存放时间和温度对凝血功能指标检测结果的影响

Influence of storage time and temperature on plasma indices of coagulation function

目的探讨标本放置时间和温度对凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)等凝血指标检测结果的影响。方法选取抗凝静脉血标本50例,血浆用于立即测定凝血4项指标和在室温放置2h、4h、6h和24h后测定凝血4项指标;并分别于室温、-4℃和-20℃下保存24h后测定凝血4项指标。抗凝血室温放置2h,离心分离血浆后即刻进行凝血指标检测。采用血液凝固仪测定研究指标,采用随机单位组设计资料方差分析比较各组间差异。结果与留取即刻检测相比,血浆放置2hAPTT、PT、TT和FIB等各种指标水平均无明显差异;血浆标本放置4h开始,APTT、PT和TT等指标出现明显延长,且变化程度随放置时间延长加重,FIB水平无明显改变;抗凝血标本放置2h留取的血浆标本各指标均有明显变化。-4℃下血浆标本保存24hAPTT、PT、TT和FIB等指标测定结果未出现明显改变,-20℃下24hAPTT出现明显延长。结论对于凝血功能4项指标的测定,采集标本后应及时送检和尽快分离血浆。常温下血浆标本应在2h内完成测定;-4℃下血浆标本保存24hPT、APTT、TT和FIB等指标测定结果未受影响,低温保存应注意避免标本冻融过程。

Objective To investigate whether storage time and temperature influence the measurement of activated partial thromboplastin time（APTT）,prothrombin time（PT）,thrombin time（TT） and fibrinogen（FIB） in plasma.Methods 50 anticoagulative venous blood samples from inpatients were collected.The coagulometer system was used to detect the levels of APTT,PT,TT and FIB.These indices in plasma were measured immediately after separation,at 2,4,6,24 h after keeping at room temperature,after 24 h storage at room temperature,-4 ℃ and-20 ℃.Anticoagulative blood was kept for 2 h at room temperature and centrifugally separated for immediately determining 4 coagulative indices.Random two-way ANOVA was used to compare differences among groups.Results Compared to measurement for immediately separated plasma,PT,APTT,TT and FIB for 2 h keeping plasma showed no significant differences.APTT,PT and TT for 4 h keeping plasma were begun to be significantly prolonged,the degrees of change became greater with the increase of storage time.The FIB level had no significant change.The various indices in anticoagulative samples for 2h keeping had significant changes.The measurement results of ATPP,PT,TT and FIB in the plasma samples kept for 24 h at-4 ℃ had no significant changes.APTT in the plasma sample stored for 24 h at-20 ℃ was significantly prolonged.Conclusion In the measurements of coagulation indices,after collecting blood sample,separating plasma should be conducted as soon as possible.The plasma sample should be detected within 2 h at room temperature.The measurement results of PT,APTT,TT and FIB remain uninfluenced for the plasma samples stored 24 h at-4 ℃.Hypothermic storage should be paid attention to avoid the freezing process of sample.