Variability in clinical laboratory practice in testing for disorders of platelet function
Variability in clinical laboratory practice in testing for disorders of platelet function
复制标题
血小板功能障碍检测临床实验室实践的差异
DOI：
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发表时间：
2005
影响因子：
6.7
通讯作者：
C. Hayward
中科院分区：
文献类型：
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作者：
K. Moffat;M. Ledford;W. Nichols;C. Hayward
血小板功能障碍是异常出血的重要原因，需要实验室检查进行诊断。目前，关于如何对这些疾病进行临床测试的指导方针有限。我们研究的目的是获得关于目前临床实验室如何评估血小板功能障碍的信息。两种模式的做法调查分发给实验室的北美专业凝血实验室协会（NASCOLA）。对收集到的信息进行了分析，以确定做法和常见问题。47个NASCOLA实验室参与了调查，54%的实验室完成了两项调查。大多数作出答复的实验室每年进行50多次聚集试验，主要使用基于富血小板血浆的方法。少数人进行血小板分泌和致密颗粒异常检测。虽然以各种方式审查血小板聚集结果，但实验室最常发布包含定量值（聚集%和/或斜率）和定性解释的组合报告。尽管实验室使用相似的激动剂进行聚集试验，但最终激动剂浓度差异很大。还使用了几种方法来获得参考区间。参与者提供的评论表明，执行和解释血小板功能测试对许多临床实验室来说是具有挑战性的。尽管常规做法已经发展，但临床实验室用于评价血小板功能障碍的诊断试验程序存在相当大的差异。这些实践模式的调查表明，需要为临床实验室进行血小板功能测试的指南和建议。
Summary Disorders of platelet function are important causes of abnormal bleeding that require laboratory tests for diagnosis. Currently there are limited guidelines on how to perform clinical testing for these disorders. The goal of our study was to obtain information on how disorders of platelet function are currently evaluated in clinical laboratories. Two patterns-of-practice surveys were distributed to laboratories of the North American Specialized Coagulation Laboratory Association (NASCOLA). The information collected was analyzed to determine practices and common problems. Forty-seven NASCOLA laboratories participated and 54% completed both surveys. The majority of the laboratories that responded performed more than 50 aggregation tests per year, mainly using platelet rich plasma based methodologies. A minority performed testing for platelet secretion and dense granule abnormalities. While platelet aggregation results were reviewed in various ways, laboratories most commonly issued a combined report containing quantitative values (% aggregation and/or slope) and a qualitative interpretation. Although laboratories used similar agonists for aggregation testing, the final agonist concentrations varied widely. Several approaches were also used to obtain reference intervals. Comments offered by the participants indicated that performing, and interpreting platelet function tests were challenging for many clinical laboratories. Although common practices have evolved, there is considerable variability in the diagnostic test procedures used by clinical laboratories to evaluate disorders of platelet function. These patterns-of-practice surveys illustrate a need for guidelines and recommendations for clinical laboratories performing tests of platelet function.