Hardy Michael, Catry Emilie, Pouplard Marie, Lecompte Thomas, Mullier François
Institut de Recherche Expérimentale et Clinique - Pôle Mont, Université Catholique de Louvain, Louvain-la-Neuve, Belgium.
Department of Laboratory Medicine, CHU UCL Namur, Yvoir, Belgium.
Res Pract Thromb Haemost. 2024 Jul 26;8(6):102536. doi: 10.1016/j.rpth.2024.102536. eCollection 2024 Aug.
Testing for lupus anticoagulant (LA) is not recommended in case of inflammation as C-reactive protein (CRP) can interfere with the phospholipids present in the activated partial thromboplastin time test used to detect an LA. However, the potential interference of an acute phase protein (ie, CRP) in LA testing using the dilute Russell's viper venom (DRVV) test is poorly studied.
To study the effect of inflammation, as evidenced by increased CRP levels, on DRVV tests.
First, a retrospective analysis (2013-2023) was performed: data on all LA workups were retrieved, and the association between CRP levels and DRVV screen, mix, and confirm clotting times was studied. Second, data on DRVV panels and CRP levels were extracted from 2 prospective studies involving intensive care unit patients to study the association between both variables. Third, CRP was added to normal pooled plasma at 6 relevant concentrations (up to 416 mg/L) to study the association between CRP itself and DRVV coagulation times.
In the retrospective analysis, DRVV screen and confirm clotting times significantly increased as CRP increased (increase of 0.11 seconds and 0.03 seconds per 1 mg/L increase of CRP level, respectively). In the prospective analysis, only DRVV screen was prolonged with high CRP levels (increase of 0.06 seconds for a 1 mg/L increase in CRP level); DRVV screen/confirm ratio was also increased with high CRP levels. , the addition of CRP did not significantly increase any DRVV clotting times.
LA testing should be performed with much caution in the presence of inflammation as it may be associated with prolongation of both activated partial thromboplastin time and DRVV clotting times.
在存在炎症的情况下，不建议检测狼疮抗凝物（LA），因为C反应蛋白（CRP）会干扰用于检测LA的活化部分凝血活酶时间试验中存在的磷脂。然而，急性期蛋白（即CRP）对使用稀释罗素蝰蛇毒（DRVV）试验进行LA检测的潜在干扰研究较少。
研究CRP水平升高所证明的炎症对DRVV试验的影响。
首先，进行了一项回顾性分析（2013 - 2023年）：检索了所有LA检查的数据，并研究了CRP水平与DRVV筛查、混合及确认凝血时间之间的关联。其次，从两项涉及重症监护病房患者的前瞻性研究中提取了DRVV检测组和CRP水平的数据，以研究这两个变量之间的关联。第三，将CRP以6种相关浓度（最高达416 mg/L）添加到正常混合血浆中，以研究CRP本身与DRVV凝血时间之间的关联。
在回顾性分析中，随着CRP升高，DRVV筛查和确认凝血时间显著增加（CRP水平每升高1 mg/L，分别增加0.11秒和0.03秒）。在前瞻性分析中，只有高CRP水平时DRVV筛查时间延长（CRP水平每升高1 mg/L增加0.06秒）；高CRP水平时DRVV筛查/确认比值也增加。此外，添加CRP并未显著增加任何DRVV凝血时间。
在存在炎症的情况下进行LA检测时应非常谨慎，因为这可能与活化部分凝血活酶时间和DRVV凝血时间延长有关。
