Celite i-STATACT和Medtronic ACTⅡ测量ACT准确性的比较

Comparison of accuracy of Celite i-STATACT and Medtronic ACTⅡin ACT measurement

目的：评价Celite i-STATACT所测得的活化凝血时间（activated clotting time,ACT）与临床常用测量方法 Medtronic ACTⅡ之间的差异及相关性。方法：择期行心脏外科手术患者60例,比较Celite i-STATACT与Medtronic ACTⅡ2种仪器所测得的ACT值,分别在体外循环建立前、肝素化后与鱼精蛋白中和后抽取血样本用2种方法进行双管检测,所测得数据进行线性回归和Pearson相关系数分析以评估两者的一致性,Bland-Altman分析用来评价偏倚。结果：Celite i-STAT ACT检测结果为85-913 s,Medtronic ACTⅡ检测结果为99-980 s,R^2=0.96,回归方程：y=7.86＋0.86x,Pearson相关系数r=0.98（P〈0.001）;ACT值在480-999 s范围具有线性相关,R^2=0.65,回归方程：y=108.82＋0.72x,Pearson相关系数r=0.80（P〈0.001）;Bland-Altman一致性分析认为2种方法测量的结果具有较好的一致性。结论：体外循环下心脏直视手术中Celite i-STAT ACT和Medtronic ACTⅡ2种设备测得的ACT值临床上都是可以接受的。

Objective：To evaluate the difference and correlation of activated clotting time（ACT） measured between Celite i-STATⅡ and clinical classical measurement method-Medtronic ACTⅡ. Methods：Sixty patients underwent elective cardiac surgery. We compared ACT values measured by Medtronic ACTⅡ and Celite i-STATⅡ. Blood samples were obtained before establishment of extracorporeal circulation,after heparinization and protamine neutralization,respectively,and then measured by the two methods.Linear regression and Pearson correlation analysis were performed to assess the consistency of the two measured data. Bland-Altman plot was performed to evaluate bias. Results：Celite i-STATACT value was 85 to 913 seconds and Medtronic ACTⅡ value was 99to 980 seconds,R^2= 0.96,regression equation：y = 7.86 ＋ 0.86x,Pearson correlation coefficient：r = 0.98（P〈0.001）. ACT value ranged from 480 to 999 seconds and had linear correlation,R^2= 0.65,regression equation：y = 108.82 ＋ 0.72x,Pearson correlation coefficient：r = 0.80（P〈0.001）. Bland-Altman plot showed that the results of the two methods had good consistency. Conclusion：In ardiac operation under extracorporeal circulation,ACT values measured by Celite i-STATACT and Medtronic ACTⅡ are acceptable clinically.