SYSMEX CS5100全自动凝血仪性能评估和参考区间的验证

目的验证SYSMEX CS5100全自动凝血仪的系统性能,确定该检测系统是否稳定、准确、可靠。方法从精密度、准确度、携带污染率、线性范围、可比性、可报告范围、检测下限、参考区间的验证等方面对SYSMEX CS5100进行验证。结果精密度、准确度、携带污染率、线性范围、可比性、可报告范围、检测下限、参考范围等验证全部通过。结论 SYSMEX CS5100凝血仪是一个精密度好,准确度高,携带污染率低,相关系数好,可比性好,检测范围宽的检测系统。     

Sysmex CA7000及CS5100全自动凝血分析仪性能评价

目的验证Sysmex CA7000和CS5100全自动凝血分析仪系统性能。方法参考美国临床和实验室标准化协会(NCCLS)相关文件,并对照全国临床检验操作规程(第4版)及卫生行业标准的有关规定,对Sysmex CA7000和CS5100不精密度、准确度、携带污染率、线性、检测限、参考区间进行系统评价。结果批内精密度、日间精密度正常样本和异常样本变异系数(CV)均在规定范围内。准确度验证各项目符合卫生部室间质评定值范围,携带污染率、线性评价、检测限、参考范围验证均符合本室质量管理要求。结论 CA7000及CS5100凝血分析仪不精密度、准确度、携带污染率、线性、检测限、参考区间验证评价通过,该系列仪器性能良好,有效保证凝血检测结果的可靠性及可比性。     

抗Xa活性检测的性能验证及临床应用探讨

【目的】探讨低分子肝素(LMWH)抗-Xa活性、普通肝素(UFH)抗-Xa活性检测的方法学性能验证和临床应用。【方法】参照国内卫生行业标准、美国临床和实验室标准协会(CLS1)发布的指南文件和试剂说明书,分别对UFH抗-Xa、LMWH抗-Xa活性检测标本批内精密度、日间精密度、准确度、线性和携带污染率进行性能验证,并对抗-Xa活性检测在肝素抗凝监测的临床应用作初步探讨。【结果】LMWH抗-Xa活性和UFH抗-Xa活性检测两个浓度水平的批内精密度、日间精密度、准确度、线性和携带污染率均符合厂家及行业要求。40例肝素抗凝治疗患者UFH抗-Xa活性达有效抗凝范围为40.0%,未达抗凝范围为52.5%,用抗UFH抗-Xa活性校正得到APTT达标监测范围为1.9~2.6。【结论】LMWH抗-Xa活性和UFH抗-Xa活性的性能能够满足相关卫生行业、指南和厂家要求,性能验证的研究有助于临床实验室LMWH和UFH抗凝治疗监测规范化,有助于临床参考用药。     

CS-5100全自动血凝仪检测抗凝血酶Ⅲ、蛋白C、蛋白S活性的性能验证

目的评价CS-5100全自动血凝仪(简称CS-5100)检测抗凝血酶Ⅲ(ATⅢ)、蛋白C(Pc)和蛋白S(Ps)活性的性能。方法参照美国临床实验室标准化协会(CLSI)系列指南文件对CS-5100检测ATⅢ、Pc和Ps活性的不精密度[以变异系数(CV)表示]、准确度、线性、携带污染率、参考区间性能进行验证。结果CS-5100检测ATⅢ、Pc和Ps活性的批内不精密度均1.9%,日间不精密度均4.1%,符合厂家说明书给定的标准。准确性验证结果偏移在生物学CV要求内。ATⅢ线性验证试验理论值和实测值的回归方程均符合线性回归方程的斜率在(1±0.05)范围内以及r2≥0.95的要求,携带污染率各参数CV10%。参考区间验证结果显示各项检测指标的R=1,符合要求(R≥0.9),参考区间验证通过。结论 CS-5100检测抗ATⅢ、Pc和Ps活性项目的精密度、准确度、携带污染率、线性结果均符合质量控制的要求,能够保证检验质量。     

