人体位改变对凝血因子某些因素水平的影响

THE EFFECT OF CHANGING BODY POSTURE ON THROMBIN ACTIVITY AND CONCENTRATION

目的 :探讨不同体位对凝血因子检测的影响 ,给循证医学和凝血因子检测全面质量控制提供实验室证据。方法 :1 0 5名志愿者经同体配对试验 ,在不同季节分批抽取不同体位、不同时间、同一部位血液 ,在全自动凝血分析仪上与质控品同批分析疑血因子 5项指标。结果 :以卧位为基线与坐位相比 ,各项指标平均改变 7.0 7% ,多者9.33 % ,差别非常显著 (P <0 .0 0 1 )。根据变化百分数大小依次为 :纤维蛋白原 (FIB) ,凝血酶时间 (TT) ,活化部分凝血活酶时间 (APTT) ,凝血酶原时间 (PT) ,国际标准化比值 (INR)。其中FIB、TT、APTT结果升高 ,呈正相关 (r>0 .97) ,而PT、INR则下降 ,呈负相关。改变体位 1 5min内 ,各参数平均恢复到原体位的 95 .2 %。季节、年龄和仪器差别不影响本实验。结论

Aim: To provide proof for Evidence based Medicine as well quality control, our laboratory detected the thrombin activity on various body position. Methods: By autogenous contrast and cross matched survey, 105 volunteers divided into 3 season patchs of winter, spring and summer, blood samples were drawn from the same part in both standing and lying position. Both samples and the quality control were detected to investigate the effect of the body position to thrombin activity's changings. The data were analyzed by SPSS 10.0. Results: Taking the lying's data as baseline, the average changing on all those the '5' index was 7.07% and the highest changing reached 9.33%.This kind changing had great significant differences( P <0.01).According to the t value, sequencely ranged: FIB>TT>PT>INR>APTT. FIB, TT and APTT' s values slowly raised, adversely PT and INR slowly went down. While sitting for 15 min after lying, these indices returned to 95.2% of the original value in sitting position in addition. Season,age and device had no relationship with body position. Conclusion:Changing body position can result in obvious physiological variation of thrombin activity.