This study investigates the causal association between genetic prediction of iron status and subarachnoid hemorrhage (SAH). A two-sample MR analysis was conducted using genome-wide association study (GWAS) summary data for four iron biomarkers: serum iron, serum ferritin, total iron-binding capacity (TIBC), and transferrin saturation (TSAT). Genetic variants were selected as instrumental variables (IVs) to minimize confounding. Causal estimates were obtained using inverse variance weighting (IVW), MR-Egger, weighted median, and weighted mode methods. Sensitivity analyses, including Cochran's Q-test, MR-Egger regression, MR-PRESSO, and leave-one-out analysis, were performed to assess heterogeneity and pleiotropy. IVW analysis revealed a significant association between increased genetically predicted TIBC and higher SAH risk (OR = 1.71, 95% CI: 1.21-2.41, P = 0.002), while higher TSAT was associated with lower SAH risk (OR = 0.76, 95% CI: 0.62-0.93, P = 0.01). No causal association was found between serum iron, serum ferritin, and SAH. Sensitivity analyses confirmed the robustness of the results, with no evidence of horizontal pleiotropy. However, heterogeneity was detected in serum ferritin, suggesting potential variability in its effect. This MR study provides genetic evidence for the causal relationship between TIBC, TSAT, and SAH risk. These findings highlight the potential role of iron metabolism in SAH pathophysiology, warranting further investigation.

BACKGROUND:Venous thromboembolism (VTE) is a major cause of global morbidity and mortality, yet its underlying molecular mechanisms remain incompletely understood, limiting the development of novel targeted therapies. While neutrophil activation is implicated in VTE, its causal role and the key genetic drivers are poorly defined. This study aimed to bridge this knowledge gap using a multi-omics genetic approach. METHODS:We conducted a Summary-data-based Mendelian Randomization (SMR) study, integrating large-scale GWAS data for VTE with molecular QTL data (mQTL, eQTL, pQTL) for 996 neutrophil activation-related genes. Causal associations were identified using SMR and validated through colocalization analysis to distinguish robust causal links from linkage. RESULTS:Our analysis identified numerous causal associations at the methylation (223 sites), expression (41 genes), and protein (21 proteins) levels. Among these, PLAU, ALOX12, and LGALS3 emerged as key candidates due to evidence of epigenetic regulation of their gene expression. Specifically, increased PLAU expression showed a causal association with higher VTE risk (OR = 1.13, 95% CI = 1.04-1.24), a finding supported by strong colocalization evidence (PPH4 > 0.5). Similarly, elevated expression of ALOX12 (OR = 1.27, 95% CI = 1.07-1.51) and LGALS3 (OR = 1.44, 95% CI = 1.04-2.01) were causally linked to increased VTE susceptibility, although these expression-level associations did not meet our stringent threshold for colocalization. CONCLUSION:This study identifies PLAU, ALOX12, and LGALS3 as genetically prioritized, causal-candidate genes for VTE, enhancing our understanding of immunothrombosis and providing promising targets for future therapeutic development.

To establish reference intervals (RIs) for the maximal aggregation rate (MA%) mainly of platelet aggregation tests induced by Collagen (COL), epinephrine (EPI), and ristocetin (RIS) using two automated haemostasis analyzers. Platelet aggregation tests were performed on 130 volunteers using CN6000 and CS5100 haemostasis analyzers. RIs were determined by a non-parametric method according to Clinical and Laboratory Standards Institute (CLSI) document EP28-A3c. The coefficient of variation (CV%) of MA% (excluding 0.6 mg/mL RIS) ranged from 3.23% to 6.29%. No significant differences in MA% were observed across gender and age groups. Significant differences were noted between the two analyzers. The RIs induced by COL at 2 µg/mL and 5 µg/mL ranged from 83.4% to 97.5% and 82.0% to 96.9% on the CN6000, and 76.3%-94.4% and 77.1%-95.7% on the CS5100, respectively. For EPI at 5 µmol/L the RIs were 76.0%-94.6% and 70.2%-93.5%. For RIS at 1.2 mg/mL, the RIs were 77.8%-95.0% and 76.4%-91.3%; for RIS at 0.6 mg/mL, were from 0%-3.0% and 0%-3.8% for CN6000 and CS5100, respectively. RIs for MA% induced by COL, EPI and RIS were established using two automated haemostasis analyzers, providing a valuable resource for clinical laboratories.

