Eschwège V, Seddiki S, Robert A
Laboratoire Central d'Hématologie, Hôpital Saint-Antoine, Paris, France.
Thromb Haemost. 1996 Jul;76(1):65-8.
Tissue thromboplastin inhibition test (TTI) is a highly sensitive but poorly specific test used in the diagnosis of lupus anticoagulant (LA) which is usually requested for patient with inflammatory status. Therefore, we investigated the influence of fibrinogen level on TTI using Recombiplastin (Ortho), Neoplastine (Diagnostica Stago) and Thromborel S (Behring), in a group of 84 patients with fibrinogen levels ranging from 1.6 to 11.8 g/l. The highly significant (p < 0.0001) positive correlation observed between fibrinogen level and TTI with the 3 thromboplastins allowed the calculation of a new TTI value corrected for fibrinogen level named TTIfg. TTIfg was defined as TTI - ("S" x fibrinogen level) where "S" was the slope of the regression line defining TTI as a function of fibrinogen values. In the group studied, the low TTI specificity, respectively 64%, 67% and 75% with Recombiplastin, Neoplastine and Thromborel S, was greatly improved to respectively 95%, 93% and 95% when results were expressed as TTIfg. TTIfg remained as sensitive as TTI when evaluated in a group of 38 patients with previously diagnosed LA.
组织凝血活酶抑制试验（TTI）是一种高度敏感但特异性较差的试验，用于诊断狼疮抗凝物（LA），通常用于有炎症状态的患者。因此，我们使用重组凝血活酶（Ortho公司）、新凝血活酶（Diagnostica Stago公司）和凝血因子S（贝林公司），在一组84例纤维蛋白原水平在1.6至11.8 g/l之间的患者中，研究了纤维蛋白原水平对TTI的影响。观察到纤维蛋白原水平与使用这3种凝血活酶检测的TTI之间存在高度显著的正相关（p < 0.0001），据此计算出一个针对纤维蛋白原水平校正后的新TTI值，称为TTIfg。TTIfg定义为TTI - （“S”×纤维蛋白原水平），其中“S”是将TTI定义为纤维蛋白原值的函数的回归线斜率。在研究组中，使用重组凝血活酶、新凝血活酶和凝血因子S时，TTI的低特异性分别为64%、67%和75%，而当结果以TTIfg表示时，特异性分别大幅提高到95%、93%和95%。在一组38例先前诊断为LA的患者中进行评估时，TTIfg与TTI一样敏感。
