Rowell J A, Elms M J, Young J, Bunce I H
Division of Hematology, Royal Brisbane Hospital, Queensland, Australia.
Am J Clin Pathol. 1988 Mar;89(3):347-52. doi: 10.1093/ajcp/89.3.347.
The results are reported of a clinical and laboratory evaluation of the use of a random-access centrifugal analyzer linked to a personal computer in the management of the routine workload of a hemostasis laboratory. Over a three-month period, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin clotting time (TCT), and derived fibrinogen (Fib) were performed on a total of 929 samples. Included in the study were 448 samples from patients receiving anticoagulants (oral anticoagulants, 228; heparin, 166; heparin and warfarin, 130) and 351 samples from patients requiring coagulation screens (PT, APTT, TCT, Fib). Tests were done in parallel with tilt-tube manual techniques and the results correlated. The correlation coefficients were PT, 0.99; TCT, 0.72; APTT, 0.96; Fib, 0.97. Discrepancies were analyzed and were due to hypofibrinogenemia and hyperlipidemia. The poorer correlation coefficient of TCT was attributable both to lower reproducibility of the manual test and the effect of dysfibrinogenemia or FDPs in liver disease. In no case was an abnormality or diagnosis missed using the centrifugal analyzer. In several cases the increased sensitivity of the analyzer improved the detection of the lupus anticoagulant. The use of automation was accompanied by a major reduction in workload and reagent costs. The machine has been used to assay a wide range of coagulation tests by clot based and chromogenic substrate methods. In conclusion, a programmed centrifugal analyzer is a safe, efficient, and flexible way of automating routine coagulation tests. It widens the reportoire of tests performed in the Hemostasis laboratory by using a machine capable of being used in other areas of pathology.
本文报告了在止血实验室的日常工作管理中，使用与个人计算机相连的随机存取离心分析仪的临床和实验室评估结果。在三个月的时间里，对总共929个样本进行了凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶凝血时间（TCT）和纤维蛋白原（Fib）检测。研究包括来自接受抗凝治疗患者的448个样本（口服抗凝剂，228个；肝素，166个；肝素和华法林，130个）以及来自需要进行凝血筛查（PT、APTT、TCT、Fib）患者的351个样本。检测与倾斜管手工技术并行进行，并对结果进行了相关性分析。相关系数分别为：PT，0.99；TCT，0.72；APTT，0.96；Fib，0.97。对差异进行了分析，发现是由于低纤维蛋白原血症和高脂血症所致。TCT的相关系数较差既归因于手工检测的可重复性较低，也归因于肝病中异常纤维蛋白原血症或纤维蛋白降解产物的影响。使用离心分析仪从未漏诊异常或诊断。在几例病例中，分析仪提高的灵敏度改善了狼疮抗凝物的检测。自动化的使用伴随着工作量和试剂成本的大幅降低。该机器已用于通过基于凝血和发色底物方法检测多种凝血试验。总之，程序化离心分析仪是一种安全、高效且灵活的自动化常规凝血试验的方法。它通过使用一台可用于病理学其他领域的机器，拓宽了止血实验室进行检测的范围。
