Hoffmann J J, Verhappen M A
Department of Clinical Laboratories, Catharina Hospital, Eindhoven, The Netherlands.
Clin Chem. 1988 Oct;34(10):2135-40.
We evaluated the performance of an automated nephelometric determination of fibrinogen, which is an integral part of the prothrombin time assay, in a new coagulation analyzer, the ACL-810 (Instrumentation Laboratory). Results were compared with those by a total clottable protein assay and with the thrombin clotting time assay for fibrinogen. In normal and slightly abnormal plasma, the performance of the ACL method was quite satisfactory (CV 3-10%). However, in abnormal plasma (prolonged prothrombin times because of heparin or oral anticoagulants) the accuracy of the ACL method was poor. Nor could the instrument determine fibrinogen in clearly lipemic plasma. In plasma containing high concentrations of fibrin(ogen) degradation products (FDP), collected during thrombolytic therapy with streptokinase-containing drugs, the ACL method gave spuriously high values for fibrinogen concentration. We determined that this was mainly because of interference by intermediate FDP (fragment Y). Finally, we demonstrated that early FDP (fragment X) increased the ACL results for fibrinogen to the same extent as in the total clottable protein method and that late FDP (fragments D and E) affected the thrombin clotting time method, but not the ACL fibrinogen determination.
我们评估了在新型凝血分析仪ACL - 810（仪器实验室）中通过自动比浊法测定纤维蛋白原（凝血酶原时间测定的一个组成部分）的性能。将结果与总可凝蛋白测定法以及纤维蛋白原的凝血酶凝血时间测定法的结果进行了比较。在正常和轻度异常血浆中，ACL方法的性能相当令人满意（变异系数为3 - 10%）。然而，在异常血浆（因肝素或口服抗凝剂导致凝血酶原时间延长）中，ACL方法的准确性较差。该仪器也无法测定明显脂血血浆中的纤维蛋白原。在用含链激酶的药物进行溶栓治疗期间采集的含有高浓度纤维蛋白（原）降解产物（FDP）的血浆中，ACL方法给出的纤维蛋白原浓度值偏高。我们确定这主要是由于中间FDP（Y片段）的干扰。最后，我们证明早期FDP（X片段）使ACL法测定纤维蛋白原的结果升高程度与总可凝蛋白法相同，而晚期FDP（D和E片段）影响凝血酶凝血时间法，但不影响ACL法测定纤维蛋白原。