CS5100全自动凝血分析仪性能验证

目的验证Sysmex CS5100全自动凝血仪的系统性能,确定该检测系统是否稳定、准确、可靠。方法从变异系数(CV)、准确度、检测限、线性范围、携带污染率、干扰试验等方面对Sysmex CS5100系统性能进行验证。结果验证精密度最大CV为8.6%;验证准确度最大偏倚为7.12%;Fg线性验证实验结果显示Fg线性范围为1.032~5.878,相关系数为r为0.9999;携带污染率最大值为-2.49%;血红蛋白小于或等于4.83g/L;甘油三酯小于或等于5.64mmol/L;总胆红素小于或等于322μmol/L时,偏离值小于或等于10%,验证全部通过。结论 Sysmex CS5100凝血分析仪检测精密度好,准确度高,检测范围宽,携带污染率低,抗干扰能力强,能够较好的满足实验室对于凝血功能检测的需求。     

Sysmex CS5100全自动凝血分析仪性能评价

目的验证Sysmex CS5100全自动凝血分析仪的系统性能,确定该检测系统是否稳定、准确、可靠。方法对Sysmex CS5100全自动凝血分析仪上的准确度、不精密度、线性、检测限、携带污染率进行评价。测试20例健康体检者的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)验证厂家提供的参考区间。结果准确度试验测定结果全部合格;批内最大变异系数(CV)3.82%、批间最大CV值为6.24%;线性试验FIB相关系数(r)为0.998 9、D-二聚体(DD)r为0.996 7、纤维蛋白(原)降解产物(FDP)r为0.998 5;检测限最大CV为6.13%;携带污染率最大值为-6.45%,验证全部合格。结论 Sysmex CS5100全自动凝血分析仪是一个精密度好、准确度高、检测范围宽、携带污染率低的检测系统。     

Sysmex CS5100全自动凝血分析仪性能评价与比对研究

目的对Sysmex CS5100全自动凝血分析仪(以下简称CS5100)的性能进行评价,并与Sysmex CA7000全自动凝血分析仪(以下简称CA7000)比对,分析系统准确性及可靠性。方法对CS5100进行正确度、精密度、纤维蛋白原(Fib)线性、携带污染率和参考区间进行评价,同时将CS5100与CA7000进行比对试验。检测指标包括凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、Fib。结果 CS5100检测PT、APTT、Fib等主要参数的准确性、批内不精密度、日间不精密度均符合ISO15189相关文件要求,Fib线性良好(r=0.994),最高携带污染率为-2.81%,参考区间符合95%的要求,参与室间质评成绩优秀,与CA7000比对结果合格。结论 CS5100各方面性能良好,可用于临床标本的检测,检测结果可用于临床的诊断和治疗。     

对ACL 300全自动血凝仪测定低分子肝素的评价

目的对ACL300全自动血凝仪测定低分子肝素(LMWH)进行评价,并对国产低分子肝素钙与进口参比制剂速避凝进行人体生物等效性对比.方法采用Heparin试剂盒在ACL300全自动血凝仪上测定血浆中LMWH抗Xa因子活性.结果日内精密度(变异系数,CV)均<10%,日间精密度中的高值、中值CV<10%,低值>10%(21.0%),携带污染率<0.4%,LMWH浓度在0.00 IUAXa/ml和1.0 IUAXa/ml内线性良好;国产低分子肝素钙与参比制剂的血药峰值时间(Tmax)分别为(2.97±0.53) h和(3.31±0.69) h,血药峰值浓度(Cmax)分别为(0.68±0.08)IUAXa/ml和(0.64±0.09) IUAXa/ml,曲线下面积(AUC0-t)分别为(5.38±0.79)(IUAXa/ml)·h和(5.03±0.73)(IUAXa/ml)·h.结论 ACL300全自动血凝仪测定LMWH时的精密度、携带污染率和线性良好,经生物等效性计算程序处理,相同剂量被试制剂与参比制剂为生物等效制剂.     

对ACL 300全自动血凝仪测定低分子肝素的评价

目的对ACL300全自动血凝仪测定低分子肝素(LMWH)进行评价,并对国产低分子肝素钙与进口参比制剂速避凝进行人体生物等效性对比。方法采用Heparin试剂盒在ACL300全自动血凝仪上测定血浆中LMWH抗Xa因子活性。结果日内精密度(变异系数,CV)均<10%,日间精密度中的高值、中值CV<10%,低值>10%(21.0%),携带污染率<0.4%,LMWH浓度在0.00 IUAXa/m l和1.0 IUAXa/m l内线性良好;国产低分子肝素钙与参比制剂的血药峰值时间(Tm ax)分别为(2.97±0.53)h和(3.31±0.69)h,血药峰值浓度(Cm ax)分别为(0.68±0.08)IUAXa/m l和(0.64±0.09)IUAXa/m l,曲线下面积(AUC0-t)分别为(5.38±0.79)(IUAXa/m l).h和(5.03±0.73)(IUAXa/m l).h。结论ACL300全自动血凝仪测定LMWH时的精密度、携带污染率和线性良好,经生物等效性计算程序处理,相同剂量被试制剂与参比制剂为生物等效制剂。     

