全血血栓弹力图及其配套试剂用于血浆血栓弹力图检测研究

Application of whole blood thromboelastogram and its correlative kit for plasma thromboelastogram detection

目的探讨全血血栓弹力图(WB-TEG)仪及其配套试剂用于血浆血栓弹力图(P-TEG)试验的可行性及其正常人P-TEG特征。方法选取17名健康志愿者用WB-TEG仪及其配套试剂检测WB-TEG,并和其P-TEG检测结果比较;分析17名正常人P-TEG的特征。选择3种血小板计数(Plt)的血浆标本各7例,3种纤维蛋白原浓度(Fib)的血浆标本7、6、4例做P-TEG,观察Plt、Fib对P-TEG试验的影响。结果17正常人WB-TEG与P-TEG各项参数均值比较:R时、MA距无明显差异(P>0.05),K(min)为1.71±0.47 vs 1.07±0.45、A(°)为66.1±5.41 vs 75.59±5.77、CI值为0.9±1.8 vs 2.52±2.58(均为P<0.05)。正常人P-TEG各项参数基本在WB-TEG 95%CI范围内,但K(时)﹑A(角)和CI值有明显差异(P<0.05)。血浆中Plt(×10^(11)/L)≥2.5时P-TEG的MA距较正常(人)值明显延长(P<0.05),Plt(×10^(11)/L)为6.0~12.0时P-TEG的MA距、CI值明显减小(P<0.05);血浆中Fib(g/L)为6.4~6.91时PTEG的R时、K时延长并A角、MA距和CI值减小(P<0.05),<1时R时、A角和MA距明显降低(P<0.05)(K时和CI值检测不出)。结论WB-TEG仪及配套试剂可以用于P-PEG试验;开展TEG试验宜结合各自实验室的条件建立相应的TEG参数参考值。

Objective To study the feasibility of whole blood thromboelastogram(WB-TEG)and its correlative kit for plasma thromboelastogram(P-TEG)detection and the characteristics of P-TEG in healthy subjects.Methods 17 healthy volunteers were detected by WB-TEG instrument and its correlative kit,and the results were compared with those by P-TEG.The P-TEG characteristics of 17 healthy volunteers were analyzed.Three groups(7 cases/group)of plasma samples with different platelet(Plt)count and the other three groups of plasma(7,6 and 4 cases,respectively)with different fibrinogen(Fib)concentration were tested for P-TEG.The effects of Plt and Fib on P-TEG detection were observed.Results There was no significant difference in R and MA value(P>0.05)as WB-TEG was compared with P-TEG in healthy subjects,while in K(min)(1.71±0.47 vs 1.07±0.45),A(°)(66.1±5.41 vs 75.59±5.77),and CI value(0.9±1.8 vs 2.52±2.58)(all P<0.05).Various parameters of healthy individuals were basically within the range of 95%CI of WB-TEG,but there were significant diffferences in K,A and CI value(P<0.05).When Plt count(×10^(11)/L)was≥2.5 in plasma,the MA value of P-TEG was significantly extended than that of normal individuals(P<0.05);when Plt count(×10^(11)/L)was 6.0~12.0,the MA and CI value of P-TEG significantly decreased(P<0.05).When Fib(g/L)was 6.4~6.91 in plasma,the R and K value of P-TEG were prolonged,but A,MA and CI value all decreased(P<0.05);when Fib(g/L)<1,the A and MA value significantly decreased(P<0.05),and K and CI value could not be detected.Conclusion The WB-TEG and its correlative kit can be used in P-TEG detection,and corresponding reference values of TEG parameters should be established in combination with the conditions of laboratories.