Legnani C, Palareti G, Boggian O, Cavallaroni K, Oca G, Lo Manto G, Abate C, Coccheri S
Department of Angiology and Blood Coagulation, University Hospital S. Orsola, Bologna, Italy.
Int J Clin Lab Res. 1992;22(2):106-10. doi: 10.1007/BF02591406.
The laboratory assessment of the lupus anticoagulant, a factor frequently associated with venous and arterial thrombosis, recurrent miscarriages and abortions, is not straightforward, as indicated by the variety of tests proposed and the different results obtained. On account of the marked variability and heterogeneity of lupus anticoagulant among patients, no single test or reagent will identify all patients with lupus anticoagulant, and a panel of several tests has to be used. This is time consuming and increases the workload of the laboratory. The aim of this study was to assess the minimum number of tests necessary for the satisfactory identification of the patient with lupus anticoagulant. Our study confirms that lupus anticoagulant may be present in a significant number of patients with normal routine activated partial thromboplastin time, a test which therefore cannot be used as the sole criterion for identifying patients suspected of having lupus anticoagulant. In contrast all patients who had positive results in at least one test could be detected (100% sensitivity) with two combinations of tests: (1) dilute activated partial thromboplastin time and Kaolin clotting time and (2) dilute activated partial thromboplastin time and tissue thromboplastin inhibition test. Since the latter inhibition test has been reported to give a high number of false-positive or negative results, we suggest the combination of dilute activated partial thromboplastin time and Kaolin clotting time as the standard pair of tests for the screening of suspected lupus anticoagulant patients.
狼疮抗凝物常与静脉和动脉血栓形成、反复流产和堕胎相关，对其进行实验室评估并非易事，这从所提出的各种检测方法以及所获得的不同结果中可见一斑。鉴于狼疮抗凝物在患者之间存在显著的变异性和异质性，没有单一的检测方法或试剂能够识别所有患有狼疮抗凝物的患者，因此必须使用一组多种检测方法。这既耗时又增加了实验室的工作量。本研究的目的是评估为满意识别患有狼疮抗凝物的患者所需的最少检测次数。我们的研究证实，狼疮抗凝物可能存在于大量常规活化部分凝血活酶时间正常的患者中，因此该检测不能用作识别疑似患有狼疮抗凝物患者的唯一标准。相比之下，通过两种检测组合可以检测出所有至少一项检测结果呈阳性的患者（灵敏度为100%）：（1）稀释活化部分凝血活酶时间和高岭土凝血时间，以及（2）稀释活化部分凝血活酶时间和组织凝血活酶抑制试验。由于据报道后者的抑制试验会产生大量假阳性或假阴性结果，我们建议将稀释活化部分凝血活酶时间和高岭土凝血时间的组合作为筛查疑似狼疮抗凝物患者的标准检测组合。
