Daves Massimo, Giacomuzzi Katia, Tagnin Enrico, Jani Erika, Adcock Funk Dorothy M, Favaloro Emmanuel J, Lippi Giuseppe
aLaboratory of Clinical Biochemistry, Regional Hospital of Bolzano, Bolzano, Italy bEsoterix Inc., Englewood, Denver, Colorado, USA cDepartment of Haematology, Institute of Clinical Pathology and Medical Research (ICPMR), Pathology West, Westmead Hospital, Westmead, New South Wales, Australia dLaboratory of Clinical Chemistry and Haematology, Department of Pathology and Laboratory Medicine, Academic Hospital of Parma, Parma, Italy.
Blood Coagul Fibrinolysis. 2014 Apr;25(3):292-5. doi: 10.1097/MBC.0000000000000026.
Sample centrifugation is an essential step in the coagulation laboratory, as clotting tests are typically performed on citrated platelet (PLT) poor plasma (PPP). Nevertheless, no clear indication has been provided as to whether centrifugation of specimens should be performed with the centrifuge brake set to on or off. Fifty consecutive sodium citrate anticoagulated samples were collected and divided into two aliquots. The former was centrifuged as for Clinical Laboratory Standards Institute (CLSI) guidelines with the centrifuge brake set to on, whereas the latter was centrifuged again as for CLSI guidelines, but with the brake set to off. In the PPP of all samples, a PLT count was performed, followed by the analysis of activated partial thromboplastin time (APTT), prothrombin time (PT) and fibrinogen (FBG). The PLT count after samples centrifugation was substantially reduced, either with centrifuge brake set to on or off (5 ± 1 versus 3 ± 1 × 10/l; P = 0.009). The frequency of samples exceeding a PLT count less than 10 × 10/l was nearly double in samples centrifuged with the brake on than in those with the brake off (14 versus 8%; P < 0.01). Although no significant difference was found for APTT values, PT was slightly prolonged using the centrifuge brake set to on (mean bias 0.2 s; P < 0.001). FBG values were also significantly higher using the centrifuge brake set to on (mean bias 0.29 g/l; P < 0.001). The results of this study indicate that sample centrifugation for routine coagulation testing should be preferably performed with the centrifuge brake set to off for providing a better quality specimen.
样本离心是凝血实验室的一个重要步骤，因为凝血试验通常在枸橼酸盐抗凝的少血小板血浆（PPP）上进行。然而，关于样本离心时离心机刹车应设置为开还是关，尚未给出明确的指示。收集了50个连续的枸橼酸钠抗凝样本，并分成两份。前者按照临床实验室标准协会（CLSI）指南，在离心机刹车设置为开的情况下进行离心，而后者再次按照CLSI指南进行离心，但刹车设置为关。在所有样本的PPP中，进行血小板计数，随后分析活化部分凝血活酶时间（APTT）、凝血酶原时间（PT）和纤维蛋白原（FBG）。无论离心机刹车设置为开还是关，样本离心后的血小板计数都大幅降低（5±1对3±1×10⁹/L；P = 0.009）。刹车开着离心的样本中血小板计数低于10×10⁹/L的样本频率几乎是刹车关着离心的样本的两倍（14%对8%；P < 0.01）。虽然APTT值没有发现显著差异，但使用离心机刹车设置为开时PT略有延长（平均偏差0.2秒；P < 0.001）。使用离心机刹车设置为开时FBG值也显著更高（平均偏差0.29g/L；P < 0.001）。本研究结果表明，常规凝血检测的样本离心最好在离心机刹车设置为关的情况下进行，以提供质量更好的样本。