Objective: To evaluate the clinical application performance of a domestic D-dimer assay reagent (ADX D-dimer). Methods: A total of 546 residual sodium citrate anticoagulated plasma samples (530 of which were used for comparability validation and 16 for sample preparation of other validation components) were selected after the completion of clinical testing at Peking Union Medical College Hospital from Jun 2022 to May 2023. According to the American Clinical Laboratory Standards Institute (CLSI) guidelines, national health industry standards and relevant references, the performance of ADX D-dimer used in Sysmex CS 5100 fully automated coagulation analyzer which included accuracy, precision, linear range, carryover rate, interference resistance capability and reference interval were validated and the agreement compared with two mainstream imported detection reagents (reagent A: Vidas D-dimer reagent; reagent B: Innovance D-dimer detection reagent) was evaluated. The clinical diagnostic efficacy of the ADX D-dimer was evaluated using the ELISA D-dimer (reagent A) test results as criteria. Results: The linear correlation coefficient of the 6-point calibrated absorbance and target value was 0.998, the bias of accuracy met the requirements (-2.8%-8.4%), and the coefficient of variation (CV) of within-run and between-day precision of the two levels were 1.0%-2.7% and 2.7%-4.1%, respectively, which were less than the requirements of the manufacturer's statement and the national health industry standard. The linear range within 0.33-9.69 mg/L FEU was verified and the carryover rate was 0. There was no significant interference with the assay results at bilirubin F≤0.22 g/L, bilirubin C≤0.22 g/L, hemoglobin≤5.5 g/L and celiac≤2 800 FTU. The manufacturer's reference interval≤0.5 mg/L FEU was verified suitable for this laboratory. For 358 samples without suspicious heterophilic antibody whose D-dimer levels range from 0.06 to143.63 mg/L FEU, the correlation between ADX D-dimer and another two assay was good, with r values being 0.968 and 0.975, respectively, the percentage of deviation and relative deviation beyond the 95% confidence interval was 3.4%-4.5% and 5.3%-7.0%. The correlation between ADX D-dimer and ELISA D-dimer was better than that of reagent B in the concentration range of 0.06-1.00 mg/L FEU (r=0.858, 0.134). For 172 samples with heterophilic antibody, the correlation between ADX D-dimer and ELISA D-dimer was still good(r=0.827), with the percentage of deviation and relative deviation being 6.4% (11/172). The diagnostic efficacy was evaluated using 530 samples, and the sensitivity, specificity, positive predictive value, negative predictive value of ADX D-dimer was 97.4%, 77.6%, 91.9%, 91.9%. The area under the curve was 0.976 (95%CI: 0.964-0.987, P<0.001). Conclusion: The ADX D-dimer reagent has superior assay and diagnostic performance, and can meet the needs of clinical laboratories.

目的 基于全自动凝血分析仪血小板聚集试验通道,建立表观健康人群血小板最大聚集率(MPAR)的参考区间.方法 募集表观健康人134例,采用Sysmex CN3000和Sysmex CS5100全自动凝血分析仪进行不同终浓度二磷酸腺苷(ADP)和花生四烯酸(AA)诱导的血小板聚集试验检测.根据美国临床和实验室标准协会(CLSI)EP28-A3c文件,按照非参数法计算MPAR的参考区间.结果 不同终浓度ADP和AA诱导的MPAR重复性为2.03％～4.92％.不同终浓度ADP和AA诱导的MPAR在不同性别和年龄组之间差异均无统计学意义(P均>0.05).2个检测系统各自ADP终浓度2和5μmol/L之间、CS系列AA终浓度0.5和1.0 mmol/L之间MPAR差异均有统计学意义(P均<0.05).除AA终浓度1.0 mmol/L(Z=-2.319,P=0.020),余不同终浓度诱导的MPAR在2个系统间差异均无统计学意义(P均>0.05).ADP终浓度2、5和10μmol/L诱导的MPAR生物参考区间在CN3000分别为45.4％～95.7％、72.0％～94.3％和76.3％～95.1％,在CS5100分别为45.3％～93.7％、73.1％～99.1％和75.9％～97.6％;AA终浓度0.5和1.0 mmol/L诱导的MPAR参考区间在CN3000分别为72.1％～95.7％和81.0％～95.9％,在CS5100分别为77.1％～96.9％和81.1％～99.5％.结论 本研究初步建立了CN3000和CS5100不同终浓度ADP和AA诱导的血小板聚集试验MPAR参考区间.

