Evaluation on the differential ability of visual APTT mixed correction test

doi:10.3969/j.issn.1673-8640.2020.06.019

Abstract

Abstract:

Objective To evaluate the differential ability of visual activated partial thromboplastin time（APTT） mixed correction test for coagulation factor deficiency and coagulation inhibitor. Methods A total of 62 specimens with prolonging APTT were collected,including 20 cases of coagulation factor deficiency,22 cases of coagulation inhibitor Ⅷ positive and 20 cases of lupus anticoagulant（LA） positive. Visual APTT mixed correction test and Rosner index method were used. Results The sensitivities of Rosner index method and visual APTT mixed correction test for judging coagulation factor deficiency were 100.0%,and the sensitivities for judging LA were 95.0%. The sensitivities for judging coagulation inhibitor were 95.5% by visual APTT mixed correction test and 50% difference method. Conclusions Using the visual APTT mixed correction test,the differential ability of coagulation factor deficiency and coagulation inhibitor is comparable to Rosner index method,and visual APTT mixed correction test is feasible for interpreting results.

Key words: Visual activated partial thromboplastin time mixed correction test, Rosner index, Lupus anticoagulant

CLC Number:

R446.1

PENG Zheng, TANG Ning, ZOU Zhiping, XIAO Fang. Evaluation on the differential ability of visual APTT mixed correction test[J]. Laboratory Medicine, 2020, 35(6): 609-613.

Figures/Tables 9

References 10

[1]	CUGNO M,GUALTIEROTTI R,TEDESCHI A,et al.Autoantibodies to coagulation factors:from pathophysiology to diagnosis and therapy[J]. Autoimmun Rev,2014,13(1):40-48.
[2]	杨仁池. 获得性血友病A诊断与治疗中国专家共识解读[J]. 临床血液学杂志,2014,27(4):547-549.
[3]	KRUSE-JARRES R,KEMPTON C L,BAUDO F,et al.Acquired hemophilia A:updated review of evidence and treatment guidance[J]. Am J Hematol,2017,92(7):695-705.
[4]	REDING M T,COOPER D L.Barriers to effective diagnosis and management of a bleeding patient with undiagnosed bleeding disorder across multiple specialties:results of a quantitative case-based survey[J]. J Multidiscip Healthc,2012,5:277-287.
[5]	MOORE G W.Reference interval mean clotting times should not be used to calculate lupus anticoagulant mixing test ratios unless they match the normal the normal pooled plasma clotting time[J]. Thromb Res,2017,159:16-18.
[6]	MILLER C H.Chapter127-Mixing studies. Transfusion medicine and hemostasis[M]. Salt Lake:Academic Press,2009.
[7]	KERSHAW G,ORELLANA D.Mixing test:diagnostic aides in the investigation of prolonged prothrombin times and activated partial thromboplastin time[J]. Semin Thromb Hemost,2013,39(3):283-290.
[8]	宋启明,鲁家才. 自制混合血浆在凝血试验室内质控的应用[J]. 湖北中医杂志,2012,34(9):49.
[9]	中华医学会血液学分会血栓与止血学组,中国血友病协作组. 血友病诊断与治疗中国专家共识(2013年版)[J]. 中华血液学杂志,2013,34(5):461-463.
[10]	OHSAKA A,ISHII K,YAMAMOTO T,et al.Automated mixing studies and pattern recognition for the laboratory diagnosis prolonged activated partial thromboplastin time using an automated coagulaion analyzer[J]. Thromb Res,2011,128(1):86-91.

序号	即时反应	延迟反应	Rosner指数	目测法	Rosner指数法	50%点差值/s
1	下凹	下凹	4.8	+	+	4.9
2	下凹	下凹	4.9	+	+	4.8
3	下凹	下凹	7.7	+	+	7.8
4	下凹	下凹	-0.9	+	+	3.9
5	下凹	下凹	4.9	+	+	5.0
6	下凹	下凹	6.2	+	+	5.4
7	下凹	下凹	6.8	+	+	5.9
8	下凹	下凹	6.4	+	+	4.1
9	下凹	下凹	6.1	+	+	7.2
10	下凹	下凹	3.2	+	+	2.8
11	下凹	下凹	10.2	+	+	3.2
12	下凹	下凹	9.0	+	+	3.2
13	下凹	下凹	5.7	+	+	6.7
14	下凹	下凹	4.4	+	+	6.2
15	下凹	下凹	5.3	+	+	-1.1
16	下凹	下凹	5.3	+	+	-1.1
17	下凹	下凹	6.1	+	+	4.6
18	下凹	下凹	7.9	+	+	3.8
19	下凹	下凹	1.5	+	+	4.7
20	下凹	下凹	5.7	+	+	6.2

