基于APTTTT的方法来确定未分离的肝素治疗范围 (HTR) 的比较研究和相关探索
Zixin Chen1, Qiang Xu1, Danyu Song1
1Center of Laboratory Medicine, Beijing Key Laboratory of Cardiovascular Disease Warning and Diagnosis, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China.
概括
肝素治疗范围 (HTR) 监测显示了体外和体外方法之间的差异,受 VIII 和 XII 因子等凝血因子的影响. 临床决策需要考虑这些方法偏差,以准确管理未分离氨酸 (UFH).
科学领域:
- 临床化学 临床化学
- 血液学 血液学 血液学
- 药理学 药理学是指药理学的学科.
背景情况:
- 对于未分离的肝素 (UFH) 监测,建立一个肝素治疗范围 (HTR) 是至关重要的.
- 现有的HTR测定方法显示差异,导致各种结果和影响因素的不确定性.
研究的目的:
- 调查 ex vivo 和 in vitro 方法之间的差异,以确定 HTR.
- 确定导致HTR结果观察到差异的因素.
主要方法:
- 测量APTT,抗Xa活性,凝血因子,FIB和AT在体外UFH患者样本中的测量.
- 使用指数模型计算HTR,用于ex vivo和体外增值样本.
- 比较了三种不同的APTT检测系统的HTR结果.
主要成果:
- 活体HTR通常低于体外HTR,在UFH度较高时差异增加.
- 凝血因子,特别是第八因子和第十二因子,显著影响了HTR,较高的水平与较低的HTR相关.
- 虽然不同的APTT检测系统显示出最小的差异,但一个系统 (Stago) 呈现出更窄的HTR,具有较低的上限.
结论:
- 凝血因子水平的变化,特别是 VIII 和 XII 因子,导致了 ex vivo 和 in vitro 方法之间的 HTR 差异.
- 肝素监测的临床决定必须考虑到ex vivo和in vitro方法的独特特征和潜在偏差.
- 切换检测试剂需要重新建立HTR以与新系统的性能保持一致.
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