目的 对Sysmex CN-3000全自动血凝仪检测常规凝血七项进行性能验证.方法 依据美国临床实验室标准化委员会(CLSI)EP文件及行业标准WS/T406-2012文件,对活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)、凝血酶时间(TT)、D-二聚体(D-dimer,D-D)、纤维蛋白原降解产物(FDP)和抗凝血酶(AT)的精密度、准确度、线性范围、方法间比对、携带污染和参考区间等性能进行验证,并比较Sysmex CN-3000与Sysmex CS 5100仪器的APTT凝固曲线报警信息.结果 APTT、PT、FIB、TT、D-dimer、FDP和AT的实验室内总不精密度(CV-实验室内)分别为0.79％～2.63％、2.14％～3.34％、3.49％～4.87％、1.60％～2.37％、3.81％～4.02％、2.54％～2.97％、4.12％～6.57％,准确度结果均在靶值允许范围内.线性验证的理论值和实测值的线性回归方程斜率在(1±0.05)范围内且R2≥0.995.所有项目在Sysmex CN-3000与Sysmex CS-5100两台仪器之间结果一致性好,且在医学决定水平处的偏移均在可接受范围内.25例标本在CS-5100仪器有早凝或凝固曲线报警,其中88％(22例/25例)的标本在CN-3000仪器无类似报警.所有项目参考区间验证通过.结论 CN-3000全自动血凝仪性能验证符合要求,可用于临床标本的检测.

目的 对一期凝固法凝血因子Ⅷ活性(FⅧ:C)检测系统进行性能验证.方法 依据中国合格评定国家认可委员会(CNAS)-GL037?临床化学定量检验程序性能验证指南?及相关卫生行业标准提供的方案,对ACL TOP 700全自动凝血分析仪及其配套试剂一期凝固法测定FⅧ:C精密度、正确度、准确度、线性范围、可报告范围、定量检出限、医学决定水平不精密度、携带污染率、抗干扰实验及参考范围进行验证.结果 批内不精密度变异系数(CV)值为1.8％～4.1％(≤5％),批间不精密度CV值为3.5％～3.9％(≤10％).正确度:偏倚为-1.3％(在±10％范围内).准确度:两个浓度室间质评物质偏倚差分别为1.81％ 和-0.87％(均在±10％范围内).线性范围:14.6％～142.7％(R2=0.9939).定量检出限:1％,与厂商声称相符.医学决定水平(1％、3％、5％)不精密度为5.1％～8.6％(≤10％).稀释验证:在32倍及以下稀释时,R值均在80％～120％之间.可报告范围:1％～428.1％.携带污染率:0(≤10％).干扰实验结果显示有较强的抗干扰能力.参考范围(50％～150％)验证:20例表观健康人有19例检测结果在参考范围内,验证通过.结论 一期凝固法Ⅷ因子活性检测系统精密度、正确度、准确度、线性范围、可报告范围、检出限、医学决定水平不精密度、携带污染率、抗干扰能力、参考范围验证等各项性能指标均满足国际标准化组织(ISO)15189的要求,可用于临床检测.

