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从血友病到深静脉血栓患者样本:如何根据现有指南进行简单凝血仪验证过程。

From Hemophilia to Deep Venous Thrombosis Patient Samples: How to Perform an Easy Coagulometer Validation Process According to Available Guidelines.

机构信息

Laboratory Hemostasis and Thrombosis, Hematology and Hemotherapy Center, University of Campinas-UNICAMP Campinas, São Paulo, Brazil.

出版信息

Clin Appl Thromb Hemost. 2020 Jan-Dec;26:1076029620915512. doi: 10.1177/1076029620915512.

Abstract

Validation protocols for the evaluation of coagulometers are needed to help professionals select the most suitable system for their regular laboratory routines. The objective of this study was to show how high standard protocols for the coagulometer validation process can fit into the daily laboratory routine. For this study, 45 healthy individuals and 112 patient samples were analyzed. From the patient samples, 51 were investigated for deep venous thrombosis, 27 for coagulopathy, 19 for antivitamin K therapy, and 15 for hemophilia. For the assessment, the performance of the 3 coagulometers and 1 point-of-care device was considered. One of the coagulometers was a new acquisition evaluated for precision, linearity, throughput, and carryover in the first moment, and the new coagulometer was then compared with the other well-established equipment in the laboratory. In normal plasma, coefficient of variation was ≤1.8% for total precision in screening tests and ≤3.5% for within-run precision in specific assays. For prothrombin time/international normalized ratio, no significant difference was found when comparing methods. Our study showed how to compare the capacity of a reagent in order to discriminate patients with severe hemophilia from patients with moderated hemophilia, and the κ coefficient agreement was 0.669 (95% confidence interval: 0.3-1.0; < .001). d-dimer evaluated in patients with deep venous thrombosis and controls showed a 20% discrepancy between the methods. In our experience across Latin America, the number of laboratories that has performed this process is limited. In this study, we demonstrated how to adapt the validation process for the hemostasis laboratory routine to help the professional chose the best and more suitable option.

摘要

为了帮助专业人员选择最适合其常规实验室常规的系统,需要评估凝血仪的验证方案。本研究的目的是展示凝血仪验证过程的高标准方案如何适应日常实验室常规。在这项研究中,分析了 45 名健康个体和 112 名患者样本。从患者样本中,有 51 例用于深静脉血栓形成,27 例用于凝血功能障碍,19 例用于抗维生素 K 治疗,15 例用于血友病。对于评估,考虑了 3 台凝血仪和 1 台即时检测设备的性能。一台新购置的凝血仪在第一时间评估了精密度、线性度、吞吐量和携带污染,然后将新凝血仪与实验室中其他成熟的设备进行了比较。在正常血浆中,筛选试验的总精密度的变异系数≤1.8%,特定试验的批内精密度的变异系数≤3.5%。对于凝血酶原时间/国际标准化比值,两种方法之间没有发现显著差异。我们的研究展示了如何比较试剂的能力,以便区分严重血友病患者和中度血友病患者,κ 系数一致性为 0.669(95%置信区间:0.3-1.0;<0.001)。在深静脉血栓形成和对照患者中评估的 D-二聚体显示两种方法之间存在 20%的差异。在我们在拉丁美洲的经验中,进行此过程的实验室数量有限。在本研究中,我们展示了如何适应止血实验室常规的验证过程,以帮助专业人员选择最佳和更合适的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b329/7427006/3050f4fb6b17/10.1177_1076029620915512-fig1.jpg

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