采用稀释法评价狼疮抗凝物对凝血因子活性检测的干扰

Using dilution method to evaluate the interference of lupus anticoagulant in the detection of coagulation factor activity

目的探讨稀释法在评价狼疮抗凝物(LAC)对凝血因子活性检测的干扰中的应用。方法选取该院健康体检者30例作为作为对照组,将这30例受试者的混合血浆标本分别按1∶1、1∶2^(1)、1∶2^(2)、1∶2^(3)、1∶2^(4)、1∶2^(5)6种不同稀释比例配制成不同浓度的血浆,检测标本中的凝血因子FⅧ、FⅨ、FⅪ、FⅫ、FⅡ、FⅤ、FⅦ、FⅩ活性,将其与所对应稀释度的理论值作线性相关分析。选取于该院住院治疗的LAC阳性且凝血酶原时间(PT)、活化的部分凝血活酶时间(APTT)均延长的抗磷脂综合征患者6例作为LAC阳性组。将6例LAC阳性组患者的血浆标本按同样的方法进行梯度稀释并对上述8种凝血因子的活性进行检测。结果对照组8种凝血因子活性检测值与理论值均呈直线相关(R^(2)≥0.90,P<0.05)。随着稀释倍数的增加,内源性凝血因子活性随之升高,能恢复到大致正常水平,且升高到一定水平时不再随着稀释倍数的增加而继续升高。结论病理性抗凝物质如LAC可对内源性凝血因子活性检测造成干扰,稀释法可通过降低干扰物质的滴度来获得更加准确的凝血因子检测值。

Objective To investigate the application value of dilution method in evaluating the interference of lupus anticoagulant(LAC)in the detection of coagulation factor activity.Methods A total of 30 healthy people in the hospital were enrolled as the control group,and the mixed plasma sample of the 30 healthy people were prepared into different concentrations of plasma according to 6 different dilution ratios 1∶1,1∶2^(1),1∶2^(2),1∶2^(3),1∶2^(4),1∶2^(5),detected the coagulation factors FⅧ,FⅨ,FⅪ,FⅫ,FⅡ,FⅤ,FⅦ,FⅩactivity in the plasma sample,and make a linear correlation analysis with the theoretical value of the corresponding dilution.Six patients with antiphospholipid syndrome who were hospitalized in the hospital with LAC positive and prolonged partial thromboplastin time(PT)and activated partial thromboplastin time(APTT)were enrolled as the LAC positive group.The plasma samples of the 6 patients in the LAC positive group were serially diluted in the same way and the activity of the above 8 coagulation factors were detected.Results In the control group,the detected activity values of the 8 coagulation factors were linearly correlated with the theoretical values(R^(2)≥0.90,P<0.05).As the dilution ratios increased,the endogenous coagulation factor activity increased and could return to roughly normal levels,and when it reached a certain level,it no longer continued to increase as the dilution factor increased.Conclusion Pathological anticoagulants such as LAC can interfere with the detection of endogenous coagulation factor activity.The dilution method can be used to obtain more accurate coagulation factor detection values by reducing the titer of interfering substances.