缩短的APTT在凝血常规检测分析后质量管理中的应用  

Application of shortened APTT in the post-analytical quality management of routine coagulation assay

作　　者：王威[1] 许薇 张琳[1] 李君 王刚[1] WANG Wei;XU Wei;ZHANG Lin;LI Jun;WANG Gang(Department of Clinical Laboratory,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,Shaanxi,China)

机构地区：[1]西安交通大学第一附属医院检验科

出　　处：《检验医学》2020年第1期63-65,共3页Laboratory Medicine

基　　金：西安交通大学第一附属医院院基金（2017MS-07）

摘　　要：目的探讨缩短的活化部分凝血活酶时间(APTT)在凝血常规检测分析后质量管理中的应用。方法收集249例APTT低于参考区间下限的凝血检测报告,进行分析后阶段检验结果确认。记录经确认的合格样本与不合格样本数据并进行分析。结果249例样本均不存在抗凝比例错误及相关干扰因素。经检验结果确认后的31例不合格样本均含微小凝块或纤维蛋白丝,分别来源于14个临床科室。APTT缩短但质量合格的样本来源集中,病种以肾病综合征、冠心病及多发性骨髓瘤为主。不合格报告占APTT缩短报告总数的12.4%。仅APTT缩短的不合格报告有21个,占APTT缩短报告总数的8.4%,占不合格报告总数的67.7%。不合格与合格凝血报告APTT数据差异无统计学意义(P=0.199)。结论缩短的APTT可作为血液是否含有微小凝块或纤维蛋白丝的独立指标,可结合临床资料指导人工样本质量复核,确认检验结果。Objective To investigate the application of shortened activated partial thromboplastin time(APTT)in the post-analytical quality management of routine coagulation assay.Methods A total of 249 coagulation assay reports with APTT being lower than the lower limit of reference interval were collected,and the results were verified through post-analytical quality management.The verified samples'data were collected,and statistical analysis was carried out.Results A total of 249 samples had no inaccurate anticoagulant ratio and related interference factors.A total of 31 unqualified samples were found after post-analytical result verification,which came from different 14 clinical departments,and all of them contained tiny clots or fibrin filaments.The qualified samples concentrated with specific departments.The distribution of diseases in these cases mainly included nephritic syndrome,coronary heart disease and multiple myeloma.The unqualified reports accounted for 12.4%of the total number of shortened APTT,and 21 of them had only APTT shortening,accounting for 8.4%of the total number of APTT shortened reports,accounting for 67.7%of the unqualified reports.The shortened APTT data had no statistical significance between qualified and unqualified reports(P=0.199).Conclusions The shortened APTT can be used as an independent factor for judging whether the blood sample contains tiny clots or fibrin filaments,and it can guide the manual verification of sample quality based on clinical information.

关 键 词：活化部分凝血活酶时间 凝血常规 分析后质量管理 检验结果确认 

分 类 号：R446.1[医药卫生—诊断学]