Clinical usefulness of international normalized ratio calibration of prothrombin time in patients with chronic liver disease
Clinical usefulness of international normalized ratio calibration of prothrombin time in patients with chronic liver disease
复制标题
凝血酶原时间国际标准化比值校准在慢性肝病患者中的临床应用
DOI：
10.1007/s12185-015-1820-2
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发表时间：
2015
影响因子：
2.1
通讯作者：
H. Kim
中科院分区：
文献类型：
--
作者：
Jun Hyung Lee;O. Kweon;Mi;H. W. Lee;Hyung Joon Kim;H. Kim
国际标准化比值（INR）可能不直接适用于肝病患者。我们的目的是为肝病患者建立一种替代的INR校准系统，并评估其在慢性肝病患者中的应用效果。采用5种市售凝血活酶测定82例肝硬化患者的凝血酶原时间（PT）。每种凝血活酶也被分配了一个国际敏感性指数（ISIliver）从LC患者的血浆。计算INRvka、INRliver、终末期肝病模型（MELD）vka、MELD liver、Child-Pugh（Child）vka和Childliverscore。INRvka的变异系数显著大于INRliver（P< 0.01）。凝血活酶组间INRvka的平均差异也显著大于INRliver组（P< 0.01）。总平均MELDliverscore高于总平均MELDvkascore。MELDvka和MELDliverscore（MELD评分≥15）之间的平均差异为3.2%。我们再次确认，将本文所述的替代校准系统用于肝病患者可以解决INR测量的变异性。我们的数据提示，我们需要重新评估LC患者使用INR肝脏时Child-Pugh分级、MELD评分和临床预后之间的相关性。
The international normalized ratio (INR) may not be directly applicable to patients with liver disease. We aimed to establish an alternative INR calibration system for patients with liver disease and to evaluate the effect of their use in chronic liver disease patients. Eighty-two patients with liver cirrhosis (LC) were included, and their prothrombin times (PTs) were measured by using 5 commercial thromboplastins. Each of the thromboplastins was also assigned an international sensitivity index (ISIliver) by the plasmas from LC patients. INRvka, INRliver, model for end-stage liver disease (MELD)vka, MELDliver, Child-Pugh (Child)vka, and Childliverscores were calculated. The coefficient of variance of INRvkawas significantly larger than that of INRliver(P< 0.01). The mean difference in INRvkabetween the thromboplastins was also significantly larger than that in INRliver(P< 0.01). The total mean MELDliverscore was higher than the total mean MELDvkascore. The mean difference between the MELDvkaand MELDliverscores (MELD score ≥15) was 3.2 %. We reconfirmed that the use of the alternative calibration system described herein for patients with liver disease may resolve the variability of INR measurement. Our data suggest that we would need to reevaluate the correlation between Child-Pugh class, MELD score, and clinical prognosis by using INRliverfor patients with LC.