离心条件对凝血三项检测结果的影响及分析

Analysis the effect of different centrifugal conditions on the results of coagulation

目的验证该实验室常规凝血检测离心条件并探讨建立优化离心条件。方法以该院体检者及住院患者为研究对象,分为常规组、标准组、提速组。应用不同离心条件离心获得乏血小板血浆（PPP）,进行常规凝血项目凝血酶原时间（PT）、国际标准化比率（INR）、纤维蛋白原（FIB）、活化部分凝血活酶时间（APTT）的检测;其次对不同血小板含量的标本采用常规条件和标准条件离心后,检测血浆中剩余血小板含量。结果常规组和提速组的凝血常规各项检测结果与标准组比较,差异无统计学意义（P〉0.05）;血小板浓度低于500×10^9/L时,常规条件和标准条件离心后PPP 100%合格,血小板浓度高于500×10^9/L时合格率降低为64%。结论目前的常规离心条件可以满足常规凝血检测,对特殊类型凝血检测及血小板浓度高于500×10^9/L的标本,需要严格按照美国临床和实验室标准化协会（CLSI）的要求进行离心处理。

Objective To verify the effect of different centrifugal conditions on coagulation and ascertain the optimum centrifugal time for coagulation testing in the laboratory.Methods Navy General hospital check-up and hospitalized patients were divided into three groups which were conventional group,standard group and speed up the group respectively according the different centrifugation conditions.The platelet poor plasma（PPP）was harvested in the three different groups.The PT,INR,FIB and APTT were tested and the results were compared and analyzed.Samples with different platelets were centrifuged in normal condition or standard condition,after that,the residual platelet in plasma was detected.Results There was no significant difference of the PT,INR,FIB and APTT results among the routine group,speed group and the standard group.The results of PPP was qualified 100%in samples which platelets were less than 500×10^9/L with routine conditions and standards of centrifugal conditions.However,the qualified result of PPP was dropped to 64%in those samples which platelets were higher than 500×10^9/L with routine and standards of centrifugal conditions.Conclusion The conventional centrifugation conditions can meet clinical routine coagulation testing requirements,the special types of coagulation assays or the samples which platelets count are more than 500×10^9/L should centrifuge in accordance with the requirements of the CLSI centrifugal processing.