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一项新的前瞻性研究中对包括治疗后患者样本在内的自动乳胶血管性血友病因子活性检测的验证。

Validation of automated latex von Willebrand factor activity assay in a new prospective study including post-treatment patient samples.

作者信息

Ettel M, Nardi M A, McVoy L

机构信息

Department of Pathology, New York University School of Medicine, New York, NY, USA.

Department of Pediatrics, New York University School of Medicine, New York, NY, USA.

出版信息

Int J Lab Hematol. 2017 Jun;39(3):286-292. doi: 10.1111/ijlh.12622. Epub 2017 Jan 25.

Abstract

INTRODUCTION

Von Willebrand disease (VWD) is the most prevalent inherited bleeding disorder. Diagnosis requires measurement of VWF-platelet binding function, for which VWF ristocetin cofactor activity (VWF:RCo) is the reference method. Recently, an automated latex particle-enhanced immunoturbidimetric von Willebrand factor activity assay (VWF:Ab) has been validated showing superior characteristics. We further validate VWF:Ab in a prospective study including post-treatment patient samples.

METHODS

A total of 1151 samples were collected from patients tested for VWD, including 119 samples from patients treated with desmopressin or VWF replacement product. All samples were tested for VWF:Ab and VWF:RCo, and the methods were compared using linear regression. Imprecision, linearity and lower detection limit were determined for both assays.

RESULTS

VWF:Ab showed improved precision compared to VWF:RCo. Linear regression of VWF:Ab and VWF:RCo across all samples exhibited good agreement (R = 0.89) with statistical significance (P < 0.001) and bias of -8.7. Concordance was high in classifying samples as normal or abnormal. Analysis of treated samples showed excellent agreement (R = 0.91) with statistical significance (P < 0.001) and bias of -4.3.

CONCLUSIONS

Our analysis validates the VWF:Ab assay in a prospective study of a large cohort of patient samples and extends these results to post-treatment patient samples.

摘要

引言

血管性血友病(VWD)是最常见的遗传性出血性疾病。诊断需要测定血管性血友病因子(VWF)与血小板的结合功能,其中VWF瑞斯托霉素辅因子活性(VWF:RCo)是参考方法。最近,一种自动乳胶颗粒增强免疫比浊法检测血管性血友病因子活性(VWF:Ab)已得到验证,显示出优越的特性。我们在一项包括治疗后患者样本的前瞻性研究中进一步验证了VWF:Ab。

方法

从接受VWD检测的患者中总共收集了1151份样本,其中包括119份接受去氨加压素或VWF替代产品治疗的患者样本。所有样本均检测VWF:Ab和VWF:RCo,并使用线性回归比较这两种方法。测定了两种检测方法的不精密度、线性和检测下限。

结果

与VWF:RCo相比,VWF:Ab显示出更高的精密度。所有样本中VWF:Ab和VWF:RCo的线性回归显示出良好的一致性(R = 0.89),具有统计学意义(P < 0.001),偏差为-8.7。在将样本分类为正常或异常方面一致性很高。对治疗后样本的分析显示出极好的一致性(R = 0.91),具有统计学意义(P < 0.001),偏差为-4.3。

结论

我们的分析在一大组患者样本的前瞻性研究中验证了VWF:Ab检测方法,并将这些结果扩展到治疗后患者样本。

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