Effect of dilution of canine blood samples on the specificity of saline agglutination tests for immune-mediated hemolysis.
Effect of dilution of canine blood samples on the specificity of saline agglutination tests for immune-mediated hemolysis.
复制标题
DOI：
10.1111/jvim.15945
复制
发表时间：
2020-11
影响因子：
2.6
通讯作者：
Jeffery U
中科院分区：
文献类型：
--
作者：
Sun PL;Jeffery U
盐水凝集试验（SAT）被广泛推荐用于诊断犬免疫介导的溶血性贫血，但经常出现假阳性结果。在较高的生理盐水-血液比下，SAT的特异性将得到改善。150只犬在兽医转诊医院接受治疗，血细胞比容≤ 30%。前瞻性诊断准确性研究。如果凝胶直接抗球蛋白试验（DAT）呈阳性且存在溶血的临床证据（n = 9），则认为存在免疫介导的溶血（IMH）;如果确定了另一种贫血机制且DAT呈阴性或无溶血，则认为不存在IMH（n = 138）;如果IMH状态不明确，则排除犬（n = 3）。以1：1、4：1、9：1和49：1的生理盐水-血液比制备生理盐水凝集试验，显微镜下凝集被视为阳性结果。IMH的特异性从1：1稀释度的29%（95%置信区间20 - 38）增加至49：1稀释度的97%（93 - 99）。1：1和4：1稀释度下的灵敏度为88%（47 - 100），9：1和49：1稀释度下的灵敏度为67%（30 - 93%）。诊断准确性从1：1稀释度时的33%（24-42）增加到49：1稀释度时的95%（90 - 98）。如果使用49：1的生理盐水与血液比例进行，SAT对IMH的特异性很高。基于阳性DAT和溶血证据的金标准，不应使用较低的生理盐水-血液比结果，因为假阳性结果很常见。
Saline agglutination tests (SATs) are widely recommended for diagnosis of immune‐mediated hemolytic anemia in dogs, but there are frequent false‐positive results. Specificity of SATs will improve at higher saline‐to‐blood ratios. One hundred fifty dogs treated at a veterinary referral hospital with hematocrits ≤30%. Prospective diagnostic accuracy study. Immune‐mediated hemolysis (IMH) was considered present if a gel direct antiglobulin test (DAT) was positive and there was clinical evidence of hemolysis (n = 9), absent if another mechanism for anemia was identified and the DAT was negative or there was no hemolysis (n = 138), and if IMH status was unclear, dogs were excluded (n = 3). Saline agglutination tests were prepared at 1 : 1, 4 : 1, 9 : 1, and 49 : 1 saline‐to‐blood ratios, and microscopic agglutination was considered a positive result. Specificity for IMH increased from 29% (95% confidence interval 20‐38) at a 1 : 1 dilution to 97% (93‐99) at a 49 : 1 dilution. Sensitivity was 88% (47‐100) at 1 : 1 and 4 : 1 dilutions and 67% (30‐93%) at 9 : 1 and 49 : 1 dilutions. Diagnostic accuracy increased from 33% (24–42) at 1 : 1 dilution to 95% (90‐98) at 49 : 1 dilution. If performed using a 49 : 1 saline‐to‐blood ratio, SATs achieve high specificity for IMH. Based on a gold standard of positive DAT and evidence of hemolysis, lower saline‐to‐blood ratio results should not be used because false‐positive results are common.
登录
查看更多内容
DOI：
10.1111/j.1476-4431.2012.00724.x
发表时间：
2012-04-01
影响因子：
1.3
作者：
Garcia-Pereira, Brandi L.;Scott, Michael A.;Brown, Andrew J.
通讯作者：
Brown, Andrew J.
影响因子：
1.6
作者：
Humm, K. R.;Chan, D. L.
通讯作者：
Chan, D. L.
影响因子：
1.2
作者：
Caldin, M;Carli, E;Lubas, G
通讯作者：
Lubas, G
影响因子：
2.6
作者：
Caviezel LL;Raj K;Giger U
通讯作者：
Giger U
影响因子：
2.1
作者：
Moirano, S. J.;Dewey, C. W.;Cohen, P. W.
通讯作者：
Cohen, P. W.