利用全血凝固时间测定组织因子活性研究.docVIP

利用全血凝固时间测定组织因子活性的研究 作者：齐金海，陶智，魏文宁 作者单位：1.武汉市新洲区人民医院检验科，新州 430400，2.华中科技大学同济医学院附属协和医院，武汉 430022 【摘要】 目的 应用内毒素（LPS）刺激后全血复钙时间检测全血中细胞组织因子（TF）的促凝血活性（TFPCA），并探讨其影响因素及临床意义。方法 用LPS刺激的全血复钙时间检测全血TF活性（tissue factor clotting time，TiFaCT），即在抗凝全血中加入或不加LPS于37℃温育一定时间，然后复钙检查全血凝固时间，根据全血凝固时间缩短的程度(△s)来判断TFPCA的强弱。结果 实验显示，LPS刺激全血中TFPCA能为TF途径抑制物（TFPI）部分抑制。组织凝血活酶浓度凝固时间反应曲线显示良好的相关性(r=0.916，P＝0.029),表明该试验有较高的敏感性和特异性。LPS刺激最适浓度为5.0～10 Μg/ml,最佳刺激时间为4 h。初步临床应用显示正常组试验管(LPS刺激)和对照管全血复钙时间差值为30.4±25.1 △s，弥散性血管内凝血（DIC）病例组差值为95.2±68.86△s,差异有极显著意义（P0.001）。结论 本实验研究示方法简单、适用，并有较高的特异性和敏感性,能为血栓性疾病的早期诊断提供信息。 【关键词】 组织因子； 全血凝固时间； 血栓形成 Study on the Determination of Tissue Factor Activity with Whole Blood Clotting Time QI Jinhai, TAO Zhi, WEI Wenning (Dpartment of Clinical Laboratory Xinzhou Peoples Hospital,Xinzhou， 430400, China) Abstract： Objective To observe the change of whole blood recalcification time after endotoxin stimulating and detect the effect factors of procoagulant activity of tissue factor (TFPCA) of whole blood cells and its clinical significance. Methods Using whole blood recalcification time stimulated by endotoxin to detect the activity of blood at 37℃ for a certain time period tissue factor clotting time (TiFaCT). Incubate the anticoagulant whole by adding LPS or not, detect the coagulation time of whole blood after alcificating, determine the level of TFPCA according to the abbreviated time (△s). Results The study indicates that the TFPCA of whole blood stimulated by LPS could be partially inhibited by tissue factor pathway inhibitor (TFPI). the response curve of the thromboplastin concentrationclotting time of brain tissue presents a favorable correlation (r=0.916,P=0.029), which indicates that the test has a higher sensitivity and specificity ,the optimal LPS stimulating concentration and time is 5.0～10 Μg /ml and 4 h, respectively. Primary clinical application shows that the difference of the whole blood clotting