血浆纠正试验差值在血友病A患儿抑制物中的诊断价值  

Diagnostic value of the difference of plasma correcting test in the prediction of hemophilia A

作　　者：李刚[1] 陈振萍[1] 唐凌[1] 甄英姿[1] 吴心怡[1] 吴润晖[1] 

机构地区：[1]首都医科大学附属北京儿童医院血液肿瘤中心,北京100045

出　　处：《检验医学与临床》2015年第23期3451-3452,3455,共3页Laboratory Medicine and Clinic

基　　金：国家自然科学基金资助项目(81341018);首都卫生发展科研专项资助项目(2014-2-2092);血友病疾病管理系统资助项目(IHECC2014HEM04);北京市医院管理局临床医学发展专项资助项目(ZY201404)

摘　　要：目的通过受试者工作特征曲线（ROC曲线）分析,确定利用即刻法与孵育后活化部分凝血活酶时间（APTT）结果差值预测血友病A凝血因子Ⅷ抑制物产生的临界诊断点。方法回顾分析172例血友病A患儿的APTT纠正试验及抑制物定量监测结果,并应用ROC曲线分析血友病A凝血因子Ⅷ抑制物阳性的最佳临界点。结果 ROC曲线下面积=0.908（95%CI：0.875-0.941,P〈0.05）,Youden值为0.679,所对应的APTT差值为2.6s,为有无抑制物的最佳诊断界点。此时敏感度为80.4%,诊断特异度为87.5%。结论 2.6s的APTT纠正试验秒值差可作为儿童血友病A凝血因子Ⅷ抑制物产生的早期筛查指标。Objective To predict the critical diagnosis point of FⅧinhibitor through determining the difference between immediate and incubated APTT results by ROC curve analysis.Methods To retrospectively analyze the quantitative results of APTT correction and FⅧinhibitor experiment in 172 cases of HA children.And to analyze the best of critical positive point of FⅧinhibitor by ROC curve.Results The area under the ROC curve（AUC）was0.908（95%CI：0.875-0.941,P〈0.05）and Youden value was 0.679.The corresponding difference of APTT（2.6s）was the best diagnostic cutoff point for predicting FⅧinhibitors.The sensitivity was 80.4% and the specificity was 87.5%for predicting FⅧinhibitors.Conclusion The time difference（2.6s）of APTT correcting test can provide a reference and predictive indicator for early diagnosis of FⅧinhibitor development in children with HA.

关 键 词：血友病 儿童 凝血因子Ⅷ 抑制物 活化部分凝血活酶时间 

分 类 号：R554.1[医药卫生—血液循环系统疾病]