血栓弹力图分析前影响因素的探讨  

Study on the influence of pre-analysis factors on thromboelastography

作　　者：马跃飞[1] 林锦骠[1] 吴文楠[1] 欧启水[1] 戴琳孙[2] MA Yue-fei;LIN Jin-biao;WU Wen-nan;OU Qi-shui;DAI Lin-sun(Department of Laboralory Medicine,the First Afiliated Hospital of Fujian Medical University,Fuzhou,Fujian 350005,China)

机构地区：[1]福建医科大学附属第一医院检验科,福建福州350005 [2]福建医科大学附属第一医院神经外科,福建福州350005

出　　处：《中国卫生检验杂志》2020年第9期1127-1130,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨分析前因素对血栓弹力图(TEG)检测的影响。方法采集健康志愿者和住院患者标本,分析标本状态如溶血/脂血、检测时间、标本采集量和人员等因素对TEG检测的影响。结果标本溶血和脂血导致反应时间(R)降低、凝块形成时间(K)升高、最大切角(α)降低、最大振幅(MA)降低,除脂血标本的K值外,各参数差异有统计学意义(P <0. 05)。R、K、α在5 min^30 min内呈现趋势性变化(P <0. 05)。MA在60 min内成"∧"型波动。R在30 min后、MA在1 h后、K和α在2 h后检测结果差异无统计学意义(P> 0. 05)。与正常采集量2. 0 ml相比,标本量2. 3 ml时K值升高,差异有统计学意义(P <0. 05),其他参数在1. 7 ml^2. 3 ml差异无统计学意义(P> 0. 05)。不同实验人操作时各参数的变异系数(CV)均高于同一实验人。结论溶血、脂血对结果影响较大,TEG应在1 h^4 h内检测,不同实验人应严格遵循相同的操作程序。Objective To analyze the influence of pre-analysis factors on thromboelastography(TEG).Methods Samples from healthy volunteers and hospitalized patients were tested to analyze how do different testing time,samples status such as hemolytic/fatty,different amount of specimen collection and personnel affect TEG detection.Results The hemolysis and lipemia of the specimen lead to a decrease in reaction time(R),an increase in clot formation time(K),a decrease in the maximum cut angle(α),and a decrease in the maximum amplitude(MA),with the differences of parameters significant except for the K value of the lipid sample(P<0.05).R,K andαshowed a trend change within 5 min-30 min(P<0.05).MA fluctuates in a"∧"shape within 60 min.There was no statistical significance on the difference between R after 30 min,MA after 1 h,K andαafter 2 h,and the differences were not statistically significant(P>0.05).Compared with the normal collection volume of 2.0 ml,the K value increased when the sample volume was 2.3 ml,and the difference was statistically significant(P<0.05);other parameters did not change significantly from 1.7 ml to 2.3 ml,and the differences were not statistically significant(P>0.05).The coefficient of variation(CV)of each parameter during operation by different experimenters is higher than that of the same experimenter.Conclusion Hemolysis and lipid have great influence on the results.TEG should be tested in 1 h-4 h,and the experimenter should follow the same procedure strictly.

关 键 词：血栓弹力图 凝血功能 分析前质量管理 

分 类 号：R446[医药卫生—诊断学]