肝素抗凝治疗监测相关项目的性能验证

目的对低分子量肝素(low molecular weight heparin,LMWH)抗-Ⅹa活性、抗凝血酶(antithrombin,AT)活性和活化部分凝血活酶时间(activated partial thromboplastin time,APTT)检测系统的性能进行验证。方法参考美国临床和实验室标准协会(CLSI)发布的多项指南、多项卫生行业标准和试剂厂家的要求,对LMWH抗-Ⅹa活性检测的批内精密度、日间精密度、线性、准确度和检出限,AT活性检测的批内精密度、日间精密度、线性和准确度,以及APTT检测的批内精密度、日间精密度和可比性进行验证。结果 LMWH抗-Ⅹa活性检测的批内精密度分别为0.03抗-Ⅹa IU/ml和0.05抗-Ⅹa IU/ml,日间精密度分别为0.04抗-Ⅹa IU/ml和0.05抗-Ⅹa IU/ml,线性范围为0~1.83抗-Ⅹa IU/ml,准确度百分偏差分别为4.3%和2.2%,检出限验证结果为0.05抗-Ⅹa IU/ml,均符合厂家要求。AT活性检测的批内精密度分别为2.0%和3.5%,日间精密度分别为2.7%和5.3%,线性范围为0~139%,准确度百分偏差分别为0.9%、–1.4%和–2.7%,均符合厂家要求。APTT活性检测的批内精密度分别为0.5%和0.4%,日间精密度分别为3.4%和4.4%,可比性验证结果符合行业标准的要求。结论 3个项目的性能能够满足厂家和行业标准的要求,性能验证方法和指标的研究有助于临床实验室实施质量改进。     

Sysmex CS2000i全自动凝血分析仪性能评价

目的对Sysmex CS2000i全自动凝血分析仪(以下简称"CS2000i仪")的性能进行系统评价。方法根据美国临床和实验室标准化协会(CLSI)相关标准对CS2000i仪进行精密度、准确度、线性、生物参考区间、携带污染率评价,同时用CS2000i仪与Sysmex CA1500全自动凝血分析仪检测5份临床标本,并进行比较。结果 CS2000i仪检测凝血酶原时间、活化部分凝血活酶时间、凝血酶时间、纤维蛋白原、D-二聚体等主要参数的批内、日间不精密度变异系数、携带污染、准确度、线性等均符合该室质量目标。结论 CS2000i仪各方面性能良好,检测结果可用于临床诊治相关疾病。     

Heparanase neutralizes the anticoagulation properties of heparin and low-molecular-weight heparin

BACKGROUND: Heparanase is a mammalian endo-D-glucuronidase that cleaves heparan sulfate (HS) in the extracellular matrix and cell surface. It is preferentially expressed by cells of the immune system and tumor cells. Heparanase overexpression in experimental tumor models results in increased angiogenesis and metastasis. Heparin and low-molecular weight heparin (LMWH) inhibit HS degradation by heparanase. OBJECTIVE: To investigate whether heparanase cleaves heparin and LMWH, and elucidate its effect on blood coagulation. METHODS: Heparin and LMWH were incubated with recombinant heparanase and subjected to measurements of molecular size (size exclusion chromatography) and anticoagulant activity (plasma APTT-activated thromboplastin time, and anti-Xa activity). APTT was also measured in plasma samples of transgenic mice overexpressing heparanase, in comparison with control mice. RESULTS: Incubation of heparin and LMWH with heparanase resulted in degradation of these substrates, as revealed by a significant decrease in their molecular weight. This was correlated with a marked suppression of the anticoagulant activity of heparin and LMWH, as indicated by a decreased effect on APTT and anti-Xa activity, respectively, when human plasma was added. Transgenic mice overexpressing heparanase exhibited a significantly shorter APTT than control mice. CONCLUSION: Heparanase is capable of degrading heparin and LMWH, so that its overexpression by tumor cells may contribute to heparin resistance, commonly occurring in cancer patients. In view of the complexity of the currently available heparanase activity assays, we propose an indirect approach to quantify heparanase activity by measuring the decrease in plasma APTT or anti-Xa activity exerted by the enzyme under the defined conditions.     