白血病是一组高度异质性的造血系统恶性肿瘤,细胞形态学检查对于筛查白血病至关重要.近年来,随着计算机图像分析技术在医学领域的不断研究,白血病细胞形态学计算机辅助识别技术也得到快速发展.相较人工镜检而言,计算机辅助识别技术快速便捷、省时省力、结果客观准确,可均衡各级医院医师的阅片水平.该文介绍了白细胞形态学计算机辅助识别技术的方法学,总结了其在急性白血病细胞形态学分析领域的研究及应用进展,并展望了未来的发展前景.

目的 评价活化部分凝血活酶时间(APTT)检测试剂APTT ACTIN FSL的性能,并与APTT ACTIN试剂比较临床诊断效能.方法 按照美国临床和实验室标准协会(Clinical and Laboratory Standards Institute,CLSI)EP5-A2、EP9-A2文件及国家卫生健康委员会WS/T406-2012文件等,对APTT ACTIN FSL试剂进行正确度、精密度、携带污染率、仪器间比对、批号间比对等性能评价并建立参考区间,同时评价APTT ACTIN FSL试剂和APTT ACTIN试剂对凝血因子、狼疮抗凝物(LA)的敏感性,并建立普通肝素抗凝治疗范围(HTR).结果 APTT ACTIN FSL试剂在CS5100和CA7000 2种仪器上,5份CAP室间质评物偏差＜4.00％;3个水平质控品的重复性为0.38％～1.83％,期间精密度为1.22％ ～ 3.57％;携带污染率分别为-1.58％和0.62％;参考区间分别为23.3～ 32.5 s和24.2～31.6 s.两批号间比对相对偏差(％)均在±5.0％以内,相关系数为0.999.APTT ACTIN试剂和APTT ACTIN FSL试剂对FⅧ、FⅨ和FⅪ各因子敏感性分别为45.0％、34.1％和53.8％,以及57.6％、39.5％和46.6％.2种试剂对76例阳性LA样本阳性检出率分别为40.8％和56.6％,卡方检验显示二者间差异有统计学意义(x2=34.432,P=0.000);2种试剂对52例中至强阳性样本阳性检出率分别为55.8％和73.1％,卡方检验显示二者间差异有统计学意义(x2=18.364,P=0.000).2种试剂建立的HTR分别为58.3～124.4 s和42.8～69.2 s,2例患者动态监测样本结果趋势一致.结论 APTTACTIN FSL试剂性能良好,对凝血因子和LA敏感性满足临床需求.实验室应建立或验证不同检测系统的参考区间及HTR,并在试剂更换时与临床有效沟通.

Objective:To establish the clot waveform analysis (CWA) reference intervals of prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fbg) and thrombin time (TT) parameters CT, |Min1|, |Min2|, |Max2| and observe the changes in patients with coagulation factors deficiency.Methods:One hundered and twenty-five cases of apparent healthy person were enrolled to establish the CWA reference intervals of four coagulation parameters and 25 cases with coagulation factors were used to study the changes of CWA patients.Results:The CWA reference intervals of PT |Min1| (dT/dt), |Min2| (d 2T/dt 2), |Max2| (d 2T/dt 2) are3.14±1.22, 0.56±0.22 and 0.50±0.18; The CWA reference intervals of APTT |Min1| (dT/dt), |Min2| (d 2T/dt 2), |Max2| (d 2T/dt 2) are 4.75±1.71, 0.78±0.29 and 0.65±0.28; The CWA reference intervals of Fbg CT(s), |Min1| (dT/dt), |Max2|(d 2T/dt 2) are 7.01±1.96, 1.22±0.51 and 0.15±0.11; The CWA reference intervals of TT |Min1| (dT/dt), |Min2| (d 2T/dt 2), |Max2| (d 2T/dt 2) are 0.95±0.32, 0.14±0.05 and 0.07±0.03.These parameters of CWA in factor Ⅴ deficient patients were significantly reduced, the activity of coagulation factor Ⅶ was 0.42, |Min2| and |Max2| were significantly lower than that of normal people. The paramenters of CWA in factor Ⅶ deficient patients were significantly reduce. Conclusion:The CWA reference intervals of four CWA parameters helps judgment of coagulation factor deficiency.

