An Analysis of Laboratory Tests for Thrombocytopenia

肝素在1-3%的患者中会导致血小板减少，其中约一半会导致血栓形成。已经有几种实验室测试来诊断这个问题，但没有一种是完美的，有些是非常劳动密集型的。最近，一种新的检测方法已经发表，该方法具有较高的灵敏度和特异度，但相对省力。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。 从医院中心收集了34名患者，从NIH收集了21名患者，并对实际发生的临床概率进行了分析。所有的实验室测试已经完成。新引进的化验方法既不够灵敏，也不够具体，无法实施，因此被放弃了。劳动密集型化验被证明并不比费力的“金标准”方法更灵敏或更特异。 我们正在等待临床评分的最终确认，然后再准备发表数据。

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 have been accrued from the Hospital Center and 21 from NIH with a spectrum of clinical probability of actually having HIT. All of the laboratory testing has been completed. The newly introduced assay was neither sensitive or specific enough to be implemented and so has been abandoned. The labor-intensive assay proved to be no more sensitive or specific than the laborious "gold standard" method. We are awaiting final confirmation of the clinical scoring before preparing the data for publication.