摘要
目的观察丁胺卡那霉素作为抗凝剂对实验室检测指标的影响,并探讨其在临床检验中的应用。方法采用硅化试管法测定10例健康志愿者不同浓度丁胺卡那霉素抗凝全血的凝血时间(CT),以CT超过7天(168h)的最低浓度确定为抗凝浓度。测定30例志愿者新鲜全血在分别使用抗凝浓度的丁胺卡那霉素和相关抗凝剂抗凝后的血细胞计数和白细胞分类(LY%和GR%)、血小板聚集率(PAR)、凝血功能试验(PT、APTT、TT和Fib)、血小板P-选择素(CD62P)和纤维蛋白原受体(Fib-R)表达水平、全血和血浆黏度以及血浆电解质(K+、Na+、Cl-、Ca2+、总Mg2+、总P)浓度,同时测定血清电解质水平。结果丁胺卡那霉素抗凝浓度为18g/L。丁胺卡那霉素抗凝组LY%显著低于而GR%显著高于EDTA-K2抗凝组(P均<0.01);丁胺卡那霉素抗凝血放置1h时血小板计数显著低于即刻检测结果(P<0.05),放置24h时,血小板计数显著高于放置1h时的结果(P<0.05),而与即刻检测结果无显著差异(P>0.05);丁胺卡那霉素抗凝组PT、APTT、TT显著高于柠檬酸三钠抗凝组(P<0.01),而两组间Fib水平无显著差异(P>0.05);丁胺卡那霉素抗凝组血小板聚集率显著低于柠檬酸三钠抗凝组(P<0.01);丁胺卡那霉素抗凝组血小板CD62P和Fib-R表达率显著低于EDTA-K2抗凝组(P均<0.05);丁胺卡那霉素抗凝组白细胞和红细胞计数以及血红蛋白浓度与EDTA-K2抗凝组无显著差异,全血和血浆黏度以及电解质浓度与肝素锂抗凝组均无显著差异(P均>0.05)。结论丁胺卡那霉素在临床检验中可作为抗凝剂使用;丁胺卡那霉素抗凝血可用于白细胞计数、红细胞参数、血液流变学以及电解质检测,但不适用于白细胞分类、凝血功能试验、血小板功能和活化指标的检测。
Objective To observe the effects of amikacin as anticoagulant on the related laboratory indicators, an to analyze its application value in clinical laboratory medicine. Methods The clotting time （CT） of fresh blood mixed with different, concentration of amikacin was determined by salicified tube method. The experimental anticoagulating concentration was derived from the lowest concentration of amikacin with a mean CT value over 168 hours. Fresh blood with amikacin and other relative anticoagulants from volunteers were detected for clotting time （CT） , complete blood count and leukocyte differentiation, maximal ratio of platelet aggregation, tests of blood coagulation function （ PT, APPT, TT and Fib） , whole blood and plasma viscosity, electrolytes （ K ＋ , Na ＋ , C1- , Ca2＋ , Mg2＋. and total phosphate） of plasma and serum, and expression levels of p - selectin（CD62p） and Fibrinogen receptor（Fib - R）. Results Experimental anticoagulating concentration of amikacin was 18g/L. In 18g/L amikacin group, percentage of lymphocyte was significantly lower but that of neutrophils was higher than those in EDTA -K2 group（P 〈 0. 01 ）. For whole blood withlBg/L amikacin, platelet count at 1 hour laying was significantly lower than that at instant detection （ P 〈 0.05 ） , platelet count at 24 hours laying was significantly higher than that at 1 hour laying （ P 〈 0. 05 ）, but there was less difference between samples of 24 - hours laying and instant - detection （ P 〉 0.05 ）. In amikacin group, APTT and TT were significantly higher than those in sodium citrate group （P 〈 0. O1 ）. Fib level had less difference between the two groups（ P 〉 0.05）. In amikacin group, maximal ratio of platelet aggregation was significantly lower than that in sodium citrate group （ P 〈 0. 01 ）, levels of CD62p and Fib - R expression were significantly lower than those at EDTA - K2 group （P 〈 0.05）. For leukocyte and erythrocyte count as well as hemoglobin concentration, there was less difference between amikacin group and EDTA - K2 group （ P 〉 0.05 ）. For whole blood and plasma viscosity as well as electrolytes concentration, there was also less difference between amikacin group and lithium heparin（P 〉 0.05）. Conclusion Amikacin can be used as an in vitro anticoagulant. Blood samples anticoagulated with amikacin is suitable for the detection of leukocyte count, erythrocyte parameters, hemorheology and plasma electrolytes, but not suitable for the differentiation of leukocyte, tests of coagulation function, and the markers of platelet function and activation.
出处
《医学研究杂志》
2013年第1期54-58,共5页
Journal of Medical Research
基金
浙江省医学重点学科基金资助项目(07-010)
