Assessment on antibody test for diagnosis performance of heparin induced thrombocytopenia
10.13602/j.cnki.jcls.2017.12.11
- VernacularTitle:肝素诱导的血小板减少症抗体试验的诊断性能评价
- Author:
Jing REN
1
;
Gang LI
;
Jian-Long MEN
Author Information
1. 天津大学天津市生物医学检测技术与仪器重点实验室
- Keywords:
heparin-induced thrombocytopenia;
pre-test probability scores;
HIT antibody;
IgG-specific antibody;
thrombosis
- From:
Chinese Journal of Clinical Laboratory Science
2017;35(12):921-924
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the antibody test for the diagnosis performance of heparin induced thrombocytopenia(HIT).Methods 52 plasma samples of patients with HIT,126 plasma samples of heparin treated patients without HIT and 50 plasma samples of healthy individuals were collected from 2014 September to 2016 November.According to thrombosis,the patients were further divided into two groups:isolated HIT group without thrombosis (30 cases) and heparin induced thrombocytopenia with thrombosis (HITY) group (22 cases).The whole HIT antibody in plasma was assayed by using ACL-TOP 700 coagulation analyzer and reagent (HemosIL HIT-AbPF4-H).The IgG-specific HIT antibody in plasma was assayed by using ACL AcuStar chemiluminescent analyzer and reagent (HemosIL AcuStar HIT-IgGPF4-H).Results The levels of whole antibody and IgG-specific antibody in the patients of heparin control group was higher than those in healthy control (U value was 1 644.0 and 1 911.0,respectively,P ＜ 0.01).The levels of two HIT antibodies in HIT patients group were higher than those in the patients of heparin control group (U value was 550.0 and 4.7,respectively,P ＜ 0.01).ROC curve showed that the sensitivities of both whole antibody and IgG-specific antibody were 100％,and up-regulating the cut-off value could improve the specificity of both tests.The positive incidence of the whole antibody was 27.8％ in the heparin control group and 100％ in HIT patients group while the cut-off value was 1.50 U/mL.The positive incidence of IgG-specific antibody was 0 in the heparin control group and 100％ in the HIT patients group while the cut-off value was 1.51 U/mL.While the cut-off value of IgG-specific antibody was 2.32 U/mL,the diagnosis sensitivity of thrombosis assessment was 90.9％ and the specificity was 80.0％.In case the cut-off value exceeded 2.32 U/mL,the accumulating risk of HIT increased significantly in HIT patients within 15 days (Log-rank x2 =56.577,P ＜ 0.01).Conclusion The whole antibody and IgG-specific antibody could contribute to excluding diagnosis,diagnosis or risk assessment for the suspected HIT patients.
