改良血浆硫酸鱼精蛋白副凝固实验的方法学建立及评价

Establishment and evaluation of a modified plasma protamine paracoagulation test

目的对传统硫酸鱼精蛋白副凝固实验进行改良,以提高其在临床应用中的灵敏度以及在临床相关疾病诊断中的价值。方法收集98例DIC患者及156例正常人血浆标本,分别进行硫酸鱼精蛋白副凝固实验、D-二聚体及改良硫酸鱼精蛋白副凝固实验。通过对改良硫酸鱼精蛋白副凝固实验进行相应的方法学评价,分析其灵敏度及特异度等相关指标,并将改良后的硫酸鱼精蛋白副凝固实验应用于临床8例疑似心梗病的辅助诊断。结果硫酸鱼精蛋白副凝固实验、D-二聚体及改良硫酸鱼精蛋白副凝固实验的灵敏度分别为16.33%,88.76%和77.56%,其特异度分别为100%,88.46%和97.44%。在5例确诊的心梗病例中,改良硫酸鱼精蛋白副凝固实验先于D-D及硫酸鱼精蛋白副凝固实验呈现阳性。结论改良后的硫酸鱼精蛋白副凝固实验较传统3P方法具有较高的灵敏度,较D-二聚体具有较高的特异度。改良硫酸鱼精蛋白副凝固实验对于血栓形成及纤溶具有早期预警作用,在相关疾病的临床诊断与鉴别诊断中具有良好的应用价值。

Objective To establish a modified plasma protamine paracoagulation test.Methods Plasma protamine paracoagulation,modified plasma protamine paracoagulation and D-dimer（D-D） tests were performed for the plasma samples collected from 98 cases of disseminated intravascular coagulation（DIC） and 156 normal subjects.The sensitivity and specificity of the 3 tests were analyzed.The plasma samples from 8 cases of suspected myocardial infarction were detected using modified plasma protamine paracoagulation for diagnostic purpose.Results The sensitivity of plasma protamine paracoagulation,modified plasma protamine paracoagulation and D-D tests was 16.33%,88.76% and 77.56%,and the specificity was 100%,88.46% and 97.44%,respectively.Positive results occurred earlier in modified plasma protamine paracoagulation test than in plasma protamine paracoagulation and D-D tests in 5 cases of myocardial infarction.Conclusion The modified plasma protamine paracoagulation test has a higher sensitivity than plasma protamine paracoagulation test and a higher specificity than D-D test,and can be helpful in early diagnosis of thrombosis and fibrinolysis.