便携式凝血检测仪在华法林抗凝治疗监测中的应用评价  

Evaluation of a point-of-care coagulometer in warfarin anticoagulation monitoring

作　　者：谭胜蓝[1] 徐萍[1] 周新民[2] 张霞[2] 周杨钊 TAN Sheng-Lan;XU Ping;ZHOU Xin-min;ZHANG Xia;ZHOU Yang-zhao(Department of Pharmacy,Second Xiangya Hospital,Central South Univeristy,Changsha 410011;Department of Cardiovascular Surgery,Second Xiangya Hospital,Central South Univeristy,Changsha 410011)

机构地区：[1]中南大学湘雅二医院药学部,长沙410011 [2]中南大学湘雅二医院心血管外科,长沙410011

出　　处：《中南药学》2019年第11期1987-1990,共4页Central South Pharmacy

基　　金：国家自然科学基金青年科学基金项目(项目编号：81703818);湖南省药学会医院药学-正大天晴研究基金项目(项目编号：hn2017006);湖南省卫生健康委2019年度科研计划课题项目(项目编号：C2019158)

摘　　要：目的探讨一种国产便携式凝血检测仪(POCT)qLabs与传统实验室法(Stago半自动凝血检测仪)所检测国际标准化比值(INR)结果的一致性,以及患者使用该POCT的意愿。方法423名长期口服华法林的人工心脏瓣膜置换术后患者,30 min内分别应用两种方法检测INR值,对结果进行相关性(Pearson相关性分析)、偏倚度(Bland-Altman法)和符合度分析,并对96位有效患者进行问卷调查。结果qLabs和Stago检测的INR平均值分别为(2.25±0.62)和(2.22±0.65),两种方法检测INR结果的相关系数r为0.911(P<0.001),偏倚度为(0.03±0.27),符合度为80.1%。问卷调查结果显示大部分患者认为使用POCT法会提高其遵医嘱复诊的次数,节约其看病总费用,并愿意使用POCT法测PT/INR。结论本研究测试的POCT与实验室法检测结果的一致性和相关性良好,绝大部分患者愿意使用POCT法监测华法林抗凝效果。Objective To determine the consistency between the results of international normalized ratio(INR)detected by a point-of-care coagulometer(POCT)qLabs and a standard laboratory method(Stago semi-automatic coagulometer),and patients’intention to use this POCT.Methods Totally 423 patients on warfarin enrolled in this study.INR of each patient was tested with portable qLabs and Stago semi-automatic coagulometer within 30 minutes.Correlation between these two methods was assessed with Pearson correlation test,mean difference was assessed with Bland-Altman plot,and coincidence was also analyzed.Questionnaires were collected from 96 patients to investigate their intention to use POCT.Results The mean INR values for qLabs and Stago were(2.25±0.62)and(2.22±0.65),with a strong positive correlation between the two methods(r=0.911,P<0.001).The Bland-Altman analysis showed a mean difference of(0.03±0.27)between the two methods.The coincidence rate was 80.1%.The questionnaires indicated most patients believed that the use of POCT would increase the number of follow-up visits,save their total medical expenses,and were willing to use POCT to measure PT/INR.Conclusion Good consistency and correlation between the tested POCT qLabs and traditional laboratory method are found.Most patients are willing to use the POCT for their warfarin anticoagulation monitoring.

关 键 词：便携式凝血检测仪 华法林 抗凝监测 国际标准化比值(INR) 

分 类 号：R969[医药卫生—药理学]