Robert A, Chazouillères O
Laboratoire Central d'Hématologie et d'Immunologie, Hôpital Saint-Antoine, Paris, France.
Hepatology. 1996 Dec;24(6):1392-4. doi: 10.1053/jhep.1996.v24.pm0008938167.
Prothrombin time (PT) is a universal indicator of liver disease severity. However, variability in thromboplastin reagents leads to large interlaboratory differences in PT results. The aim of this study was to determine whether the use of the international normalized ratio (INR) or other modes of expression might achieve PT standardization in patients with liver failure. PT was measured with seven thromboplastin reagents with different sensitivities in plasmas from 27 patients with miscellaneous chronic and acute liver failure and, as a control population, 29 patients on oral anticoagulation therapy. PT was expressed in seconds, ratio, activity percentage, and INR. In patients with liver failure, only activity percentage expression eliminated variability in PT results obtained with the seven thromboplastins while INR, seconds, and ratio values remained significantly different (P < .01). In patients on oral anticoagulant therapy, only INR normalized PT results. We conclude that, in patients with liver failure, INR fails to yield a PT expression independent of the thromboplastin used and only activity percentage expression may provide a common international scale of PT reporting.
凝血酶原时间（PT）是肝病严重程度的通用指标。然而，凝血活酶试剂的差异导致PT结果在不同实验室间存在较大差异。本研究的目的是确定使用国际标准化比值（INR）或其他表达模式是否能实现肝衰竭患者PT的标准化。在27例患有各种慢性和急性肝衰竭的患者以及作为对照人群的29例接受口服抗凝治疗的患者的血浆中，使用七种不同灵敏度的凝血活酶试剂测量PT。PT以秒、比值、活性百分比和INR表示。在肝衰竭患者中，只有活性百分比表达消除了使用七种凝血活酶获得的PT结果的变异性，而INR、秒和比值仍存在显著差异（P <.01）。在接受口服抗凝治疗的患者中，只有INR使PT结果标准化。我们得出结论，在肝衰竭患者中，INR无法产生与所使用的凝血活酶无关的PT表达，只有活性百分比表达可能提供PT报告的通用国际标准。