Objective:To establish autoverification rules for coagulation tests in multicenter cooperative units, in order to reduce workload for manual review of suspected results and shorten turnaround time (TAT) of test reports, while ensure the accuracy of results.Methods:A total of 14 394 blood samples were collected from fourteen hospitals during December 2019 to March 2020. These samples included: Rules Establishment Group 11 230 cases, including 1 182 cases for Delta check rules; Rules Validation Group 3 164 cases, including 487cases for Delta check; Clinical Application Trial Group 77 269 cases. Samples were analyzed for coagulation tests using Sysmex CS series automatic coagulation analyzers, and the clinical information, instrument parameters, test results, clinical diagnosis, medication history of anticoagulant and other relative results such as HCT, TG, TBIL, DBIL were summarized; on the basis of historical data, the 2.5 and 97.5 percentile of all data arranged from low to high were initially accumulated; on the basis of clinical suggestions, critical values and specific drug use as well as relative guidelines, autoverification rules and limits were established.The rules were then input into middleware, in which Stage I/Stage II validation was done. Positive coincidence, negative coincidence, false negative, false positive, autoverification pass rate, passing accuracy (coincidence of autoverification and manual verification) were calculated. Autoverification rules underwent trial application in coagulation results reports.Results:(1) The autoverification algorisms involve 33 rules regarding PT/INR, APTT, FBG, D-dimer, FDP,Delta check, reaction curve and sample abnormalities; (2)Autoverification Establishment Group showed autoverification pass rate was 68.42% (7 684/11 230), the false negative rate was 0%(0/11230), coincidence of autoverification and manual verification was 98.51%(11 063/11 230), in which positive coincidence and negative coincidence were respectively 30.09% (3 379/11 230) and 68.42%(7 684/11 230); Autoverification Validation Group showed autoverification pass rate was 60.37%(1 910/3 164), the false negative rate was 0%(0/11 230), coincidence of autoverification and manual verification was 97.79%(3 094/3 164), in which positive coincidence and negative coincidence were respectively 37.42%(1 184/3 164) and 60.37%(1 910/3 164); (3) Trialed implementation of these autoverification rules on 77 269 coagulation samples showed that the average TAT shortened by 8.5 min-83.1 min.Conclusions:This study established 33 autoverification rules in coagulation tests. Validation showedthese rules could ensure test quality while shortening TAT and lighten manual workload.

目的 对3种稀释蝰蛇毒磷脂时间试验(dRVVT)的狼疮抗凝物(LA)检测方法进行性能评价,比较不同系统间检测结果的一致性,并初步探讨不同检验流程对检测结果的影响.方法 按照美国临床和实验室标准协会(CLSI)文件及临床血液学检测常规项目分析质量文件(WS/T 406—2012),对3种LA检测方法的精密度、携带污染率进行评价,验证3种方法检测LA的参考区间(RI)/cut-off值,并分析检验结果一致性和不同检验流程对检测结果的影响.结果 3种dRVVT检测方法重复性以CV表示为0.44％～1.69％;期间精密度以CV表示,为1.43％～2.43％.3种检测方法携带污染率绝对值<3.00％.系统1和2的RI验证通过,系统3验证未通过.3种不同系统筛选试验、确认试验及比值间结果差异有统计学意义(P=0.000).3种不同系统阴阳性判断结果间差异有统计学意义(χ2=11.333,P=0.000).系统3以说明书推荐流程分析结果,与筛选/确认比值(R)或标准化比值(NR)结果表示方式相比,53例阴性结果中2例为假阴性.结论 3种dRVVT检测系统性能良好,适于临床常规使用.但各实验室应验证或建立适合本实验室的RI/cut-off值,确定合理的检测流程,关注检测分析前中后影响因素,合理解释检测结果.

The application of Aptio automation system has greatly developed the intelligent management of coagulation testing in the laboratory. The hardware system of the Aptio automation in coagulation screening tests consists of the Siemens Healthineers Aptio Automation system, Sysmex CS-5100 coagulation analyzer, and the software system including the data-management system of Aptio Automation, Centrlink system middleware, and the laboratory information system (LIS). Based on the actual operating conditions and the quality management requirements of coagulation testing, the LIS, the Aptio automation system and the pure-water management system of the Sysmex analyzers were optimized repeatedly, which enhances the efficiency and the quality of the work in the lab. Now the lab uses the intelligent management system to establish rerun rules for coagulation screening testing and will achieve autoverification of results in the future.

