不同ACT促凝试剂检测低分子量肝素灵敏性体外研究  

The sensitivity of different reagents for laboratory monitoring of low molecular weight heparin： an in vitro study

作　　者：史旭波[1] 胡大一[2] 王建旗[1] 白英[1] 陈喆[1] 于海荣[1] 

机构地区：[1]首都医科大学附属北京同仁医院心血管中心,北京100730 [2]北京大学人民医院心脏中心

出　　处：《中国医师杂志》2011年第3期296-299,共4页Journal of Chinese Physician

摘　　要：目的 本研究通过探讨活化凝血时间（ACT）不同促凝试剂检测LMWH抗凝活性灵敏性的差异,尝试通过筛选适宜强度促凝试剂把ACT仪用于LMWH抗凝活性床旁检测.方法 选择30例健康志愿者,抽取血标本分装后,依次加入不同剂量的低分子量肝素（达肝素钠）,最终血标本浓度范围为0.2～1.8 IU/ml,应用3种不同促凝试剂玻璃珠、硅藻土、高岭土分别依次测定ACT值,对不同浓度达肝素钠与相应的ACT值进行相关性分析.结果 用3种促凝试剂分别测得的ACT值均与达肝素钠浓度成直线相关关系（P＜0.01）,对ACT值与达肝素钠浓度的直线回归方程分析发现,3种促凝试剂的直线斜率差异很大,玻璃珠249.7 s/IU,硅藻士77.7 s/IU,高岭土59.3 s/IU（P＜0.01）.不同促凝试剂对达肝素钠的反应性不同,在0.2～1.8 IU/ml的浓度范围内,高岭土对达肝素钠很不敏感,玻璃珠是较适宜的检测达肝素钠的促凝试剂.结论 玻璃珠、硅藻土、高岭土3种促凝试剂对达肝素钠的灵敏性不同,应用玻璃珠作促凝试剂的ACT检测是较适宜的达肝素钠抗凝活性监测方法.Objective This study was designed to determine the in vitro sensitivity of LMWH caused by different reagents,and to explore whether the ACT can be used to monitor LMWH.Methods This study was performed in vitro.ACT was measured with different reagents（glass beads,celite,and kaolin）on volunteer（n =30）blood samples spiked with increasing concentrations of LMWH（datleparin,0.2-1.8IU/ml）.Linear regression analysis was performed to establish a regression equation from different concentration of datleparin and corresponding ACT values.Results Analysis of dose-response curves obtained in vitro,an excellent linear relationship was observed between the ACT and dalteparin concentrations for all three reagents（p less than 0.01）.Differences in slope of the regression curves of ACT were observed with all the reagents tested（glass beads 249.7s/IU,celite 77.7s/IU,and kaolin 59.3s/IU,p less than 0.01）.Reagents vary widely in their in-vitro sensitivity related to dalteparin.In the concentration range of 0.2-1.8 IU/ml,the gaolin reagent was insensitive to dalteparin,and glass beads was the most suitable reagent for monitoring the anticoagulant effect of dalteparin.Conclusions Glass beads,celite,and kaolin.Glass beads were the most suitable reagent for monitoring the anticoagulant effect of dalteparin.Vary widely in their in-vitro sensitivity related to datleparin.

关 键 词：凝血酶时间 促凝药 指示剂和试剂 肝素 低分子量/分析 

分 类 号：R973.2[医药卫生—药品]