【摘要】 目的探讨口服华法令和肌肉注射低分子肝素(LMWH)对狼疮抗凝物(LA)检测的干扰。方法选择心脏瓣膜置换术后口服华法令和肾病透析肌肉注射LMWH患者各80例为研究对象(排除引起LA阳性疾病),对照组为健康体检者20例,检测各组LA比值,观察LA比值假阳性率。从口服华法令LA比值假阳性样本中随机选出20例,用健康人混合血浆1∶1稀释做混合试验,重新检测上述指标。结果口服华法令、肌肉注射LMWH各组筛选、确证试验时间均高于对照组,差异有统计学意义(P<0.01);且随着INR、LMWH抗Ⅹa活性增加,筛选、确证试验时间值及LA比值、LA比值假阳性率呈上升趋势。混合试验中,口服华法令组筛选、确证试验时间均高于对照组(P<0.01),LA比值差异无统计学意义(P>0.05),LA比值假阳性率均为0。结论口服华法令和肌肉注射LMHW对LA检测有较大干扰。更多还原

【Abstract】 Objective To study the interference of oral warfarin and intramuscular injection of low molecular weight heparin(LMWH)on the lupus anticoagulant(LA)detection.Methods Each 80 patients with oral warfarin after heart valve replacement and 80 patients with intramuscular injection of LMWH due to nephropathy dialysis were selected as the study subjects(excluding the diseases causing LA positive).Twenty persons undergoing the physical examination served as the control group.The LA value in each group was detected.The false positive rate of LA ratio was observed.Then 20 cases were randomly selected from the LA ratio false positive samples in oral warfarin.The mixed test was conducted with healthy person mixed plasma1∶1 dilution.The above index was detected again.Results The time of screening test and time of confirmatory test in the oral warfarin group and intramuscular injection LMWH group were higher than those in the control group,and the difference was statistically significant(P<0.01),moreover,with the INR value and anti-Xa activity increase,the time of screening test and confirmatory test,LA ratio and LA ratio false positive rate showed the increasing trend.In the mixed test,the time of screening and confirmatory tests in the oral warfarin group were all higher than those in the control group(P<0.01),and the difference in the LA ratio had no statistical significance(P>0.05).The false positive rate of LA ratio was 0.Conclusion Oral warfarin and intramuscular injection of LMWH have great interference on LA detection.更多还原