肝素诱导的血小板减少症的实验室诊断进展  

Progress in laboratory diagnosis of heparin induced thrombocytopenia

作　　者：门剑龙[1] 任静[1] 

机构地区：[1]天津医科大学总医院医学检验科,300052

出　　处：《中华检验医学杂志》2016年第10期795-800,共6页Chinese Journal of Laboratory Medicine

摘　　要：肝素诱导的血小板减少症（HIT）是严重的由抗体介导的肝素副作用，实验室检查有两个主要类型，包括功能分析和HIT抗体检测。功能分析试验中的5-羟色胺释放试验（SRA）和肝素诱导的血小板活化试验（HIPA）有高度灵敏性和特异性，是公认的参考方法，缺点是操作复杂且耗时长，不能作为常规检查手段。HIT抗体检测方法中的ELISA、免疫比浊法、化学发光法和侧流免疫分析均有很高的诊断敏感性且可在普通实验室进行，这些试验与验前概率评分（4TS评分）结合使用可有效进行HIT的排除诊断或诊断。Heparin induced thrombocytopenia （HIT） is a severe side effect of heparin with antibody-mediation. Laboratory assays can be divided into two major categories, about functional assays and HIT antibodiesdetection. Thefunctional assays, such as the serotonin release assay （SRA） and heparin- induced platelet activationassay（HIPA） , are sensitive and specific for HIT. They arethe reference standard assays generally, but have thedeficiencies of complicated operation and time-consuming, and cannot be used as a routine examination. TheHIT antibodiesdetections, such as ELISA, immune turbidimetry assay, chemiluminescent assay and lateral flow immunoassay, have high diagnostic sensitivityandareavailable at routine laboratories. They can exclude the diagnosis of HIT or beused to diagnose HIT effectively combined with the pre-test probability score（4Ts score） of HIT.

关 键 词：血小板减少 肝素 自身抗体 血清素 血小板活化 酶联免疫吸附测定 散射测浊法和比浊法 免疫测定 

分 类 号：R558.2[医药卫生—血液循环系统疾病] R446.11[医药卫生—内科学]