中国北京地区健康人群血栓弹力图参考范围的建立  

Establishment of normal reference values for thromboelastography on Chinese population in Beijing

作　　者：纪宏文[1] 马丽[1] 高旭蓉[1] 刘娜[1] 张颖[1] 王杨[2] 马祖轩[1] 王跃[1] 王静[1] 富新[1] 熊乾[1] 齐虹美[1] 

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外心血管病医院输血科,北京100037 [2]中国医学科学院北京协和医学院国家心血管病中心阜外心血管病医院生物统计部,北京100037

出　　处：《中华医学杂志》2011年第14期980-983,共4页National Medical Journal of China

摘　　要：目的 测定北京地区常住中国成年居民健康志愿者血栓弹力图（TEG）数据,建立正常参考值,并与试剂厂家提供的正常值进行比较.方法 2010年6-8月采集健康成年志愿者静脉血4 ml,分别测定TEG和凝血4项.TEG检测：应用Haemoscope 5000分别测定凝血反应时间（R）、凝血形成时间（K）、凝固角（α-Angle）、最大振幅（MA）、纤维蛋白溶解率（LY30）和凝血指数（CI）.凝血4项检测包括：凝血酶原时间（PT）、激活部分凝血致活酶时间（APTT）、凝血酶时间（TT）和纤维蛋白原.结果 137名志愿者TEG各参数正常参考值分别为R：3.8～8.4 min,K：0.8～3.3 min,α-Angle：46.2～76.2°,MA：50.0～70.8 mm,LY30：-3.3%～4.0%,CI：-3.8～2.9.24.1%（33/137）的健康志愿者至少一项参数超出厂家提供的正常范围,约有7.3%（10/137）的健康人被诊断为凝血异常,其检测的特异性为76.0%.与西方人参考范围（厂家提供的）比较,中国人健康志愿者的α-Angle低.男女性别间分组比较,R、K、α-Angle、MA和CI组间差异均有统计学意义（均P＜0.01）.结论 TEG检测实验室有必要根据检测人群特点建立自己的正常参考值.Objective To determine the normal values for thromboelastography （TEG） in Chinese healthy adult volunteers residing in Beijing for over three years and compare them with those of the manufacturer＇s. Methods A total of 137 healthy adult volunteers were enrolled from June 2010 to August 2010. The technique was standardized with citrated blood and kaolin activator. And a Haemoscope 5000 device was employed. The TEG parameters analyzed were R, K, α, maximal amplitude （ MA）, LY30 and coagulation index （ CI）. All volunteers underwent the tests of prothrombin time （ PT）, activated partial thromboplastin time （APTT）, thrombin time （TT） and plasma fibrinogen level with the same blood sample. Results The reference ranges of 95% for 137 volunteers were R：3.8 - 8.4 min, K：0. 8 - 3.3min, α-Angle：46.2 -76.2°, MA： 50.0-70.8 mm, LY30： -3.3% -4.0% and CI： -3.8 -2.9.Overall, 24. 1% （33/137） of the volunteers had at least one abnormal parameter while 7.3% （10/137）would have been considered coagulopathy had the manufacturer＇s reference values been used, resulting in a test specificity of 76.0%. As compared with the western ethnicity （ the manufacturer＇s reference values）,Chinese healthy volunteers were associated with lower fibrinogen functions. There were significantly diffenrent in R, K, α-Angle, MA and CI bettween men and women groups（ all P ＜0. 01 ）. Conclusion This study supports the manufacturer＇s recommendation that each institute should determine its own normal reference values.

关 键 词：血栓弹力描记术 参考值 北京 中国 

分 类 号：R540.4[医药卫生—心血管疾病]