ABSTRACT
Objective:To establish the clot waveform analysis (CWA) reference intervals of prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fbg) and thrombin time (TT) parameters CT, |Min1|, |Min2|, |Max2| and observe the changes in patients with coagulation factors deficiency.Methods:One hundered and twenty-five cases of apparent healthy person were enrolled to establish the CWA reference intervals of four coagulation parameters and 25 cases with coagulation factors were used to study the changes of CWA patients.Results:The CWA reference intervals of PT |Min1| (dT/dt), |Min2| (d 2T/dt 2), |Max2| (d 2T/dt 2) are3.14±1.22, 0.56±0.22 and 0.50±0.18; The CWA reference intervals of APTT |Min1| (dT/dt), |Min2| (d 2T/dt 2), |Max2| (d 2T/dt 2) are 4.75±1.71, 0.78±0.29 and 0.65±0.28; The CWA reference intervals of Fbg CT(s), |Min1| (dT/dt), |Max2|(d 2T/dt 2) are 7.01±1.96, 1.22±0.51 and 0.15±0.11; The CWA reference intervals of TT |Min1| (dT/dt), |Min2| (d 2T/dt 2), |Max2| (d 2T/dt 2) are 0.95±0.32, 0.14±0.05 and 0.07±0.03.These parameters of CWA in factor Ⅴ deficient patients were significantly reduced, the activity of coagulation factor Ⅶ was 0.42, |Min2| and |Max2| were significantly lower than that of normal people. The paramenters of CWA in factor Ⅶ deficient patients were significantly reduce. Conclusion:The CWA reference intervals of four CWA parameters helps judgment of coagulation factor deficiency.
ABSTRACT
Objectives@#To assess the diagnostic values of latex immunoturbidimetric assay (LIA) and particle immunofiltration assay (PIFA) for heparin-induced thrombocytopenia (HIT) .@*Methods@#Samples from 94 patients with suspected HIT from May 2016 to July 2018 in our hospital were prospectively analyzed by the two immunoassays. Their medical records and further follow-up data were also collected and analyzed by our hematologists to make the 4Ts scores and confirm the diagnosis of HIT, respectively. Performance characteristics of the two immunoassays were assessed, including sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) . Their post-test probabilities (PTP) were also calculated based on the 4Ts score.@*Results@#Among 94 cases, 15 (16.0%) had a positive HIT, including 6 of 37 (16.2%) with an intermediate, and 9 of 15 (60.0%) with a high 4Ts score. PIFA operating characteristics were: sensitivity 100.0% (15/15) , specificity 51.9% (41/80) , PPV 28.3% (15/53) , NPV 100.0% (41/41) . The positive PTP in intermediate and high 4Ts score group were 28.7% and 75.7%, respectively, while negative PTP were all 0. At manufacturers’ cutoffs, LIA operating characteristics were: sensitivity 66.7% (10/15) , specificity 94.9% (75/79) , PPV 71.4% (10/14) and NPV 93.8% (75/80) . The positive and negative PTP in intermediate 4Ts score group were 71.8% and 6.3%, while 95.2% and 34.4% in high 4Ts score group, respectively. Receiver operating characteristic (ROC) analysis manifested that LIA was preferable than PIFA, and combining the 2 assays together was significantly better than single test.@*Conclusions@#4Ts score is still an important tool for the diagnosis of HIT. Combining clinical score with heparin/PF4 antibody assay can increase the accuracy of confirming or excluding HIT. Although PIFA is inferior to LIA in the diagnostic value, its user friendliness and 100% NPV have major advantages. Combining the 2 assays together can achieve a higher diagnostic value.