激活剂对检测活化部分凝血活酶时间的差异性研究

目的探讨不同激活剂作为活化部分凝血活酶时间(APTT)检测试剂时对APTT测定结果的影响。方法用鞣花酸和白陶土两种激活剂分别在LG-PABER-1型血凝分析仪和Sysmex CA-500全自动血凝分析仪上进行APTT检测,并在血浆中分别加入肝素钠和乏因子血浆进行APTT检测。运用t检验和方差分析对检测结果进行统计学分析。结果⑴在LG血凝仪上运用鞣花酸和白陶土作为不同激活剂,对37例临床标本进行APTT测定结果显示:白陶土作为激活剂测得的结果高于鞣花酸测得的结果(P0.05)。⑵同一批号的鞣花酸作为激活剂在Sysmex血凝仪和LG血凝仪上分别对40例临床标本进行APTT测定,结果显示:LG血凝仪上测得的结果高于Sysmex血凝仪测得的结果(P0.05)。⑶鞣花酸和白陶土作为不同激活剂对含有不同浓度肝素钠的血浆35例进行APTT测定结果显示:随着肝素钠浓度的增加,两种激活剂的APTT结果明显延长,与未加肝素钠组比较有显著差异(P0.05)。且鞣花酸组变化比白陶土组变化更明显。⑷运用鞣花酸和白陶土作为不同激活剂,对加入不同乏凝血因子的血浆后的血浆33例进行APTT测定显示:随着血浆中加入乏因子血浆的比例增多,两种激活剂的APTT结果延长也明显,与未加乏因子血浆的血浆的APTT比较有显著差异(P0.05)。且白陶土组变化比鞣花酸组更明显。结论不同激活剂APTT检测结果存在差异,且对肝素或乏因子血浆的敏感性存在差异;同一激活剂在不同仪器上APTT检测结果存在差异。建议不同的实验室应建立自己的参考范围。

Comparison of two activators on activated partial thromboplastin time(APTT) test

Objective To investigate the influence of different activators on activated partial thromboplastin time (APTT) test. Methods The APTT level of plasma which differential concentration heparin or poor ⅧandⅨplasma was added into was deter-mined by ellagic acid and kaolin in blood clotting analyzers between LG-PABER-1 analyzer and Sysmex CA-500 analyzer. The results were operated by t test and analysis of variance in statistics. Results ⑴The APTT levels of 37 cases clinical specimen were tested by ellagic acid and kaolin with the same calcium chloride in LG analyzer. And the result of kaolin group was much higher than result of ellagic acid group (P<0.05). ⑵The APTT levels of 40 cases specimen were tested by the same ellagic acid with the same calcium chloride in LG analyzer and Sysmex analyzer. And the result of LG analyzer was much higher than Sysmex analyzer’s(P<0.05).⑶The APTT levels of 35 cases specimen that had differential concentration heparin were tested by two activa-tors. The APTT was obviously increase along with increasing concentration of heparin(P<0.05). And ellagic acid group had marked change than kaolin group.⑷The APTT levels of 33 cases specimen that had differential poorⅧandⅨplasma were tested by two activators. The increasing degree of APTT was obviously increase along with increasing concentration of poor ⅧandⅨplasma(P<0.05). And kaolin group had marked change than ellagic acid group. Conclusions The APTT level was different when in differen-tial analyzer,when by differential activator. Reference range must been established himself by differential analyzer and activator in differential laboratory.