快速微粒凝胶免疫测定法与酶联免疫吸附测定法检测HIT抗体的临床应用比较

目的比较快速微粒免疫凝胶法（PaGIA）和酶联免疫吸附测定法（ELISA）检测HIT抗体在诊断肝素诱导的血小板减少症（HIT）中的应用。方法选取应用肝素制剂患者197例,男性120例、女性77例,根据4 Ts评分系统临床诊断HIT,所有患者均应用ELISA法进行HIT抗体检测,对ELISA法检测阳性及出现血小板减少的患者再次应用PaGIA法进行检测,并对两次HIT抗体检测结果进行比较。结果 4 Ts评分临床诊断HIT患者6例,两种检测方法分别检测出5例抗体阳性。24例ELISA法检测阳性患者中的19例非HIT患者,应用PaGIA法再次检测仅有3例阳性。结论4 Ts评分系统仍是目前临床诊断HIT的重要依据,联合HIT抗体检测可提高确诊和除外HIT诊断的准确性。PaGIA法检测HIT抗体与临床符合度更高,优于ELISA法。

Comparision of Rapid Particle gel Immunoassay and Enzyme-linked Immunosorbent Assay to Detect HIT-antibody in the Diagnosis of Heparin-Induced Thrombocytopenia

Objective To evaluate the particle gel immunoassay and Enzyme-linked immunosorbent assay to detect HIT-antibody in the diagnosis of heparin-induced thrombocytopenia（ HIT）. Methods 197consecutive patients,including 120 males and 77 females,who were treated with heparin preparations,were enrolled in our study. HIT was diagnosed based on＂4 Ts＂Pretest Clinical Scoring System. All patients were detected HIT-antibody by ELISA kits,and the patients with ELISA-HIT antibody positive and thrombocytopenia were also detected HIT-antibody by PaGIA kits. Results 6 patients were clinically diagnosed as HIT,5 of them were detected HIT-antibody positive respectively by two methods. Among the 19 HIT-antibody positive non-HIT patients,only 3 patients were detected HIT-antibody by PaGIA kits. Conclusion The diagnosis of HIT is based on＂4 Ts＂scoring system and HIT-antibody assay. PaGIA is better than ELISA for HIT-antibody assay.