应用CLSI EP7-A2文件探讨4种抗生素对凝血检测的干扰  

Investigation of interference of four kinds of antibiotics on coagulation test by CLSI EP7-A2 document

作　　者：易四维[1] 李涛[1] 徐宁[1] 何文军[1] 李嘉胜[1] 张霞[2] 

机构地区：[1]广东省中医院检验医学部,广东广州510370 [2]广东省梅州市人民医院检验科,广东梅州514000

出　　处：《热带医学杂志》2014年第3期308-310,323,共4页Journal of Tropical Medicine

摘　　要：目的探讨4种抗生素(头孢曲松钠、青霉素钠、头孢呋辛钠、头孢噻肟钠)在不同剂量下对凝血检测的干扰情况。方法参照CLSI EP7-A2文件"配对-差异"实验对干扰物抗生素进行筛选后,进一步利用"剂量-效应"实验对抗生素浓度与凝血检测干扰程度之间的关系进行分析。结果 4种抗生素均为凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)检测的干扰物质;4种抗生素浓度与其对PT、APTT检测的干扰程度呈正相关,其剂量效应曲线呈线性关系,干扰PT检测的剂量效应分析回归方程依次为y=0.0008x-0.6594,相关系数r2=0.9719;y=0.0007x-0.4361,相关系数r2=0.9867;y=0.0004x-0.2734,相关系数r2=0.9813,y=0.0002x-0.1234,相关系数r2=0.9849。干扰APTT检测的剂量效应分析回归方程依次为y=0.0018x-0.2632,相关系数r2=0.971;y=0.0016x-0.8324,相关系数r2=0.9929;y=0.0025x-0.4375,相关系数r2=0.9826;y=0.0002x-1.091,相关系数r2=0.9762。结论 4种抗生素大剂量使用时均可对凝血检测产生干扰,临床上应引起重视。Objective To investigate interference of four kinds of antibiotics on coagulation test. Methods Firstly according to EP7-A2 document, paired-difference experiment was used to filter interference material. Then ＂dose- response＂ test was further used to analyze the relationship between the drug concentration and the interference levels. Results Both of prothrombin time（PT） and activated partial thromboplastin time（APTT） became longer along with the increase of concentration of four kinds of antibiotics （ceftriaxone, penicillin sodium, cefuroxime sodium, and cefotaxime sodium）.The interference levels were positively related to the drug concentration which showed a linear dose-response curve. The regression equation of PT were y=0.0008x-0.6594,r^2=0.9719;y=0.0007x-0.4361,r^2=0.9867;y=0.0004x- 0.2734,r^2=0.9813, y=0.0002x-0.1234, r^2=0.9849.The regression equation of APTT were y=0.0018x-0.2632, r^2=0.971 ; y= 0.0016x-0.8324,rZ=0.9929;y=0.0025x-0.4375, r^2=0.9826;y=0.0002x-1.091,r^2=0.9762. Conclusion The four kinds of antibiotics at high doses could interfere coagulation test, which should be considered when we analyze the result.

关 键 词：凝血检测 抗生素 干扰实验 

分 类 号：R446.11[医药卫生—诊断学]