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在XVIII因子抑制剂试验中,直接的口服抗凝剂干扰和去除因子VIII抑制剂

Rick Timmerije^1,2, Saskia E M Schols^3,4, Daniëlle Meijer^3,4

¹Laboratory of Hematology, Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.

Research and practice in thrombosis and haemostasis

|February 2, 2026

概括

直接口服抗凝剂 (DOACs) 在XVIII因子抑制剂测试中引起虚假阳性. 移除DOAC有效地恢复了测定精度,支持其在抗凝治疗患者的临床实践中使用.

科学领域:

血液学血液学血液学
临床化学临床化学
药理学药理学是指药理学的学科.

背景情况:

直接口服抗凝剂 (DOAC) 是广泛使用的抗凝剂.
DOACs可以干扰实验室测试,包括因子VIII (FVIII) 抑制剂测试.
这种干扰可能导致不准确的结果和潜在的有害的临床决定.

研究的目的:

在FVIII抑制剂测定中调查DOAC干扰的程度.
评估基于活性木炭的DOAC去除在恢复试验可靠性的有效性.
在FVIII抑制剂测试中评估DOAC去除的临床适用性.

主要方法:

血样本中添加了不同度的多种DOACs (阿皮克萨班,埃多克萨班,里瓦罗克萨班,达比加特兰).
用Nijmegen-Bethesda测定法测量FVIII抑制剂活性,使用或不使用DOAC去除治疗.
评估了工作流的表现,使用患者血样本从获得的血友病A.个体.

主要成果:

DOAC的增量导致了度依赖的虚假阳性FVIII抑制剂结果.
达比加特兰表现出最强的干扰,而阿皮克萨班表现出最弱的干扰.
移除DOAC显著减少或消除干扰,移除后的结果与基线水平非常接近.

结论:

在FVIII抑制剂测定中,DOACs存在错误阳性结果的重大风险.
基于活性炭的DOAC去除是一种有效的方法,以确保试验准确性.
在接受抗凝固药治疗的患者中,建议将DOAC去除纳入测试方案.

关键词:

在DOAC测量测量.删除DOAC的删除 DOAC 的删除第八个因子的因素.作为第八因子抑制剂.抑制剂抑制剂的作用干扰干扰是干扰的

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