Harenberg J, Wang L, Hoffmann U, Huhle G, Feuring M
Department of Medicine I, University Hospital, Theodor-Kutzer-Ufer, D-68167 Mannheim, Germany.
Am J Clin Pathol. 2001 Mar;115(3):432-8.
We studied whether laboratory confirmation of heparin-induced thrombocytopenia (HIT) can be improved after antigen clearance by determining free antibody and combining the results of an antigenic and a biologic assay. Blood samples taken over 40 days in 14 patients with HIT with thromboembolism underwent fluorescence-linked immunofiltration and the carbon 14-serotonin release assays. Of the 14 patients, 11 showed positive results in both assays at day 1 after stopping heparin. The 3 patients with negative results seroconverted in one or both assays during the subsequent 7 days. Combining the positive results of the assays increased the sensitivity from 85% at day 1 to 100% at day 7. Assay results became negative in all patients within 40 days. The platelet count normalized between days 2 and 9 after withdrawal of heparin. It is assumed that the free antibody can be detected after withdrawal of heparin and after clearance of the platelet factor 4-heparin complex in patients with HIT.
我们研究了通过测定游离抗体并结合抗原检测和生物学检测的结果，在清除抗原后能否改善肝素诱导的血小板减少症（HIT）的实验室确诊情况。对14例发生血栓栓塞的HIT患者在40天内采集的血样进行荧光连接免疫过滤和碳14 - 血清素释放检测。14例患者中，11例在停用肝素后第1天的两种检测中均呈阳性结果。3例检测结果为阴性的患者在随后7天内一种或两种检测中出现血清转化。将检测的阳性结果结合起来，敏感性从第1天的85%提高到第7天的100%。所有患者在40天内检测结果均变为阴性。停用肝素后血小板计数在第2天至第9天恢复正常。据推测，在HIT患者停用肝素并清除血小板因子4 - 肝素复合物后可检测到游离抗体。
