Lang Thomas, Bauters Anne, Braun Siegmund L, Pötzsch Bernd, von Pape Klaus-Werner, Kolde Hans-Jürgen, Lakner Meret
Clinical Institute of Medical and Chemical Laboratory Diagnostic, University Clinic of Graz, Austria.
Blood Coagul Fibrinolysis. 2005 Jun;16(4):301-10. doi: 10.1097/01.mbc.0000169225.31173.19.
Reagent-supported thromboelastometry (TEM) with the ROTEM Whole Blood Haemostasis Analyser is an enhancement of thromboelastography, a method that is increasingly used for the point of care monitoring of acute perioperative bleeding disorders. We investigated the reference ranges of two activated tests (INTEM and EXTEM) and a test analysing specifically the fibrin component of coagulation (FIBTEM) in a multi-centre approach. The reference ranges obtained for the clotting time (CT), clot formation time (CFT), alpha angle (ALP), maximum clot firmness (MCF) and clot lysis parameters were comparable from centre to centre. INTEM: CT equals; 137-246 s, CFT equals; 40-100 s, MCF equals; 52-72 mm. EXTEM: CT equals; 42-74 s, CFT equals; 46-148 s, MCF equals; 49-71 mm. FIBTEM: MCF equals; 9-25 mm. ROTEM whole blood coagulation correlated weakly with a trend towards enhanced coagulation in females compared with males and in advanced age. The repeatability (within-run imprecision) of the results was dependent on the test with the following coefficients of variation: 1-5% (clot firmness, alpha angle), 3-12% (CT, CFT), 6-13% (FIBTEM clot firmness). Citrated blood samples were stable for ROTEM analysis stored within 6 h from drawing. In summary, the data showed that ROTEM thromboelastometry yields consistent values between centres and that providing general orientating reference ranges seems to be possible.
使用ROTEM全血止血分析仪进行的试剂支持血栓弹力图分析（TEM）是血栓弹力描记术的一种改进，血栓弹力描记术是一种越来越多地用于急性围手术期出血性疾病床旁监测的方法。我们采用多中心研究方法，调查了两种激活试验（INTEM和EXTEM）以及一种专门分析凝血纤维蛋白成分的试验（FIBTEM）的参考范围。各中心获得的凝血时间（CT）、凝血形成时间（CFT）、α角（ALP）、最大凝血硬度（MCF）和凝血溶解参数的参考范围具有可比性。INTEM：CT等于137 - 246秒，CFT等于40 - 100秒，MCF等于52 - 72毫米。EXTEM：CT等于42 - 74秒，CFT等于46 - 148秒，MCF等于49 - 71毫米。FIBTEM：MCF等于9 - 25毫米。与男性相比，女性以及老年患者的ROTEM全血凝血相关性较弱，且有凝血增强的趋势。结果的重复性（批内不精密度）取决于试验，变异系数如下：1 - 5%（凝血硬度、α角），3 - 12%（CT、CFT），6 - 13%（FIBTEM凝血硬度）。枸橼酸盐血样在采血后6小时内保存用于ROTEM分析时保持稳定。总之，数据表明ROTEM血栓弹力图分析在各中心之间产生一致的值，并且提供一般的定向参考范围似乎是可行的。
