Quien E T, Morales E, Cisar L A, Kim H C, Cimini C, Saidi P, Philipp C S
Division of Hematology, University of Medicine and Dentistry of New Jersey (UMDNJ)-Robert Wood Johnson Medical School, New Brunswick 08903, USA.
Am J Hematol. 1997 Aug;55(4):193-8. doi: 10.1002/(sici)1096-8652(199707)55:4<193::aid-ajh5>3.0.co;2-n.
To measure the amount of tissue factor released during specimen collection and its potential effect of shortening the prothrombin time, we measured tissue factor and prothrombin time in twenty-three paired venous and capillary blood samples from anticoagulated patients and in ten paired samples from controls. We also compared venous prothrombin time determined by a plasma-based assay with venous and capillary prothrombin time determined with a whole blood assay. Venous specimens were obtained using a two-syringe technique; capillary specimens were obtained by fingerstick after wiping the first drop of blood. Plasma tissue factor was determined by an enzyme-linked immunoabsorbant assay. The patients' mean venous tissue factor (235 +/- 101 pg/ml) and capillary tissue factor (268 +/- 106 pg/ml) were higher than those of the controls (161 +/- 42 pg/ml and 187 +/- 63 pg/ml, respectively, P < 0.05). These differences disappeared after adjusting for age. Capillary tissue factor levels were higher than venous tissue factor (244 +/- 102 pg/ml vs. 213 +/- 93 pg/ml), with a mean difference of 31 pg/ml (P = 0.0001). In addition, whole blood prothrombin time was lower in the capillary than in the venous samples (17.7 +/- 5 sec vs. 18.3 +/- 5.4 sec, P = 0.004). However, there was no correlation between capillary-venous differences in tissue factor and capillary-venous differences in the whole blood prothrombin time. Whole blood capillary and venous prothrombin times highly correlated with the plasma-based venous prothrombin time (r = 0.98, P < 0.0001). These results demonstrate that obtaining blood by fingerstick does not result in a clinically significant release of tissue factor. In addition, we did not observe any interference of plasma tissue factor with the whole blood prothrombin time assay. A direct relationship between tissue factor and age was observed.
为了测量标本采集过程中释放的组织因子量及其缩短凝血酶原时间的潜在作用，我们检测了23例抗凝患者的配对静脉血和毛细血管血样本以及10例对照的配对样本中的组织因子和凝血酶原时间。我们还比较了基于血浆检测法测定的静脉凝血酶原时间与全血检测法测定的静脉和毛细血管凝血酶原时间。静脉标本采用双注射器技术采集；毛细血管标本通过擦拭第一滴血后手指采血获得。血浆组织因子通过酶联免疫吸附测定法测定。患者的平均静脉组织因子（235±101 pg/ml）和毛细血管组织因子（268±106 pg/ml）高于对照组（分别为161±42 pg/ml和187±63 pg/ml，P<0.05）。校正年龄后这些差异消失。毛细血管组织因子水平高于静脉组织因子（244±102 pg/ml对213±93 pg/ml），平均差异为31 pg/ml（P = 0.0001）。此外，毛细血管全血凝血酶原时间低于静脉样本（17.7±5秒对18.3±5.4秒，P = 0.004）。然而，组织因子的毛细血管 - 静脉差异与全血凝血酶原时间的毛细血管 - 静脉差异之间无相关性。毛细血管和静脉全血凝血酶原时间与基于血浆的静脉凝血酶原时间高度相关（r = 0.98，P<0.0001）。这些结果表明，手指采血不会导致临床上显著的组织因子释放。此外，我们未观察到血浆组织因子对全血凝血酶原时间检测有任何干扰。观察到组织因子与年龄之间存在直接关系。