序号	即时反应	延迟反应	Rosner指数	目测法	Rosner指数法	50%点差值/s
1	下凹	下凹	4.8	+	+	4.9
2	下凹	下凹	4.9	+	+	4.8
3	下凹	下凹	7.7	+	+	7.8
4	下凹	下凹	-0.9	+	+	3.9
5	下凹	下凹	4.9	+	+	5.0
6	下凹	下凹	6.2	+	+	5.4
7	下凹	下凹	6.8	+	+	5.9
8	下凹	下凹	6.4	+	+	4.1
9	下凹	下凹	6.1	+	+	7.2
10	下凹	下凹	3.2	+	+	2.8
11	下凹	下凹	10.2	+	+	3.2
12	下凹	下凹	9.0	+	+	3.2
13	下凹	下凹	5.7	+	+	6.7
14	下凹	下凹	4.4	+	+	6.2
15	下凹	下凹	5.3	+	+	-1.1
16	下凹	下凹	5.3	+	+	-1.1
17	下凹	下凹	6.1	+	+	4.6
18	下凹	下凹	7.9	+	+	3.8
19	下凹	下凹	1.5	+	+	4.7
20	下凹	下凹	5.7	+	+	6.2

序号	即时反应	延迟反应	Rosner指数	目测法	Rosner指数法
1	上凸	上凸	47.1	+	+
2	上凸	上凸	42.6	+	+
3	上凸	上凸	11.3	+	+
4	上凸	上凸	29.5	+	+
5	上凸	上凸	39.7	+	+
6	上凸	上凸	19.8	+	+
7	下凹	下凹	9.3	-	-
8	上凸	上凸	31.0	+	+
9	上凸	上凸	23.1	+	+
10	上凸	上凸	39.8	+	+
11	上凸	上凸	33.1	+	+
12	上凸	上凸	13.6	+	+
13	上凸	上凸	36.2	+	+
14	上凸	上凸	15.9	+	+
15	上凸	上凸	26.0	+	+
16	上凸	上凸	51.2	+	+
17	上凸	上凸	62.6	+	+
18	上凸	上凸	43.3	+	+
19	上凸	上凸	15.4	+	+
20	上凸	上凸	18.0	+	+

序号	即时反应	延迟反应	Rosner指数	目测法	Rosner指数法
1	上凸	上凸	47.1	+	+
2	上凸	上凸	42.6	+	+
3	上凸	上凸	11.3	+	+
4	上凸	上凸	29.5	+	+
5	上凸	上凸	39.7	+	+
6	上凸	上凸	19.8	+	+
7	下凹	下凹	9.3	-	-
8	上凸	上凸	31.0	+	+
9	上凸	上凸	23.1	+	+
10	上凸	上凸	39.8	+	+
11	上凸	上凸	33.1	+	+
12	上凸	上凸	13.6	+	+
13	上凸	上凸	36.2	+	+
14	上凸	上凸	15.9	+	+
15	上凸	上凸	26.0	+	+
16	上凸	上凸	51.2	+	+
17	上凸	上凸	62.6	+	+
18	上凸	上凸	43.3	+	+
19	上凸	上凸	15.4	+	+
20	上凸	上凸	18.0	+	+

序号	即时反应	延迟反应	Rosner指数	目测法	50%点差值/s
1	下凹	下凹	2.8	-	17.4
2	下凹	上凸	8.3	+	40.4
3	下凹	上凸	4.8	+	13.3
4	下凹	上凸	13.5	+	28.3
5	下凹	上凸	14.1	+	26.8
6	下凹	上凸	7.0	+	9.1
7	上凸	更上凸	33.7	+	21.5
8	下凹	上凸	20.5	+	35.7
9	下凹	上凸	7.1	+	27.6
10	下凹	上凸	19.8	+	17.4
11	下凹	上凸	8.1	+	38.4
12	下凹	上凸	8.9	+	42.0
13	下凹	上凸	18.6	+	33.9
14	下凹	上凸	7.0	+	23.6
15	下凹	上凸	7.2	+	12.6
16	下凹	上凸	12.6	+	33.8
17	下凹	上凸	11.5	+	14.5
18	下凹	上凸	4.4	+	16.3
19	上凸	更上凸	32.3	+	23.3
20	下凹	上凸	7.5	+	27.0
21	下凹	上凸	7.5	+	23.7
22	下凹	上凸	14.3	+	17.9