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[即时检验与自动凝血分析仪在肝素抗凝治疗中凝血功能检测的差异]

[Difference in examination of coagulation function in heparin anticoagulant therapy between point of care tests and automatic coagulation analyzer].

作者信息

Li Jian, Cong Yu-long, Tu Guo-hong, Yang Li, Zhu Bing-bo, Jin Lan

机构信息

Department of Clinical Laboratory, Chinese PLA General Hospital, Beijing 100853, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2007 May 15;87(18):1269-71.

Abstract

OBJECTIVE

To investigate the difference in coagulation screening in heparin anticoagulant therapy between dry-chemistry point of care tests (POCT) and automatic analyzer.

METHODS

Blood samples were collected from 44 patients with myocardial infarction or intracranial hemorrhage, 34 males aged 78 +/- 10 and 10 females aged 73 +/- 8, to undergo examination of prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), and fibrinogen (Fbg) by dry-chemistry methods with coagulation analyzers of the models CG02 and Hemochron Jr II. The levels of APTT of 30 patients were measured by the bedside with analyzers model Hemochron Jr II, after their anticoagulation samples underwent measurement of the plasma heparin activity with ACL Advance automatic coagulation analyzer; the APTT was determined with STA-R.

RESULTS

The correlation coefficients of PT, INR, APTT, and Fbg between the CG02 and STA-R results were 0.945, 0.966, 0.662, and 0.977 respectively (all P < 0.05). However, t test showed that the levels of PT and INR between these 2 groups were not significant, and the differences in the levels of APTT and Fbg were significant (both P < 0.05). ACL Advance analyzer showed that the heparin activities of 30 samples were 172 approximately 1465 U/L, and the APTT values measured by Hemochron Jr II and STA-R were 87 s +/- 32 s and 90 s +/- 46 s (P < 0.01).

CONCLUSION

Dry-chemistry POCT is not suitable to report the results of the same patient simultaneously with the automatic analyzer.

摘要

目的

探讨干化学即时检验(POCT)与自动分析仪在肝素抗凝治疗中凝血筛查结果的差异。

方法

收集44例心肌梗死或颅内出血患者的血液样本,其中男性34例,年龄78±10岁,女性10例,年龄73±8岁,采用CG02型和Hemochron Jr II型凝血分析仪的干化学方法检测凝血酶原时间(PT)、国际标准化比值(INR)、活化部分凝血活酶时间(APTT)和纤维蛋白原(Fbg)。30例患者的抗凝样本经ACL Advance自动凝血分析仪检测血浆肝素活性后,用Hemochron Jr II型分析仪在床边测定APTT水平;用STA-R测定APTT。

结果

CG02与STA-R检测结果中PT、INR、APTT和Fbg的相关系数分别为0.945、0.966、0.662和0.977(均P<0.05)。然而,t检验显示两组间PT和INR水平差异无统计学意义,APTT和Fbg水平差异有统计学意义(均P<0.05)。ACL Advance分析仪显示30份样本的肝素活性为172~1465 U/L,Hemochron Jr II型和STA-R测定的APTT值分别为87 s±32 s和90 s±46 s(P<0.01)。

结论

干化学POCT不适合与自动分析仪同时报告同一患者的检测结果。

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