Coagulation Laboratory, Department of Clinical Chemistry, Microbiology and Immunology, Ghent University Hospital, Ghent, Belgium.
Int J Lab Hematol. 2018 Jun;40(3):292-303. doi: 10.1111/ijlh.12784. Epub 2018 Feb 5.
Haemostasis testing is influenced by many pre-analytical variables, such as storage time and temperature, which can affect the stability of coagulation factors and influence the results of coagulation assays. We investigated the stability of haemostasis tests after storage of aliquoted plasma at RT, including the variability of measurement principle and reagent used for determination.
Blood samples from 20 healthy volunteers were obtained, processed to PPP and aliquoted. Aliquots were stored at RT for 0 hour, 2 hours, 4 hours, 6 hours, 8 hours, 12 hours, 24 hours and 48 hours. PT, aPTT, fibrinogen, D-Dimers and coagulation factors (FII, FV, FVII, FX, FVIII, FIX, FXI, FXII) were determined by STA-R Max and ACL-TOP . VWF:Ag and vWF:RCo were determined by AcuStar . Clinically relevant changes, compared to the initial measurement, were denoted as a percentage change of > 10% according to the 99% CI.
For both analysers, a clinically relevant change of > 10% was observed for FV after 2 hours, FVIII after 4 hours and for aPTT, FII, FVII, FX and FXII after 48 hours of storage at RT. Statistically significant, but no clinically relevant differences were observed after 48-hours storage for PT, fibrinogen and FIX. D-Dimers, FXI, vWF:Ag and vWF:RCo were found stable up to 48 hours at RT.
Overall, compared to the limits given by the current CLSI guidelines, for most coagulation parameters investigated in this study a longer storage period could be accepted. Time intervals for FVIII and FV dosage were shorter than recommended by the CLSI guidelines. For PT determination, our findings were consistent.
止血测试受到许多分析前变量的影响,例如储存时间和温度,这些因素会影响凝血因子的稳定性,并影响凝血分析的结果。我们研究了在室温下储存等分血浆后止血测试的稳定性,包括用于确定的测量原理和试剂的可变性。
从 20 名健康志愿者中采集血液样本,处理为 PPP 并等分。等分样本在室温下储存 0 小时、2 小时、4 小时、6 小时、8 小时、12 小时、24 小时和 48 小时。PT、aPTT、纤维蛋白原、D-二聚体和凝血因子(FII、FV、FVII、FX、FVIII、FIX、FXI、FXII)通过 STA-R Max 和 ACL-TOP 进行测定。VWF:Ag 和 vWF:RCo 通过 AcuStar 进行测定。与初始测量值相比,临床相关变化表示为 > 10%的百分比变化,根据 99%CI 确定。
对于两种分析仪,FV 在 2 小时后、FVIII 在 4 小时后以及 aPTT、FII、FVII、FX 和 FXII 在室温下储存 48 小时后观察到临床相关变化 > 10%。PT、纤维蛋白原和 FIX 在 48 小时储存后观察到统计学上显著但无临床相关差异。D-二聚体、FXI、vWF:Ag 和 vWF:RCo 在室温下可稳定储存 48 小时。
总体而言,与当前 CLSI 指南给出的限制相比,本研究中大多数凝血参数的储存时间可以更长。VIII 和 FV 剂量的时间间隔短于 CLSI 指南建议的时间间隔。对于 PT 测定,我们的发现是一致的。