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INT J LAB HEMATOL：比较光透射聚集法与多极聚集法评价黏膜出血患者

2019-01-27 MedSci MedSci原创

黏膜出血
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光透射聚集测定法(LTA)作为体外血小板功能评估的“金标准”诊断试验，由于样本要求，其应用目前存在局限性。全血或多个电极aggregometry(MEA)使用多平台®分析仪(罗氏诊断)因其需要较小的血液量，减少样本比LTA操纵，现成为一个有吸引力的临床测试的选择。目前有关MEA与LTA在血小板聚集异常诊断中的直接比较较少。 研究人员纳入99例患者(66 F/33 M;中位年龄26岁[范围2‐

光透射聚集测定法(LTA)作为体外血小板功能评估的“金标准”诊断试验，由于样本要求，其应用目前存在局限性。全血或多个电极aggregometry(MEA)使用多平台®分析仪(罗氏诊断)因其需要较小的血液量，减少样本比LTA操纵，现成为一个有吸引力的临床测试的选择。目前有关MEA与LTA在血小板聚集异常诊断中的直接比较较少。

研究人员纳入99例患者(66 F/33 M;中位年龄26岁[范围2‐86]，作为黏膜皮肤出血初步实验室评估的参考，进行了平行MEA/LTA测试。在正常对照组中产生阈值反应的ADP、花生四烯酸(AA)、胶原蛋白和凝血酶受体‐活化肽(TRAP)的浓度用于检测患者。

结果显示，99例患者中，29例(30%)LTA至少有一次异常激动剂反应；其中15例患者>1激动剂反应异常。36例患者(36%)经MEA至少有1例异常激动剂反应；27例>1激动剂反应异常。MEA相对于LTA的敏感性/特异性:ADP, 0.70/0.72;AA,0.71/0.85；胶原蛋白,0.85/0.71；TRAP0.25/0.84。MEA相对于LTA的负预测值为：ADP, 0.90;AA,0.93;；胶原蛋白,0.97； TRAP,0.96。

研究表明，，MEA检测的特定异常结果不能充分预测在使用阈值激动剂浓度的LTA检测中特定异常。然而，有利的npv提示MEA可能有助于筛查患者血小板聚集异常；MEA结果正常，不需要进一步LTA诊断检测。

原始出处：

Ping Sun Eileen McMillan‐Ward, Comparison of light transmission aggregometry and multiple electrode aggregometry for the evaluation of patients with mucocutaneous bleeding

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1317467, encodeId=2c81131e4675a, content=<a href='/topic/show?id=74916e0414' target=_blank style='color:#2F92EE;'>#EMA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6704, encryptionId=74916e0414, topicName=EMA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Tue Jan 29 07:56:00 CST 2019, time=2019-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1444489, encodeId=cc8314444893d, content=<a href='/topic/show?id=3d9291459d1' target=_blank style='color:#2F92EE;'>#评价#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91459, encryptionId=3d9291459d1, topicName=评价)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1fee5134542, createdName=huagfeg, createdTime=Tue Jan 29 07:56:00 CST 2019, time=2019-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1520019, encodeId=ff461520019ec, content=<a href='/topic/show?id=6ab11032506f' target=_blank style='color:#2F92EE;'>#黏膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103250, encryptionId=6ab11032506f, topicName=黏膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=057f11309297, createdName=snowpeakxu, createdTime=Tue Jan 29 07:56:00 CST 2019, time=2019-01-29, status=1, ipAttribution=)]
    2019-01-29 fengyi812

    #EMA#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1317467, encodeId=2c81131e4675a, content=<a href='/topic/show?id=74916e0414' target=_blank style='color:#2F92EE;'>#EMA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6704, encryptionId=74916e0414, topicName=EMA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Tue Jan 29 07:56:00 CST 2019, time=2019-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1444489, encodeId=cc8314444893d, content=<a href='/topic/show?id=3d9291459d1' target=_blank style='color:#2F92EE;'>#评价#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91459, encryptionId=3d9291459d1, topicName=评价)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1fee5134542, createdName=huagfeg, createdTime=Tue Jan 29 07:56:00 CST 2019, time=2019-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1520019, encodeId=ff461520019ec, content=<a href='/topic/show?id=6ab11032506f' target=_blank style='color:#2F92EE;'>#黏膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103250, encryptionId=6ab11032506f, topicName=黏膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=057f11309297, createdName=snowpeakxu, createdTime=Tue Jan 29 07:56:00 CST 2019, time=2019-01-29, status=1, ipAttribution=)]
    2019-01-29 huagfeg

    #评价#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1317467, encodeId=2c81131e4675a, content=<a href='/topic/show?id=74916e0414' target=_blank style='color:#2F92EE;'>#EMA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6704, encryptionId=74916e0414, topicName=EMA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a35a460, createdName=fengyi812, createdTime=Tue Jan 29 07:56:00 CST 2019, time=2019-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1444489, encodeId=cc8314444893d, content=<a href='/topic/show?id=3d9291459d1' target=_blank style='color:#2F92EE;'>#评价#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91459, encryptionId=3d9291459d1, topicName=评价)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1fee5134542, createdName=huagfeg, createdTime=Tue Jan 29 07:56:00 CST 2019, time=2019-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1520019, encodeId=ff461520019ec, content=<a href='/topic/show?id=6ab11032506f' target=_blank style='color:#2F92EE;'>#黏膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103250, encryptionId=6ab11032506f, topicName=黏膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=057f11309297, createdName=snowpeakxu, createdTime=Tue Jan 29 07:56:00 CST 2019, time=2019-01-29, status=1, ipAttribution=)]
    2019-01-29 snowpeakxu

    #黏膜#

    0