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1 The Journal of Qazvin Univ. of Med. Sci. No. 31, Summer * Assessment of mutual impact of different sodium citrate concentrations and minimum specimen volume on the result of routine coagulation tests P. MohammadiTorbati Abstract Background: Routine coagulation assays including prothrombine time [PT] and activated partial thromboplastine time [aptt] are influenced by two independent parameters comprising sample volume and tri-sodium citrate concentration. Objective: To evaluate minimum specimen volume requirements for routine coagulation testing with dependence on citrate concentration. Methods: An experimental study was performed on samples obtained from randomized healthy persons and patients receiving oral anticoagulant therapy. The tubes (3.2% and 3.8% sodium citrate) were filled to varying total sample volumes ranging from 3.0 to 5.0 ml and results of routine coagulation tests were compared. Findings: By using 3.8% citrate, there is a statistically significant difference in the results of PT and aptt assays in the sample less than 80% and 90% filled compared with those that are 100% filled. There is no significant difference in PT results from a 3.2% citrate tube between fill volume of 60% and 100% as well as 70% and 100% for aptt. Conclusion: Underfilling may significantly affect the aptt and PT, resulting in artifactual prolongation of results, particularly in samples drawn into 3.8% citrate. This study supports the recommendations to use 3.2% citrate, because 60% of the optimum filled for PT and 70% for aptt are acceptable. Keywords: Prothrombine Time, Thromboplastine, Tri-sodium Citrate, Blood :. :. : /% /%... aptt PT /% :.(p</) ( /) % % aptt % % PT % % /%. PT /% : % PT /%. aptt. % aptt : * - : Page (28)
2 :... / / (). /. / / / / / /. (). g Plateletpoor) (plasma () /. /. aptt PT Sysmex :.. / / / /. NCCLS. ( ) (PT) (). aptt NCCLS / (). aptt PT.
3 aptt PT.( ) aptt PT PT aptt. aptt PT. / ) /.( aptt PT ) ( ) (. / aptt PT. / aptt PT.( ).». «» /. «. / /. ( ) /... : aptt PT / aptt PT / aptt PT
4 PT aptt - aptt(s) PT(s) < / < / < / < / < / < / < / < / < / < / / ± / / ± ) / ( = ) / ( = : ( /) / : aptt PT - / aptt(s) PT(s) < / / ± / : ( /) / :
5 aptt PT - / / - aptt (s) / ± / / ± / ± / / ± / / ± / ± / / ± aptt (s) % / ± / ± / ± / / ± / ± / ± / ± / ± / / ± / ± / PT (s) / ± / / ± / / ± ± / / ± / / ± / / ± / / ± / PT (s) % / ± / / ± / / ± / / ± / / -/ / ± / / - -/ / -/ -/ / -/ -/ / -/ - / -/ -/ / -/ -/ / -/ -/ + ( /) = aptt PT aptt PT aptt PT / / : aptt PT /. / aptt. /. : PT. aptt. (). aptt PT.
6 . aptt PT PT aptt / (). / PT. /. / International / / / Ratio Normalization... aptt PT /. NCCLS () PT. /. / aptt PT. /. NCCLS H21-A2 aptt PT NCCLS. (). NCCLS.. (). ()..
7 4. Dacie SJV, Lewis SM. Practical haematology. 9th ed, 2001, Linne J, Ringsrud KM.Clinical laboratory science. 4th ed, Mosby, 1999, International Committee for Standardization in Hematology. International Committee on Thrombosis and Haemostasis: ICSH/ ICTH recommendations for reporting prothrombine time in oral anticoagulant control. Thromb Haemost 1993; 53: Turgeon ML. Clinical hematology: theory and procedures. 3rd ed, Philadelphia, Lippincott-Raven Publishers, 1998, Pai SH, Michalaros K. Effect of sample volume on coagulation test. Lab Med 1990; 21: Ingram GIC, Hills M. The prothrombine time test: effect of varying citrate concentration. Thromb Haemost 1976; 36: Adcock DM, Kressin DC, Marlar RA. Are discard tubes necessary in coagulation studies?. Lab Med 1997; 28: Adcock PM, Kressing DC, Marlar RD. Effect of 3.2% vs 3.8% sodium citrate concentration on routine coagulation testing. Am J Clin Pathol 1997; 107: Peterson P, Gottfried EL. The effects of inaccurate blood sample volume on prothrombin time (PT) and activated partial thromboplastin (APTT). Thrombo Haemost 1982; 47: / / ().. aptt PT ( ) /. : 1.National committee for clinical laboratory standards. Collection, transport and processing of blood specimens for coagulation testing and performance of coagulation assays. 2nd ed, Waven, Pa National committee for clinical laboratory standards, NCCLS document H21-A2, Glenn P, Swami VK. The effect of low hematocrit on the activated partial thromboplastin time and prothrombine time. Am J Clin Pathol 1996; 105: NCCLS. one-stage prothrombine time (PT) test and activated partial thromboplastin time (aptt) test: approved guidline. Villanova, Pa National Committee for Clinical Laboratory standards, document H47-A, 1996
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