint Petersburg, 197341

ВавиловаТ. В.VavilovaT. V.

Вавилова Татьяна Владимировна, д.м.н., профессор, заведующий кафедрой лабораторной медицины и  генетики

ул. Аккуратова, д. 2, Санкт-Петербург, 197341

Vavilova Tatiana V., MD, D.Sc., Head, Laboratory Medicine and Genetics Department

Akkuratova str., 2, Saint Petersburg, 197341

Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр имени В. А. Алмазова» Министерства здравоохранения Российской Федерации, Научный центр мирового уровня «Центр персонализированной медицины»РоссияAlmazov National Medical Research Centre, World-Class Research Centre for Personalized MedicineRussian Federation20221307202223119128Copyright © Мельничникова О.С., Жиленкова Ю.И., Золотова Е.А., Пищулов К.А., Сироткина О.В., Симакова М.А., Вавилова Т.В., 20222022Мельничникова О.С., Жиленкова Ю.И., Золотова Е.А., Пищулов К.А., Сироткина О.В., Симакова М.А., Вавилова Т.В.Melnichnikova O.S., Zhilenkova Y.I., Zolotova E.A., Pishchulov K.A., Sirotkina O.V., Simakova M.A., Vavilova T.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://persmed.elpub.ru/jour/article/view/62

Данный обзор литературы посвящен одному из интегральных тестов оценки системы гемостаза — тесту генерации тромбина (ТГТ), его техническим характеристикам, проблемам в стандартизации и возможному клиническому использованию. Оценка генерации тромбина (ГТ) более чувствительна к изменениям, происходящим в системе гемостаза, поскольку учитывает действие как прокоагулянтных, так и антикоагулянтных факторов в процессе образования тромбина. Важно отметить, что существуют варианты постановки ТГТ в богатой тромбоцитами плазме или в цельной крови, что приближает исследователя к условиям in vivo. Однако, несмотря на явные преимущества этого анализа при сравнении со скрининговыми тестами оценки системы гемостаза, существует ряд ограничений, в том числе отсутствие стандартизации, что не позволяет на данный момент внедрить ТГТ в клиническую практику. В данном обзоре обсуждаются технические характеристики ТГТ и варианты наборов реагентов в зависимости от поставленной клинической задачи, а также приводятся результаты последних исследований в области клинического применения ТГТ, демонстрирующие перспективность анализа ГТ для оценки риска как геморрагических осложнений, так и тромботических событий.

This review is devoted to one of the integral tests for assessing the hemostasis system — the thrombin generation test (TGT), its technical characteristics, problems in standardization and possible clinical use. Evaluation of thrombin generation (TG) is more sensitive to changes occurring in the hemostasis system, since it takes into account the effect of both procoagulant and anticoagulant factors in the process of TG. It is important to note that there are options for setting TGT in platelet-rich plasma or in whole blood, which brings the researcher closer to in vivo conditions. However, despite the obvious advantages of this analysis when compared with routine screening tests for assessing the hemostasis system, there are number of limitations, including the lack of standardization, which does not currently allow the introduction of TGT into clinical practice. This review discusses the technical characteristics of TGT and variants of reagent kits depending on the clinical task, and provides the results of recent studies in the field of clinical use of TGT, demonstrating the prospects of GT analysis for assessing the risk of both hemorrhagic complications and thrombotic events.

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The authors declare that there are no conflicts of interest present.