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揭示脂诱导的"效应"及其影响 - - 增加脂也可以导致凝血测试中的更长的凝血时间

Liqin Ling¹, Chaonan Liu¹, Xunbei Huang¹

¹Department of Laboratory Medicine, Clinical Laboratory Medicine Research Center, West China Hospital, Sichuan University Sichuan Clinical Research Center for Laboratory Medicine, No. 37 Guo Xue Alley, Chengdu, 610041, Sichuan, China.

Journal of thrombosis and thrombolysis

|October 10, 2025

概括

更高的脂度可以矛盾地延长狼抗凝剂 (LA) 试验中的凝血时间,可能导致误诊,特别是在患有凝血因子缺乏症的患者中. 仔细解释这些依赖脂的测试非常重要.

科学领域:

血液学血液学血液学
临床化学临床化学
凝血诊断凝血诊断凝血诊断

背景情况:

脂度通常被接受,以缩短凝血时间.
脂依赖性狼抗凝剂 (LA) 试验,如dRVVT和SCT,被广泛使用.
在LA中观察到较长的凝血时间与缩脂的悖论性发现,证实了测试.

研究的目的:

在LA试验中,研究用缩脂化合物的较长凝血时间的原因.
评估这种现象对LA诊断的影响.
了解不同类型血中不同脂度对凝血时间的影响.

主要方法:

测试了拉塞尔蛇毒时间 (RVVT) 和不同脂度的凝时间 (SCT).
使用了正常聚合等离子体 (NPP),缺因子等离子体,肝硬化患者等离子体 (CPP) 和LA阳性等离子体 (LPP).
在有或没有因子缺乏症的LPP进行了例行LA测定.

主要成果:

在NPP和缺因子等离子体中,较高的脂缩短了凝血时间,显示出U形曲线效应.
在CPP中,凝血时间随着脂度 (U形的右侧) 的增加而增加.
在LPP中,凝固时间最初缩短,然后随着脂的增加 (U形的左侧) 趋于平稳.
缺乏因子的LPP在确认试验中显示出更小的校正,增加了LA误诊风险 (dRVVT:25.9%对15.1%;SCT:28.6%对4.1%).

结论:

增加的脂度可以在凝血试验中诱导"效应".
基于凝块的脂依赖性测定,包括LA测定,需要仔细解释.
患者的凝血因子缺乏症可能会显著影响LA测定结果,并导致误诊.

关键词:

凝血是凝固的过程.缺陷因子是因子缺乏的原因之一.这是一种狼抗凝剂.脂酸是一种脂酸.

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