Flint Sarah K, Wood R Darren, Abrams-Ogg Anthony C G, Kruth Stephen A, Bersenas Alexa
Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.
Vet Clin Pathol. 2012 Jun;41(2):249-55. doi: 10.1111/j.1939-165X.2012.00431.x. Epub 2012 May 2.
Thrombelastographic (TEG) analysis is a test of global hemostasis in veterinary medicine; however, there have been limited comparisons of analysis of citrated native and kaolin-activated samples.
The purpose of this study was to determine the variation in TEG variables between citrated native and kaolin-activated whole blood samples and to establish reference intervals for both sample types.
Citrated whole blood samples were obtained from 40 healthy dogs. Thirty minutes after collection, TEG analysis was performed simultaneously on samples with and without kaolin-activation. Reaction time (R), clotting time (K), angle (α), maximum amplitude (MA), global clot strength (G), and clot lysis at 30 minutes (LY30) were recorded, and the concordance correlation coefficient (ρ(c)) was calculated for each sample type.
Significant differences between results obtained for kaolin-activated and native samples were obtained for R (mean difference -1.3 minute, P = .0009), K (-0.7 minute, P = .0003), α (+5.1º, P = .002), MA (+2.4 mm, P = .002), and G (+568 dyn/cm(2), P = .0009). LY30 was not different between methods. There was substantial agreement between methods for G (ρ(c) = .69) and MA (ρ(c) = .65), moderate agreement for R (ρ(c) = .45) and α (ρ(c) = .44), fair agreement for K (ρ(c) = .29), and slight agreement for LY30 (ρ(c) = .04).
The TEG variables were significantly altered by kaolin activation; however, some agreement between sample types suggests a consistent bias. In citrated whole blood activated with kaolin, clot formation time is shortened and the amplitude of the tracing is increased, resulting in a TEG tracing that appears to indicate relative hypercoagulability compared with that obtained using native citrated whole blood samples.
血栓弹力图（TEG）分析是兽医学中一项全面的止血检测方法；然而，枸橼酸化全血样本与高岭土激活样本的分析比较有限。
本研究旨在确定枸橼酸化全血样本与高岭土激活全血样本之间TEG变量的差异，并为两种样本类型建立参考区间。
从40只健康犬获取枸橼酸化全血样本。采集后30分钟，对有或无高岭土激活的样本同时进行TEG分析。记录反应时间（R）、凝血时间（K）、角度（α）、最大振幅（MA）、整体凝血强度（G）和30分钟时的凝血溶解（LY30），并计算每种样本类型的一致性相关系数（ρ(c)）。
高岭土激活样本和未激活样本的结果在R（平均差异-1.3分钟，P = 0.0009）、K（-0.7分钟，P = 0.0003）、α（+5.1°，P = 0.002）、MA（+2.4毫米，P = 0.002）和G（+568达因/平方厘米，P = 0.0009）方面存在显著差异。两种方法的LY30无差异。两种方法在G（ρ(c) = 0.69）和MA（ρ(c) = 0.65）方面有高度一致性，在R（ρ(c) = 0.45）和α（ρ(c) = 0.44）方面有中度一致性，在K（ρ(c) = 0.29）方面有一般一致性，在LY30（ρ(c) = 0.04）方面有轻度一致性。
高岭土激活显著改变了TEG变量；然而，样本类型之间的一些一致性表明存在一致的偏差。在用高岭土激活的枸橼酸化全血中，凝血形成时间缩短，描记图的振幅增加，导致与使用未激活的枸橼酸化全血样本相比，TEG描记图似乎显示相对高凝状态。
