三种方法测定血浆纤维蛋白原的结果比对

Comparison of three different methods for measuring plasma fibrinogen

目的对克劳斯（vonClauss）法、免疫透射比浊法、凝血酶原时间（PT）演算法（PT—Der法）测定纤维蛋白原的结果进行评价并探讨其影响因素。方法用以上三种方法分别测定40例一般患者（Ⅰ组）、20例心脑血管病患者（Ⅱ组）、20例纤维蛋白原含量减少患者（Ⅲ组）的纤维蛋白原（Fib），并对高、中、低值Fib分别作批内、批间精密度及黄疸、溶血、脂血分析，结果用SPSS10．0软件进行统计学处理。结果在重复性实验中，vonClauss法精密度最高，免疫透射比浊法精密度良好。PT—Der法精密度高值较差，中、低值良好。Ⅰ组Fib差异无统计学意义；Ⅱ组差异有统计学意义；Ⅲ组PT—Der法Fib值差异有统计学意义，免疫透射比浊法结果差异无统计学意义。严重脂血PT-Der法有显著性差异。结论vonClauss法测定Fib精密度高，与免疫透射比浊法均不受黄疸、脂血、溶血标本的影响。PT—Der法、免疫透射比浊法对高、低值Fib测定有不同程度的差异，可用于手术前常规检查或健康人体检筛查。对高、低值标本最好采用vonClauss法。

Objective To evaluate three methods of measuring plasma fibrinogen, including yon Clauss assay, prothrombin time（PT）-Der assay, and immunoturbidimetric assay, and to study their influential factors. Methods The patients were divided into three groups, the common patients group including 40 cases （Group Ⅰ ）, the cardio-cerebrovascular disease patients group including 20 cases （Group Ⅱ ） and the lowared fibrinogen patients group including 20 cases （Group Ⅲ ）. The fibrinogen （Fib） concentration of all cases was measured by three methods mentioned above respectively, and the precision of three methods toward high, media and low Fib value were evaluated between-batch and within-batch. Besides, the different influences of jaundice, haemolysis and lipaemia to such three methods were also accounted in our experiment. Statistical analysis was performed by SPSS 10.0 soft- ware. Results The precision of yon Clauss assay was the best, the precision of immunoturbidimetric assay was better, and the precision of PT-Der assay was the worst on the higher value, better in the normal and lower value. There was no significant difference of Fib in Group I among the three methods （P〉0.05）. The Fib value measured by PT-Der assay was higher than that measured by yon Clauss assay in Group Ⅱ and Group m significantly. In Group Ⅱ , the Fib value measured by immunoturbidimetric assay was lower than that measured by yon Clauss assay significantly. Serious lipaemia influenced to PT-Der assay significantly. Conclusion The Fib measured by yon Clauss assay is of high pre- cision, and has a great ability of resistance to the interference of jaundice, hemoglobin and lipidemia, the same as the immunoturbidimetric assay. There is significant difference of Fib in evaluation of the abnormal value by PT-Der assay and immunoturbidimetric assay, and the two methods can be used for pre-operation routine examination or a healthy checkup. Von Clauss assay is the best choice for measuring abnormal Fib value.