1 Department of Biochemistry, Jinhua Municipal Central Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang Province, China.
2 Department of Thrombosis and Haemostasis, Ruijin Hospital of Shanghai Jiaotong University Shanghai, China.
Clin Appl Thromb Hemost. 2019 Jan-Dec;25:1076029619867137. doi: 10.1177/1076029619867137.
To describe the effect of dabigatran on thrombin time (TT) reagents at different concentrations of thrombin. Pooled normal plasma enriched with dabigatran was dissolved in dimethylsulfoxide (DMSO) at concentrations of 0, 20, 50, 100, 200, 300, and 500 ng/mL. Samples with each concentration were evaluated using a semiautomatic coagulation analyzer to assess the effect of dabigatran on internal normalized ratio (INR), thromboplastin time (APTT), and TT, which were purchased from Instrument Laboratory (IL), Sysmex (SYS), and Stago (STA), respectively. Regarding INR, no reagent showed good sensitivity to increasing concentration of dabigatran, despite all reagents showing good linear response curves ( = .012). Regarding APTT, all reagents had low sensitivity to increasing dabigatran concentration, but SYS-APTT showed a better linear response curve ( = .001). Regarding TT, all reagents had a good linear response to the concentration of dabigatran; however, SYS-TT was very sensitive at low concentrations of dabigatran (0-100 ng/mL), while IL (TT-5 mL) and STA-TT were sensitive at medium concentrations of dabigatran (0-300 ng/mL), and IL (TT-2 mL) was less sensitive for a wide concentration of dabigatran (0-500 ng/mL; = .007). Internal normalized ratio and APTT showed low sensitivity and SYS-TT showed high sensitivity to concentrations of dabigatran that were unsuitable to monitor. Both IL (TT-5 mL) and STA-TT were useful at medium concentrations of dabigatran by semiautomatic coagulation analyzer, which calculated results using the end point method of coagulation. Instrument Laboratory (TT-2 mL), which contains a higher concentration of thrombin, had better sensitivity to the concentration of dabigatran than APTT and was suitable for routine monitoring by an automatic analyzer.
描述达比加群对不同浓度凝血酶的凝血酶时间（TT）试剂的影响。将富含达比加群的混合正常血浆用二甲基亚砜（DMSO）溶解在 0、20、50、100、200、300 和 500ng/mL 的浓度下。使用半自动凝血分析仪评估每种浓度的样品，以评估达比加群对内源性比值（INR）、活化部分凝血活酶时间（APTT）和 TT 的影响，这些试剂分别购自Instrument Laboratory（IL）、Sysmex（SYS）和Stago（STA）。关于 INR，尽管所有试剂均显示出良好的线性响应曲线（=0.012），但没有一种试剂对达比加群浓度的增加具有良好的敏感性。关于 APTT，所有试剂对达比加群浓度的增加均不敏感，但 SYS-APTT 显示出更好的线性响应曲线（=0.001）。关于 TT，所有试剂对达比加群浓度均有良好的线性响应；然而，SYS-TT 在低浓度达比加群（0-100ng/mL）时非常敏感，而 IL（TT-5mL）和 STA-TT 在中等浓度达比加群（0-300ng/mL）时敏感，而 IL（TT-2mL）在宽浓度达比加群（0-500ng/mL）时不太敏感（=0.007）。INR 和 APTT 显示出低敏感性，SYS-TT 对不适合监测的达比加群浓度显示出高敏感性。IL（TT-5mL）和 STA-TT 均通过半自动凝血分析仪在中等浓度的达比加群下有用，该分析仪使用终点法计算凝血结果。含有较高浓度凝血酶的 Instrument Laboratory（TT-2mL）对达比加群浓度的敏感性优于 APTT，适合通过自动分析仪进行常规监测。
