联合使用Clauss法和凝血酶原时间衍生法测定纤维蛋白原浓度：先天性异常纤维蛋白原血症的筛查
Combined use of Clauss and prothrombin time-derived methods for determining fibrinogen concentrations: Screening for congenital dysfibrinogenemia.
作者信息
Xiang Liqun, Luo Meiling, Yan Jie, Liao Lin, Zhou Weijie, Deng Xuelian, Deng Donghong, Cheng Peng, Lin Faquan
机构信息
Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Department of hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
出版信息
J Clin Lab Anal. 2018 May;32(4):e22322. doi: 10.1002/jcla.22322. Epub 2017 Sep 18.
BACKGROUND
In this study, the significance of fibrinogen concentration assessed by a combination of Clauss and prothrombin time (PT)-derived methods for screening for congenital dysfibrinogenemia were investigated, and the screening efficiency of fibrinogen PT-derived/Clauss ratio on congenital dysfibrinogenemia was analyzed.
METHODS
We compared fibrinogen concentrations determined by the Clauss, PT-derived, and enzyme-linked immunosorbent assay (ELISA) methods in 73 patients with congenital dysfibrinogenemia and 81 normal controls. Receiver operating characteristic (ROC) curves were utilized to evaluate the efficacy of fibrinogen PT-derived/Clauss ratio in screening for congenital dysfibrinogenemia.
RESULTS
Fibrinogen concentrations determined by the Clauss method were dramatically lower than by the PT-derived method and ELISA, and correlated poorly with the latter two methods in patients with congenital dysfibrinogenemia. Fibrinogen concentrations in normal controls were slightly lower according to the Clauss method than to the PT-derived method and ELISA; however, each method yielded results within the normal range and the correlation was good. The area under the ROC curve of fibrinogen PT-derived/Clauss ratio for diagnosis of congenital dysfibrinogenemia was 1 with a standard error of 0, 95% confidence interval of 0.976-1.00, and optimal critical diagnosis point of 1.43. When fibrinogen PT-derived/Clauss ratio was >1.43, the sensitivity and specificity for diagnosis of congenital dysfibrinogenemia were both 100%.
CONCLUSIONS
The combined use of Clauss and PT-derived methods for determining fibrinogen concentrations improves the efficiency of screening for congenital dysfibrinogenemia, as the fibrinogen PT-derived/Clauss ratio has high sensitivity and specificity in diagnosis of congenital dysfibrinogenemia. This ratio could serve an important screening tool for this disease.
背景
本研究探讨了采用Clauss法与凝血酶原时间（PT）衍生法相结合评估纤维蛋白原浓度对先天性异常纤维蛋白原血症进行筛查的意义，并分析了纤维蛋白原PT衍生/Clauss比值对先天性异常纤维蛋白原血症的筛查效率。
方法
我们比较了73例先天性异常纤维蛋白原血症患者和81例正常对照者采用Clauss法、PT衍生法和酶联免疫吸附测定（ELISA）法测定的纤维蛋白原浓度。采用受试者工作特征（ROC）曲线评估纤维蛋白原PT衍生/Clauss比值对先天性异常纤维蛋白原血症的筛查效能。
结果
在先天性异常纤维蛋白原血症患者中，Clauss法测定的纤维蛋白原浓度显著低于PT衍生法和ELISA法，且与后两种方法的相关性较差。正常对照者中，Clauss法测定的纤维蛋白原浓度略低于PT衍生法和ELISA法；然而，每种方法的结果均在正常范围内，且相关性良好。纤维蛋白原PT衍生/Clauss比值诊断先天性异常纤维蛋白原血症的ROC曲线下面积为1，标准误为0，95%置信区间为0.976 - 1.00，最佳临界诊断点为1.43。当纤维蛋白原PT衍生/Clauss比值>1.43时，诊断先天性异常纤维蛋白原血症的灵敏度和特异度均为100%。
结论
联合使用Clauss法和PT衍生法测定纤维蛋白原浓度可提高先天性异常纤维蛋白原血症的筛查效率，因为纤维蛋白原PT衍生/Clauss比值在诊断先天性异常纤维蛋白原血症方面具有高灵敏度和特异度。该比值可作为本病重要的筛查工具。
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