国际血液学标准化委员会 实地研究 评估激活的部分血质子时间和前血时间混合研究的最佳解释方法
Robert C Gosselin1, Gary W Moore2,3, Geoffrey W Kershaw4
1From the Hemostasis & Thrombosis Center, University of California, Davis Health System, Sacramento (Gosselin).
Archives of pathology & laboratory medicine
|November 30, 2023
概括
确定延长的前列血时间 (PT) 和激活的部分血栓形成时间 (APTT) 的原因需要对混合试验进行仔细分析. 没有一种单一的计算方法能够始终地将因子缺乏与抑制剂区分开来.
科学领域:
- 血液学 血液学 血液学
- 临床化学 临床化学
- 诊断 实验室科学 诊断 实验室科学
背景情况:
- 血栓激素时间 (PT) 和激活的部分血栓塑时间 (APTT) 是对出血障碍的关键查测试.
- 与正常血混合试验用于在PT/APTT延长时区分因子缺乏与抑制剂.
- 由于试剂和方法的变化,解释混合试验结果可能具有挑战性.
研究的目的:
- 在国际多站点研究中确定解释等离子体混合试验的最佳计算方法.
- 评估各种PT和APTT试剂的不同计算方法的性能.
- 评估不同方法的错误预测率,以区分因子缺陷和抑制剂.
主要方法:
- 一项国际性的多站点研究,涉及22个异常和25个正常血样本.
- 在每个测试地点使用局部PT和APTT试剂进行混合研究.
- 对11种不同的计算方法进行评估,以解释混合试验结果,包括百分比校正和减法.
主要成果:
- 百分比校正是解释PT混合试验的最合适方法;不建议化PT混合试验.
- 对于APTT混合试验,建议进行百分比校正,并通过减去III确认可疑的因子缺陷.
- 鉴定因子缺陷的有效方法往往具有高的错误预测率抑制剂,反之亦然.
结论:
- 没有一种单一的混合试验计算方法能够一致而准确地区分因子缺陷和抑制剂.
- 在解释混合试验结果时,不同试剂和试验场所之间存在显著的变化.
- 为了准确诊断出血障碍,需要进一步标准化或开发可靠的解释方法.
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