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首页> 外文期刊>Journal of thrombosis and thrombolysis >Comparison of polyspecific versus IgG specific ELISA in predominately cardiac patients with suspected heparin induced thrombocytopenia
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Comparison of polyspecific versus IgG specific ELISA in predominately cardiac patients with suspected heparin induced thrombocytopenia

机译：具有疑似肝素诱导血小板减少血小阴性血小阴盆血小阴性血小阴盆肾上腺患者

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摘要

A diagnosis of heparin induced thrombocytopenia (HIT) must often be made based on clinical and laboratory evidence. This was a quasi-experimental study of patients admitted from June 2016 to October 2017. The primary endpoint was the incidence of false positive results in polyspecific and IgG specific enzyme-linked immunosorbent assay (ELISA); then we compared the sensitivity and specificity of each assays in predominately cardiac patients with suspected HIT. A sensitivity/specificity analysis was conducted using serotonin release assay (SRA) as the 'gold standard'. The secondary outcome measures included length of hospital stay. We identified a total of 155 patients who met the inclusion criteria. Confirmatory tests with SRA on both groups were completed; false positive result was higher in the polyspecific group when compared to the IgG group [60% vs. 5%]. The IgG specific ELISA test yielded a sensitivity of 100% and a specificity of 95% however, the polyspecific ELISA had a low yield for specificity of 24% but maintained 100% sensitivity. In the IgG specific group with HIT-, their median length of stay was halved compared to those who were HIT + ; hospital LOS in days, IQR [30 (27-81) vs. 15 (7-33) p = 0.023] and a shorter median LOS in the ICU, IQR [24 (5-47) vs. 6 (2-14); p = 0.079]. Hospital or ICU LOS was the same in both (HIT+ and HIT-) groups managed with polyspecific ELISA. The IgG specific test had few false positive results and a high sensitivity score. Ensuring appropriate testing can bring a substantial decrease in drug expenditure, reduced length of stay and prevent unnecessary anticoagulation.
机译：必须通常根据临床和实验室证据进行肝素诱导的血小板减少症（命中）的诊断。这是对2016年6月至2017年10月录取的患者的准实验研究。主要终点是多特异性和IgG特异性酶联免疫吸附试验（ELISA）的假阳性结果的发病率;然后我们将各种测定的敏感性和特异性与疑似的击中患者进行了比较。使用Serotonin释放测定（SRA）作为“金标准”进行敏感性/特异性分析。二次结果措施包括住院时间的长度。我们确定了共有155名符合纳入标准的患者。两组上的SRA确认测试完成;与IgG组相比，多特异性组的假阳性结果在[60％对5％]。 IgG特异性ELISA试验产生100％的敏感性，但特异性为95％，多特异性ELISA的特异性率低24％但保持100％的灵敏度。在IgG特定群体中，与+ +的人相比，他们的中位数的逗留时间减半;医院LOS在几天内，IQR [30（27-81）与15（7-33）P = 0.023]和ICU中的较短中位数LOS，IQR [24（5-47）与6（2-14） ; p = 0.079]。与多私市ELISA管理的（HIT +和HIT-）集团的医院或ICU LOS相同。 IgG特异性测试具有很少的假阳性结果和高灵敏度分数。确保适当的测试可以降低药物支出，减少的逗留时间并防止不必要的抗凝。

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