不同存放条件对凝血功能指标检测结果的影响

Influence of different storage condition on plasma indices of coagulation function

目的探讨标本不同存放条件对凝血功能指标检测结果的影响，在无法即刻测定情况下尽可能保证凝血指标检测的准确性。方法选取抗凝静脉血标本60例，同一标本取适量血液立即分离血浆，分别于即刻、室温（18～25℃）1h、2h,4h及-4℃4h、12h、24h条件下检测凝血酶原时间（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，剩余血液标本置室温2h后再分离血浆测凝血指标。比较不同存放条件下各凝血功能指标的检测结果。结果与留取即刻检测相比，室温下血浆放置1h、2h及-4℃放置24h凝血功能各指标均无明显差异；室温下放置4h后凝血指标准确性明显下降[APTT和TT分别为（35．30±6．86）S与（32．03±4．98）s、（18．21±2．32）S与（16．35±1．94）s，均P〈0．05]；室温2h后再分离血浆测凝血指标则已明显改变[PT、APTT、TT、FIB分别为（13．78±2．48）s与（12．25±1．81）s、（35．70±6．32）s与（32．034±4．98）s、（19．01±2．86）s与（16．35±1．94）s、（2．72±2．08）g／L与（3．19±1．02）g,／L，均P〈0．05]。结论测定凝血功能指标，应及时送检和尽快分离血浆，分离血浆后应于室温下2h内、-4℃下24h内完成测定以保证检测结果的准确性。

Objective To explore whether storage time and temperature influence the measurement of blood clotting functional parameter,in order to ensure accuracy of result. Methods 60 anticoagulated blood samples were selected. The levels of APTT, PT, TT and FIB were detected immediately after separated plasma, at 1h,2h, and 4h after keeping at room temperature, at 4h, 12h,24h after keeping at -4℃. Part of anticoagulated blood samples were separated plasma and detected 2h after keeping at room temperature. Results Compared to measurement for immediately separated plasma,APTT,PT,TT and FIB showed no differences for 1h,2h after keeping at room temperature and 4h, 12h,24h after keeping at -4℃. But the result for 4h after keeping at room temperature showed bad accuracy. Conclusion In the measurement of coagulation indices, after collecting blood sample, separating plasma should be conducted as soon as possible. The separated plasma should be measured within 2h after keeping at room temperature and 24h after keeping at -4℃.