重视凝血检测中的影响因素

Reconstruction of influencing factor in hemostasis examination

目的:观察不同实验条件对凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)及凝血酶时间(TT)测定的影响。方法:用SysmexCA7000型全自动血凝分析仪及配套试剂分别进行采血器具、离心时间、血浆标本转移及标本放置时间对实验结果影响的观察,并将所得到的检测结果用统计学方法处理。结果:美国BD公司和国内武汉致远公司生产的凝血专用真空采血器与奥地利格雷那公司的采血器相比无统计学意义。当标本以2500g速度离心时间小于15min时,其PT、APTT结果缩短,与离心时间20min的结果比较有显著差异(P<0.01),FIB、TT结果则无影响,用心时间大于15min时,四项结果均无显著差别(P>0.05)。将血浆标本转移到塑料测定杯中再进行检测的实验结果比用采血器直接进行检测的结果明显延长(P<0.01)。在室温下PT在8h内,APTT在4h内测定的结果与即刻测得的结果无统计学意义(P>0.05),FIB、TT的测定结果24h内无明显影响(P>0.05)。结论:凝血标本的采集必须采用符合国家标准的专用真空采血器,并且要有足够的离心速度和离心时间,同时还要保证在较短的时间内完成测定,才能确保凝血检测质量,为病人疾病的诊断提供可靠的实验室信息。

Object： To investigate effect of different Laboratory conditions to examination of some hemostasis： prothrombin time （PT）, activated partial thromboplastin time （APTT）, fibrinogen （FIB） and thrombin time （TT）. Methods： After treated with different method by appropriate reagent, specimens were measured for hemostasis by Sysmex CA7000 automatic machine. In method one blood was collected by general anticoagulative glass tube without silicification.. In method two blood was collected by specific anticoagulative silicification glass tube provided by different manufactory. The measured result were compared by statistics method. Results： There was significant difference between method one and two when measured value of PT, AFTT and Tr were concerned （P 〈 0.01）. If centrifuging （2500r/min） time was less than 15 minutes, the detected value of PT, APTI＂ would be significantly longer than normal （P 〈 0.01）. If the blood sample was transferred to plastic cup before added to automatic machine, all the detected value would be significantly longer（P 〈 0.01）. If PT was examined in room temperature in 8 h, APTT in 4 h, FIB and TF in 24 h, there was no difference in the detected result compared with examined immediately after sampled. Conclusion： Specimens for hemostasis examination should be ampled with specific tube, centrifuged in adequate time, and should be detected in limited time.