The effects of hemolysis and lipemia on thromboelastography (TEG) analysis have been scarcely evaluated in human samples, and neglected in clinical practice. We aimed to investigate the effects of in vitro mechanical hemolysis and lipemia on TEG analysis and conventional coagulation tests. Twenty-four healthy volunteers were enrolled in the study. Besides the controls, three groups with slight, moderate and severe mechanical hemolysis were constituted according to free hemoglobin (Hb) concentrations of 0.5-1.0, 2.0-6.0 and 7.0-13.0g/L, respectively; and three groups with mild, moderate and high lipemia were established according to triglyceride concentrations of approximate to 6.0, approximate to 12.0, and approximate to 18.0mmol/L, respectively. Four TEG parameters, reaction time (R), coagulation time (K), angle (), and maximum amplitude (MA), were measured alongside conventional plasma tests including prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen (FIB) by mechanical method, and platelet count by optical method. Results showed that the median R and MA values at moderate and severe hemolysis and K at severe hemolysis exceeded respective reference intervals, and were considered unacceptable. Median values of TEG parameters in lipemic samples were all within reference intervals. Bias values of conventional plasma tests PT, APTT and FIB in hemolyzed or lipemic samples were all lower than the Clinical Laboratory Improvement Amendments (CLIA) allowable limits. Bias values of platelet count at moderate to severe hemolysis and lipemia exceeded the CLIA allowable limits. In conclusion, the detection of TEG was in general more affected by mechanical hemolysis than plasma coagulation tests. Pre-analytical variables should be taken into account when unexpected TEG results are obtained.
第一作者单位:[1]Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Clin Lab, Wuhan, Hubei, Peoples R China
通讯作者:
推荐引用方式(GB/T 7714):
Tang Ning,Jin Xi,Sun Ziyong,et al.Effects of hemolysis and lipemia interference on kaolin-activated thromboelastography, and comparison with conventional coagulation tests[J].SCANDINAVIAN JOURNAL OF CLINICAL & LABORATORY INVESTIGATION.2017,77(2):98-103.doi:10.1080/00365513.2016.1271906.
APA:
Tang, Ning,Jin, Xi,Sun, Ziyong&Jian, Cui.(2017).Effects of hemolysis and lipemia interference on kaolin-activated thromboelastography, and comparison with conventional coagulation tests.SCANDINAVIAN JOURNAL OF CLINICAL & LABORATORY INVESTIGATION,77,(2)
MLA:
Tang, Ning,et al."Effects of hemolysis and lipemia interference on kaolin-activated thromboelastography, and comparison with conventional coagulation tests".SCANDINAVIAN JOURNAL OF CLINICAL & LABORATORY INVESTIGATION 77..2(2017):98-103