Kovacs M J, Keeney M, MacKinnon K, Boyle E
London Health Sciences Centre, Ontario, Canada.
Clin Lab Haematol. 1999 Feb;21(1):55-60. doi: 10.1046/j.1365-2257.1999.00183.x.
In this study we compare three chromogenic methods (IL-Heparin, Stachrom Heparin and Heparin Sigma) on two different instruments (ACL300+ and AMAX CS190) for patients on dalteparin (n = 41), a low molecular weight heparin or unfractionated heparin (n = 50). For dalteparin the mean anti-Xa levels for IL-Heparin, Stachrom Heparin and Heparin Sigma were 0.27, 0.30 and 0.21 U/ml, respectively, while for heparin they were 0.52, 0.55 and 0.41 U/ml, respectively. To test for instrument specific effects, IL-Heparin and Stachrom Heparin were repeated on both instruments on 42 patients receiving unfractionated heparin. For IL-Heparin the mean anti-Xa levels on the AMAX CS190 and ACL300+ were 0.51 and 0.59 U/ml, respectively, while for Stachrom Heparin they were 0.55 and 0.67 anti-Xa U/ml. We conclude that different chromogenic anti-Xa methods do not give equivalent anti-Xa levels for the same samples. Moreover, the differences are clinically significant. This is not explained entirely by instrumentation effects. Recommended therapeutic ranges may need to be method and instrument specific.
在本研究中，我们在两种不同仪器（ACL300+和AMAX CS190）上比较了三种显色法（IL-肝素法、Stachrom肝素法和肝素西格玛法），研究对象为使用达肝素（n = 41）的患者，达肝素是一种低分子量肝素或普通肝素（n = 50）。对于达肝素，IL-肝素法、Stachrom肝素法和肝素西格玛法的平均抗Xa水平分别为0.27、0.30和0.21 U/ml，而对于肝素，它们分别为0.52、0.55和0.41 U/ml。为了测试仪器特异性效应，对42例接受普通肝素治疗的患者在两种仪器上重复进行IL-肝素法和Stachrom肝素法检测。对于IL-肝素法，AMAX CS190和ACL300+上的平均抗Xa水平分别为0.51和0.59 U/ml，而对于Stachrom肝素法，它们分别为0.55和0.67抗Xa U/ml。我们得出结论，不同的显色抗Xa方法对于相同样本不会给出等效的抗Xa水平。此外，这些差异具有临床意义。这不能完全由仪器效应来解释。推荐的治疗范围可能需要因方法和仪器而异。
