抗脂抗体对前激素时间和国际正常化比率的影响:一个范围审查
Arne Vandevelde1,2, Mohammad Amir2, Katrien M J Devreese1,2
1Department of Diagnostic Sciences, Ghent University, Ghent, Belgium.
Critical reviews in clinical laboratory sciences
|December 3, 2025
概括
抗脂抗体 (aPL) 可以影响抗脂综合征 (APS) 患者的凝血测试 (INR). 这次审查强调,某些测试可能会产生不可靠的结果,影响抗凝血监测.
科学领域:
- 临床化学和血液学
- 免疫学和自身免疫性疾病
背景情况:
- 已知抗脂抗体 (aPL) 会干扰实验室检测.
- 患有抗脂综合征 (APS) 的患者需要使用国际正常化比率 (INR) 进行可靠的抗凝血监测.
- aPL干扰INR测定的程度及其临床意义尚不清楚.
研究的目的:
- 进行范围审查,对APS和aPL对前列血时间 (PT) /INR测定影响的证据进行映射.
- 描述该领域使用的研究方法.
- 为了确定未来调查的研究差距.
主要方法:
- 根据PRISMA-Scr指南的范围审查方法.
- 从1984年1月到2025年6月,搜索了MEDLINE和Embase数据库.
- 包括39项研究 (观察性,病例报告/系列,体外调查),涉及患有APS或aPL的人类受试者,用INR/PT测定分析.
主要成果:
- 观察性研究表明,基于复合人体组织因子 (TF) 的测定方法,包括治疗点测试 (POCT),比组织衍生型血小板蛋白测定方法更容易受到aPL干扰.
- 病例报告显示,在患有多重aPL.PL的患者中,对抗凝血状态的临床意义上的误解.
- 实验室研究表明,由于特定的aPL (例如,抗β2-糖蛋白I,抗原血IgG) 的变异性PT延长或缩短,取决于试剂和抗体特征.
结论:
- 有证据表明,APS患者的INR结果可能不可靠,特别是某些基于TF和POCT的重组试剂.
- 干扰取决于抗体配置,水平和特定的试验试剂.
- 不同类型的研究设计和方法需要明确的未来研究,以确定针对特定测试的不可靠INR结果的APS子组.
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