Analysis of Lab Tests for Heparin-Induced Thrombocytopen

肝素在1 - 3%的患者中引起血小板减少症，并在其中约一半患者中导致血栓形成。有几个实验室测试来诊断这个问题，但没有一个是完美的，有些是非常劳动密集型的。最近发表了一种新的测定方法，它提供了高灵敏度和特异性的希望，但相对较少的劳动。为了收集足够数量的患者样本来研究这种新的检测方法，我们与华盛顿医院中心的医生合作，在那里肝素诱导的血小板减少症（HIT）比这里更常见。34例患者（目标为40例）已经累积了实际患有HIT的临床概率谱。来自这些患者的样本已经用新的HIT实验室测试以及我们目前认为最好的历史悠久但困难的分析进行了测试。不幸的是，这些测试之间存在一些差异。患者的临床概率评分是盲法的，直到所有的测试完成。

Heparin causes thrombocytopenia in 1 - 3 per cent of patients and leads to thrombosis in about half of these. There have been several laboratory tests to diagnose this problem, but none of them is perfect and some are very labor intensive. Recently a new assay method has been published that offers the promise of high sensitivity and specificity but with relatively little labor. In order to collect a sufficient number of patient samples to study this new assay, we have collaborated with physicians at Washington Hospital Center, where heparin-induced thrombocytopenia (HIT) is much more common than here. Thirty-four patients (from a goal of 40) have been accrued with a spectrum of clinical probability of actually having HIT. Samples from these patients have been tested with the new laboratory test for HIT as well as the time-honored but difficult assay that we currently consider the best. Unfortunately there have been several discrepancies between the tests. The clinical probability scores of the patients have been blinded until all of the testing is complete.