稀释回归法在脂血标本凝血检测中的应用探讨

目的探讨稀释回归法在脂血标本凝血凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)检测中应用的可行性。方法随机收集昆明市延安医院40例门诊及住院外观正常(无脂血、无黄疸、无溶血)凝血标本,分别检测原血浆和3倍、5倍稀释后血浆的PT、APTT两项指标,将稀释前与稀释后两组数据进行线性回归分析,得到各指标的回归方程。另外收集昆明市延安医院门诊及住院外观脂血标本33例,根据三酰甘油(TG)的不同浓度分成3组,轻度脂血组(1.7mmol/L≤TG11.0mmol/L)12例,中度脂血组(11.0mmol/L≤TG20.0mmol/L)13例,重度脂血组(TG≥20.0mmol/L)8例,检测3倍稀释血浆和高速离心后血浆的PT、APTT两项指标,并将稀释后结果带入正常凝血标本的回归方程所得结果与高速离心法结果进行比较。结果正常凝血标本5倍稀释血浆绝大部分标本无法检测出结果,所以取3倍稀释血浆稀释前后结果进行线性回归分析得到PT、APTT的回归方程。3组脂血标本3倍稀释后的PT、APTT两项指标经过相应回归方程计算,所得结果与原血浆高速离心后检测结果的差异均无统计学意义(P0.05)。结论稀释回归法可以用于临床脂血标本的凝血PT和APTT检测。

Application of dilution regression method in the coagulation detection of fat blood samples

Objective To explore the dilution regression method of coagulation detection(PT ,APTT) in fat blood samples . Methods We collected 40 normal blood coagulation specimens (no fat blood ,no jaundice ,no hemolysis) in Yan′an hospital of Kun-ming ,then we detected the PT and APTT of the original plasma and 3-fold diluted plasma and 5-fold diluted plasma ,the we used the data both of before dilution and diluted to do the linear regression analysis ,and finally we got the regression equations of each index .we also collected 33 fat blood samples in Yanan hospital of Kunming ,which be divide into three groups through the severity of triglycerides :mild fat blood group(1 .7 mmol/L≤TG<11 .0 mmol/L) and moderate fat blood group(11 .0 mmol/L≤TG<20 .0 mmol/L)and severe fat blood group(TG≥20 .0 mmol/L) ,then we detected the PT and APTT after 3-fold diluted plasma and high-speed centrifugation plasma ,and then we brought diluted results into the normal regression equations and the results were compared with the high-speed centrifugation results .Results Because most of the 5-fold diluted plasma can not get the effective results ,so we use 3-fold diluted plasma to get the regression equations .The results of 3-fold diluted plasma was calculated by the regression equa-tions ,which then compared with high-speed centrifugation results ,after the analysis of statistical software ,two results had not sta-tistically significant (P>0 .05) .Conclusion Dilution regression method can be used to detect the fat blood samples in the clinical coagulation detection .