An Analysis of Laboratory Tests for Thrombocytopenia

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。

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.