MEK-7222K血细胞分析仪器性能评价

目的评估MEK-7222K血细胞分析仪的各项性能参数是否符合相关要求,能否应用临床。方法以MEK-7222K血细胞分析仪作为评价仪器,分别进行空白检测、批内和批间精密度测试、携带污染率测试、线性验证,并将MEK-7222K血细胞分析仪全血白细胞计数结果与显微镜手工分类计数结果进行比对,评估仪器的测量准确度。结果仪器的空白值、批内精密度、批间精密度、携带污染率均满足要求;线性验证通过;白细胞分类合格率满足白细胞分类计数准确度的要求。结论 MEK-7222K血细胞分析仪的各项性能参数符合要求,可应用于临床。     

BECKMAN DxI 800全自动 化学发光仪检测泌乳素的性能验证

目的 对BECKMAN DxI 800全自动化学发光仪检测泌乳素(PRL)的分析性能进行验证。方法 参照美国临床实验室标准化协会(NCCLS)的文件,选取病人血清和质控室间质评质控品,对PRL的批内精密度、批间精密度、准确度、线性范围等方面进行验证。结果 PRL的批内和批间精密度CV值均小于厂家声明的CV值,在允许范围内; PRL线性范围验证结果显示,a值为1.011 4,r值为0.997 4,均在仪器要求范围内,并具有良好的线性; PRL准确度验证结果显示,测定5份室间质评的检测结果与“靶值”的偏倚为-1.18%～-7.78%,均在室间质评的测量范围之内。结论 BECKMAN DxI 800全自动化学发光仪测定PRL在精密度、准确度、线性范围等性能指标均在仪器要求范围内,符合要求,可应用于临床检测。     

Plasma kinetics of lipoprotein lipase and hepatic lipase activities induced by heparin and a low molecular weight heparin fragment

Intravenous injections of conventional heparin and a low molecular weight heparin fragment (LMWH, mean molecular weight 4000-6000) were given to six male volunteers at doses of 10, 50 and 100 U (antiFXa)/kg body wt. The plasma kinetics of lipoprotein lipase (LPL) and hepatic lipase (HL) were analysed. The peak values, as well as the accumulated release of LPL activity, were dose dependent and were twice as high after heparin as after LMWH. The plasma half-life of LPL activity followed first order kinetics and was similar for both heparin preparations when given in comparable doses. The peak values and the plasma half-life of HL activity were the same for heparin and LMWH in the clinically relevant doses (50 and 100 U (antiFXa)/kg). Compared with LMWH, the total release of HL was twice as large after the heparin injections, possibly due to mobilization of an additional enzyme pool by the conventional heparin. It is concluded that the use of LMWH as an anticoagulant is associated with a lower plasma lipolytic activity than with standard heparin.     

Lipolytic and anticoagulant activities of a low molecular weight fragment of heparin

Low molecular weight heparin (LMWH) and standard heparin were given intravenously to six healthy subjects receiving a continuous infusion of Intralipid. After infusion, antifactor Xa, antithrombin II and coagulation activity (Normotest) were the same for both heparins. Activated partial thromboplastin time increased significantly, but the increase was much higher after standard heparin (+473%) than after LMWH (+48%). The increase in lipoprotein lipase activity was less pronounced after LMWH infusion. This resulted in a smaller decrease in Intralipid-triglyceride concentration and a smaller increase in both plasma FFA concentration and Intralipid fractional removal rate compared to standard heparin. This study shows that the plasma lipolytic potential of LMWH is weaker than that of standard heparin when given in doses with equipotent anticoagulation. LMWH may therefore be preferable to standard heparin as an antithrombotic agent in clinical situations where a high plasma lipolytic activity may be disadvantageous.     

