Developmental haemostasis - Impact for clinical haemostasis laboratories
Developmental haemostasis - Impact for clinical haemostasis laboratories
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DOI：
10.1160/th05-01-0047
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发表时间：
2006-02-01
影响因子：
6.7
通讯作者：
Rowlands, S
中科院分区：
文献类型：
--
作者：
Monagle, P;Barnes, C;Rowlands, S
发育性止血是由 Andrew 等人提出的一个概念，现已被普遍接受。在 20 世纪 80 年代末。然而，凝血分析仪和试剂在过去 15 年中发生了显着变化。众所周知，凝血测试对个别试剂和分析仪的变化很敏感。我们假设安德鲁等人制定的参考范围。可能不适合在现代凝血实验室中使用。我们的研究旨在确定当今的凝血检测系统（STA Compact 分析仪和 Diagnostica Stago 试剂系统）是否对凝血检测中与年龄相关的变化敏感。这是自安德鲁等人以来第一个大规模研究。确定与年龄相关的凝血蛋白数值变化。我们的结果证实了安德鲁等人阐明的发育性止血的概念。然而，我们的结果清楚地表明，新生儿和儿童凝血测定的参考范围的绝对值随分析仪和试剂系统的不同而变化。结果证实，凝血实验室需要针对自己的测试系统开发与年龄相关的参考范围。如果没有这一点，就不可能对疑似出血或凝血障碍的新生儿和儿童进行准确的诊断和治疗。最后，我们提出了之前未描述过的 D-二聚体、TFPI 和内源性凝血酶电位的年龄相关参考范围。
Developmental haemostasis is a concept, now universally accepted, introduced by Andrew et al. in the late 1980's. However, coagulation analysers and reagents have changed significantly over the past 15 years. Coagulation testing is known to be sensitive to changes in individual reagents and analysers. We hypothesised that the reference ranges developed by Andrew et al. may not be appropriate for use in a modern coagulation laboratory. Our study was designed to determine whether a current day coagulation testing system (STA Compact analyser and Diagnostica Stago reagent system) was sensitive to age-related changes in coagulation assays. This is the first large scale study since Andrew et al. to determine the age associated numerical changes in coagulation proteins. Our results confirm the concepts of developmental haemostasis elucidated by Andrew et al. However, our results clearly demonstrate that the absolute values of reference ranges for coagulation assays in neonates and children vary with analyser and reagent systems. The results confirm the need for coagulation laboratories to develop age-related reference ranges specific to their own testing systems. Without this, accurate diagnosis and management of neonates and children with suspected bleeding or clotting disorders is not possible. Finally we present age related reference ranges for D-dimers,TFPI, and endogenous thrombin potential, previously not described.