凝血活酶敏感指数对凝血酶原时间测定的影响

The Effects of Prothrombin Sensitivity Index on Prothrombin Time Test

本文观察了四种不同国际敏感指数（ＩＳＩ）的凝血活酶试剂。在相同条件下，对２５例正常人和５０例口服华法令（ｗａｒｆａｒｉｎ）病人进行ＰＴ测定，结果显示正常参考值随所用凝血活酶的ＩＳＩ不同而异。建议各实验室应依其所用试剂建立自己实验室的正常参考值。对口服抗凝药的５０例患者测得ＰＴｓ（秒）和ＰＴＲ（比率）经方差分析，四组结果有显著性差异（Ｐ＜０．０１）；而按ＩＮＲ＝ＰＴＲ￣（ＩＳＩ）换算成国际标准化比率（ＩＮＲ）后，经方差分析，四组ＩＮＲ无显著差异（Ｐ＞０．０５）。为使ＰＴ结果具备可比性和可信性，我国的凝血活酶试剂应有准确ＩＳＩ值标定。并推行以ＩＮＲ作为ＰＴ测定报告形式。

Four prothrombin time (PT) test reagents with different international sensitivity index (ISI) were studied for PT test in 25 healthy persons and 50 patients with oral Warfarin administration. Resuls showed that the normal reference value was varied with the ISI reagent used. We suggest that each laboratory should establish one's own values according to the ISI reagent used. The obtained PTs (second) and PTR (ratio ) from those 50 patients with anticoagulant administration indicated that there were significant differences among four groups (P<0.01) ; however, after the calculation with INR=PTR(ISI), an international normalized ratio (INR), there were no signicant difference among the four groups (P>0.05). Therefore, to the reliability and comparability of the test, we believe that our domestic prothrombin reagents should be marked with accurate ISI value and INR should be used as PT report form.