在实验室实践中测量直接口服抗凝剂水平:血液样本不同存储条件的影响
Andrea Sorrentino1, Angela Rogolino2, Francesca Cesari2
1Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
International journal of laboratory hematology
|December 23, 2025
概括
在各种储存条件下,直接口服抗凝剂 (DOAC) 的血水平在24小时内保持稳定,即使在延迟时也能确保可靠的测试. 对一些DOAC的轻微偏差通常不会影响临床决策.
科学领域:
- 药理学 药理学是指药理学的学科.
- 临床化学 临床化学
- 分析毒理学分析毒理学
背景情况:
- 直接口服抗凝剂 (DOAC) 广泛使用,需要在特定的临床场景中进行可靠的血水平测试.
- 样品储存条件对DOAC测定准确性的影响尚未得到充分证实.
- 这项研究调查了四种DOACs (阿皮克萨班,里瓦罗克萨班,埃多克萨班,达比加特兰) 在24小时储存后的稳定性.
研究的目的:
- 为了评估24小时储存后阿皮克萨班,里瓦罗克萨班,埃多克萨班和达比加特兰的血水平的稳定性.
- 评估不同储存条件 (室温,4°C,-20°C) 引入的潜在系统错误.
- 为了确定延迟的DOAC测试是否会影响临床解释.
主要方法:
- 纳入了接受DOAC治疗的182名患者.
- 血液样本被两次采集,其中一个被立即处理,另一个被存储为全血或血24小时.
- 使用专用测定测量DOAC度,使用统计方法分析稳定性,包括布兰德-阿尔特曼分析.
主要成果:
- 所有测试的DOAC在24小时内都表现出良好的稳定性,中位数的恢复率在93%至102%之间.
- 在整个储存条件中没有发现任何显著的比例错误.
- 对于阿皮克萨班,里瓦罗克萨班和埃多克萨班,观察到较小的常量偏差,而达比加特兰没有显着的偏差. 波动性仍然很低 (<7%).
结论:
- 在各种储存条件下,DOAC的血水平至少稳定24小时,包括室温,4°C和-20°C.
- 在大多数情况下,对某些DOAC观察到的轻微偏差不太可能影响临床解释.
- 在不危及结果可靠性的情况下,DOAC水平测试可以在收集后推迟.
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