Danielson C F, Davis K, Jones G, Benson J, Arney K, Martin J
Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Ind 46202, USA.
Arch Pathol Lab Med. 1997 Sep;121(9):956-9.
Does citrate concentration in specimen collection tubes affect the International Normalized Ratio?
The International Normalized Ratio was determined on quadruplicate plasma specimens from 32 patients treated long term with oral anticoagulants-two from tubes with 3.2% citrate and two with 3.8% citrate. Two laboratories, using two different coagulometers, tested the specimens.
International Normalized Ratios of plasma from tubes with 3.8% citrate were significantly higher than those from tubes with 3.2% citrate when tested with either coagulometer. Patients given adequate anticoagulation on the basis of the International Normalized Ratio at one concentration of citrate appeared either overanticoagulated and at risk of bleeding or underanticoagulated and at risk of thromboembolism at the other concentration of citrate.
Results emphasize the need for using a single concentration of citrate for prothrombin time testing. We recommend 3.2% citrate.
样本采集管中的枸橼酸盐浓度会影响国际标准化比值吗？
对32例长期接受口服抗凝剂治疗患者的血浆样本进行四次重复检测，两份样本来自含3.2%枸橼酸盐的试管，两份来自含3.8%枸橼酸盐的试管。两个实验室使用两种不同的凝血仪对样本进行检测。
使用任一凝血仪检测时，含3.8%枸橼酸盐试管中的血浆国际标准化比值显著高于含3.2%枸橼酸盐的试管。基于一种枸橼酸盐浓度下的国际标准化比值给予充分抗凝的患者，在另一种枸橼酸盐浓度下，要么抗凝过度有出血风险，要么抗凝不足有血栓栓塞风险。
结果强调了凝血酶原时间检测使用单一浓度枸橼酸盐的必要性。我们推荐使用3.2%的枸橼酸盐。
