·维勒布兰德因子的个体内变异性以及需要重复测试的需要
Malene Helligsø Kirkeby1, Johanne Andersen Højbjerg1,2, Anders Mønsted Abildgaard1,2
1Department of Clinical Biochemistry, Aarhus University Hospital, Denmark.
Research and practice in thrombosis and haemostasis
|June 18, 2025
概括
·维勒布兰德因子 (VWF) 水平的个体内变化使诊断复杂化. 在VWF水平接近诊断截止点时,重复测试对于准确的维尔布兰德病 (VWD) 诊断至关重要.
科学领域:
- 血液学 血液学 血液学
- 临床化学 临床化学
- 诊断医学 诊断医学
背景情况:
- 诊断·威尔布兰德病 (VWD) 是具有挑战性的,因为在·威尔布兰德因子 (VWF) 水平显著的个体内变化.
- 目前对VWD的诊断指南依赖于VWF抗原 (VWF:Ag) 或活动水平低于特定值 (0.30或0.50 × 103 IU/L).
- 对于患有接近这些诊断截止点的VWF水平的患者需要重复测试的必要性,没有确立的共识.
研究的目的:
- 调查VWF抗原 (VWF:Ag),VWF血小板结合活性 (VWF:GPIbR) 和VWF原结合活性 (VWF:CB) 的个体内变异程度.
- 根据观察到的VWF变异,使用单个血液样本确定可靠的切断值,以排除VWD.
- 通过评估VWF变异性的影响,为VWD的诊断策略提供信息.
主要方法:
- 一项横截面研究分析了VWF:Ag,VWF:GPIbR和VWF:CB.CB的例行患者数据.
- 数据是从2013年1月到2024年1月从奥胡斯大学医院临床化学系提取的.
- 计算的非分析变化系数 (CVnonanalytical) 用于量化变化和估计方法特定的单个样本截止值.
主要成果:
- 对VWF:Ag,VWF:GPIbR和VWF:CB的非分析CV分别为22.03%,24.10%和24.07%,表明了实质性的个体内变化.
- 基于性别,年龄或VWF水平的亚组之间没有观察到CVnonanalytical的显著差异.
- 用单个样本排除VWD的方法特定的截止值被确定为0.67 × 103 IU/L (VWF:Ag),0.66 × 103 IU/L (VWF:GPIbR) 和0.88 × 103 IU/L (VWF:CB).
结论:
- 在接受VWF测试的患者中,VWF水平存在相当大的个体内变化.
- 这些发现强调了在水平接近下诊断范围时重复VWF测试的关键重要性.
- 这种方法是必要的,以防止虚假排除真正的·维莱布兰德病诊断.
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