针对影响因素细化的vWF抗原与活性检测参考范围的建立  

Establishment of variables-specific reference ranges of von Willebrand factor antigen and activity

作　　者：李莉莉[1,2] 邹纬[1] 许冠群[1] 张利伟[1] 沈韵[1] 许林敏 蔡晓红[1] 王学锋[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院实验诊断中心,上海200025 [2]温州市人民医院输血科

出　　处：《中国输血杂志》2017年第7期690-692,共3页Chinese Journal of Blood Transfusion

基　　金：上海市公共卫生重点学科建设项目(15GWZK0501);上海市自然科学基金(17ZR1417000)

摘　　要：目的对本院患者血管性血友病因子结果进行统计并分析,探讨ABO血型以及年龄、性别对血管性血友病因子(vWF)抗原与活性检测的影响,按影响因素分类细化vWF抗原与活性检测参考范围。方法对本院患者247例随机选择的无出凝血异常临床表现,且常规凝血象实验室检查正常的外科手术患者,运用免疫比浊法测定vWF抗原(vWF:Ag)、vWF活性(vWF:Act),同时用血型血清学方法鉴定ABO血型,并应用统计方法比较A、B、O、AB不同血型、性别和高(≥40岁)、低年龄组(<40岁)之间结果的差异。结果不同血型人群vWF:Ag水平分别为:A型:98.5-142.00,B型:97.90-160.30,O型:82.13-125.45,AB型:103.00-135.80。不同血型正常人群vWF:Act水平分别为:A型:76-130.14,B型:78.06-144.3,O型:60.89-116.11,AB型:88.99-124.09。O血型组vWF:Ag和vWF:Act均低于非O型组,差异有统计学意义(P<0.05);低年龄组vWF:Ag和vWF:Act低于高年龄组,差异有统计学意义;男性和女性组vWF:Ag和vWF:Act水平差异无统计学意义。据此得出各组vWF抗原(活性)的参考范围。结论血浆vWF抗原与活性水平检测受ABO血型和年龄的显著影响,针对这些影响因素建立的细化的参考范围有利于更精细地诊断VWD以及预判患者vWF水平相关的出血与血栓风险。Objective To analyze the screening results of van Willebrand factor among patients before blood transfusion in Ruijin Hospital and discuss van Willebrand factor in ABO blood group and the relationship between age and gender, refine the classification of vWF antigen and activity by reference factors. Methods The van Willebrand factor among 247 cases of patients before blood transfusion in Ruijin Hospital with no clinical manifestations of abnormal blood clots and routine coagu- lation as laboratory tests for normal surgical patients.The vWF： Ag and vWF： Act were measured by immune turbidimetric method and ABO blood group was identified by blood type serology.Furthermore, the differences between A, B, O, AB different blood groups, sex and high （ ≥40 years） and low age group （ 〈40 years） were compared by statistical methods. Results The levels of vWF ： Ag in different blood groups were as follows ： A blood type ： 98.5 - 142. 00, B blood type ： 97.90 - 160. 30, O blood type：82. 13-125.45, AB blood type： 103.00-135.80.The levels of vWF： Act in different blood groups were as follows ： A blood type ： 76- 130. 14, B blood type ： 78.06- 144. 3, O blood type ： 60. 89- 116. 11, AB blood type ： 88. 99- 124. 09.0 blood type vWF： Ag and vWF： Act were lower significantly （P〈0. 05 ） than non-O blood type, the difference was. Besides, young vWF： Ag and vWF： Act were lower significantly than in the elderly. There was no significant difference in vWF ： Ag and vWF ： Act levels between male and female groups. At last, the reference range of four groups of vWF activity （antigen） was obtained .Conclusion Plasma vWF antigen and activity levels were significantly affected by ABO blood type and age, and the refined reference range established for these influencing factors was beneficial for more detailed diagnosis of VWD and predicting vWF levels associated with bleeding and thrombosis risk.

关 键 词：血管性血友病因子 ABO血型 性别 年龄 参考范围 

分 类 号：R457.1[医药卫生—治疗学]