Jones P G, McClelland A, McNeil A, Gamble G
Departments of Emergency Medicine and Clinical Chemistry, Auckland Hospital, Auckland, New Zealand.
Emerg Med (Fremantle). 2001 Dec;13(4):451-5. doi: 10.1046/j.1035-6851.2001.00260.x.
To determine whether there was a clinically significant effect on troponin T measurement when the sample was collected in a heparinized (plasma) blood collection tube compared with a serum tube.
Prospective cohort study using a convenience sample of 198 patients with undifferentiated illness presenting to an Emergency Department who required troponin T measurement. Samples were collected in both plain (serum) tubes and plasma tubes for comparison. All samples were measured using an Elecsys 2010 Immunoassay system (Roche-Boehringer Mannheim, Germany).
There were 35 troponin T measurements > or = 0.03 microg/L (the limit of reproducibility of the test). The negative predictive value for troponin T performed in heparinized tubes compared with plain tubes was 100% (95% confidence interval 96.4-100) at the > or = 0.03 microg/L level and 100% (95% confidence interval 97-100%) at the > or = 0.1 microg/L level. At a cut-off point for risk stratification in acute coronary syndromes (> or = 0.1 microg/L), there was 100% concordance between the two measurements for each sample.
The use of plasma (heparinized) tubes for the collection of troponin T samples is unlikely to produce clinically significant false-negative results compared with collection of troponin T samples in serum (plain) tubes.
确定与血清管相比，使用肝素化（血浆）采血管采集样本时，对肌钙蛋白T测定是否有临床显著影响。
采用前瞻性队列研究，便利抽样选取了198例到急诊科就诊的未分化疾病患者，这些患者均需测定肌钙蛋白T。分别在普通（血清）管和血浆管中采集样本进行比较。所有样本均使用Elecsys 2010免疫分析系统（德国罗氏-宝灵曼公司）进行检测。
有35次肌钙蛋白T测定结果≥0.03μg/L（该检测的可重复性限度）。在≥0.03μg/L水平时，与普通管相比，肝素化管中肌钙蛋白T检测的阴性预测值为100%（95%置信区间96.4 - 100）；在≥0.1μg/L水平时，阴性预测值为100%（95%置信区间97 - 100%）。在急性冠脉综合征风险分层的截断点（≥0.1μg/L），每个样本的两次检测结果100%一致。
与在血清（普通）管中采集肌钙蛋白T样本相比，使用血浆（肝素化）管采集肌钙蛋白T样本不太可能产生具有临床显著意义的假阴性结果。