Plasma lipolytic activity and substrate oxidation after intravenous administration of heparin and a low molecular weight heparin fragment

Summary. This study examines the effects of heparin and a low molecular weight heparin (LMWH) fragment on plasma lipolytic activity and substrate oxidation. Indirect calorimetry was performed continuously in healthy male subjects receiving a constant infusion of fat emulsion (0·2 g min^-1) and glucose (0·8 g min^-1) during a period of 4 h. After 2 h an infusion of heparin (n= 6) or LMWH (n= 6) (100 antifactor Xa units kg^-1) or saline (n= 6) was given over 1 h. Plasma concentration of the fat emulsion decreased by 76 ± 5% with heparin and by 12 ± 7% with LMWH (P<0·01). In the case of LMWH the initial fall was followed by a consistent rise in fat emulsion concentration for the entire remaining study period. Compared to the control experiments, plasma FFA increased five times with heparin and three times with LMWH (P<0·05). The average respiratory quotient (RQ) and energy expenditure (EE) increased constantly during the study period and did not differ significantly between the groups. In all groups the average increase in glucose oxidation was 40–50%, while fat oxidation decreased to a comparable extent. Infusions of heparin and LMWH had no effect on RQ or EE. A microcalorimetric study on isolated rat adipocytes in buffer solutions containing glucose, fat emulsion, heparin or LMWH was also made. The heat output from the adipocytes was not influenced by the presence of heparin or LMWH. In conclusion, infusion of heparin resulted in a pronounced increase in FFA availability, whereas LMWH exerted a less marked lipolytic effect. However, the heparin-induced elevations in plasma FFA were not accompanied by measurable rises in lipid oxidation rate.     

Use of the Du Pont aca to measure cholesterol in high-density lipoprotein fractions prepared by the heparin/Mn2+ precipitation method.

The enzymatic cholesterol method used with the Du Pont aca has been modified to provide a reliable measurement of high-density lipoprotein cholesterol in serum after heparin/Mn2+ precipitation of the low- and very-low-density lipoproteins. Interference by Mn2+, equivalent to about 90 mg of cholesterol per liter, is decreased to less than 40 mg of cholesterol per liter by the presence of ethylenediaminetetraacetate (8 mmol/liter) in the diluent; the residual effect of Mn2+ is compensated by calibrating the aca with standards containing Mn2+ and heparin. With an 80-microliter sample, the sensitivity is 236 muA/mg per liter and linearity ranges from 50 to 1500 mg/liter. Average analytical recovery of cholesterol added to the high-density lipoprotein fraction was 103%. Diluted fractions give the expected results. Between-run reproducibility (CV) is 1.3 and 1.6% at 463 and 554 mg/liter. Correlation with the Lipid Research Clinics' procedure (25 samples) gave a regression line of y(aca) = 1.039x- 15, and a correlation coefficient of 0.997.     

壳聚糖水凝胶微球模板的载肝素层层自组装微胶囊（英文）

背景：近年来,对抗凝血药物肝素的控释一直存在争议,静电层层自组装是微胶囊载药简单有效的新方法。目的：制备壳聚糖水凝胶微球模板的载肝素层层自组装微胶囊,从而实现对抗凝血药物肝素的控释。方法：采用硫酸钠沉淀的方法制备了具有正电荷的壳聚糖微球模板,通过层层自组装的方法装载抗凝血药物肝素。壳聚糖（CS）作为聚阳离子和肝素（Heparin,Hep）作为聚阴离子,在壳聚糖微球的模板上层层自组装形成{CS/Hep}3。{CS/Hep}3包被壳聚糖微球模板的微胶囊通过倒置荧光显微镜、激光共聚焦显微镜和激光粒度分析进行了表征。壳聚糖和肝素的层层自组装过程通过Zeta电位分析进行监测。结果与结论：{CS/Hep}3包被壳聚糖微球模板的微胶囊平均直径1μm,包封率和载肝素量分别为83.8%和3.05%。成功制备了壳聚糖水凝胶微球模板的载肝素层层自组装微胶囊,进而实现对抗凝血药物肝素的控释。     

强生Vitros 5.1 FS生化分析仪上乳酸脱氢酶的性能验证

目的探讨强生Vitros 5.1 FS生化分析仪上乳酸脱氢酶(LDH)的性能验证。方法根据美国临床和实验室标准化协会的检测仪器评价标准,并参照美国强生公司提供的验证方案对LDH的精密度、正确度、线性范围、最大稀释度、生物参考区间进行验证。结果 LDH批内及批间精密度试验均≤3.30%;正确度试验≤4.00%;线性试验决定系数为0.997 2;LDH用生理盐水稀释最大稀释度为8倍;生物参考区间试验证实《VITROS方法学手册》提供的参考区间313~618U/L可以引用。结论强生Vitros 5.1 FS生化分析仪检测的LDH性能验证基本符合质量目标要求和厂商说明要求,满足临床检验的需求。