The automation system described here, which consists of the Siemens Healthineers Aptio® Automation system, Sysmex® CS-5100 coagulation analyzer, and a Laboratory Information System (LIS), can contribute to intelligent management of coagulation testing in the laboratory. Based on actual operating conditions and the qualitymanagement requirements of coagulation testing, the laboratory in this study realized intelligent management of many aspects of the testing process, including sample management, priority testing of STAT samples, designation of the testing instrument, color coding of sample priority and other variables in the LIS interface, timeout reminders, and online reruns. The lab also benefited from the automatic decanting and quality-control functions of the coagulation analyzer. By adapting the pure-water management system of the Sysmex analyzer and optimizing the CentraLink® Data Management System middleware and laboratory information system, the lab reduced the need for manual sorting and enhanced workflow efficiency and quality while also accommodating higher test volume. The lab also used the intelligent management system to establish rerun rules for coagulation testing. The lab’s next goal is to achieve intelligent verification of results.

Background To conduct a comprehensive performance evaluation of a fully automated analyzer for measuring thrombomodulin (TM), thrombin-antithrombin complex (TAT), plasmin-alpha 2-antiplasmin complex (PAP), and t-PA: PAI-1 complex (tPAI-C). Methods According to the Clinical and Laboratory Standards Institute (CLSI) EP05-A2, EP06-A specifications, TM, TAT, PAP, and tPAI-C were analyzed to evaluate intraassay variability and interassay variability, linear range, carryover rate, reference range, sample stability, and interferences. Results The intraassay variability and interassay variability of the four factors were all below 5%. The carryover rates were below 1%. Linear verification analysis revealed correlation coefficients of 0.998-0.999. The recommended reference ranges of TM, TAT, and PAP were appropriate for our laboratory, whereas the reference of tPAI-C should be established by each laboratory. Stability assessment revealed that TM is stable for 2 days at room temperature but lacks stability at colder temperatures. In contrast, TAT is stable for 5 days at 4 degrees C and -20 degrees C but has poor stability at room temperature. PAP and tPAI-C are stable for 3 days at all three temperatures. The measurement of TM, TAT, PAP, and tPAI-C is not altered by the presence of 510 mg/dL hemoglobin, 1490 FTU triglycerides, or 21.1 mg/dL conjugated and free bilirubin. Conclusion The determination of TM, TAT, PAP, and tPAI-C using a high-sensitivity chemiluminescence analyzer performs well in terms of precision, carryover rate, linear range, and interference. Thus, this method is suitable for the detection of these substances in clinical specimens.

疟原虫感染检测可通过厚血膜、薄血膜、疟原虫抗体、疟原虫抗原以及分子生物学等方法进行.厚血膜、薄血膜方法是查找疟原虫的金标准,但该方法技术要求高,且费时[1].血液分析仪散点图特征性改变在疟原虫感染检测中具有重要的提示作用.不同型号血液分析仪因检测原理不同,散点图特征也各不相同[2-7].本研究报道了血液分析仪散点图提示疟原虫感染2例.

Objective To evaluate 2 lupus anticoagulant (LA) assays based on diluted Russell viper venom time (dRVVT) and silica clotting time (SCT),and to provide a reference to choose suitable assay for LA determination. Methods The platelet (PLT) counts of 50 cases of poor platelet plasma(PPP) were counted to validate centrifuge procedure. According to the Clinical and Laboratory Standards Institute (CLSI)documents and the Analytical Quality Specifications for Routine Tests in Clinical Hematology(WS/T406-2012),their precisions, carryover rates and methodological comparisons were evaluated. The reference interval (RI)/cut-off value was also established. Results PLT count was (0-9)×109/L in the 50 cases of PPP,and met the requirements of guidelines (<10×109/L). The within-run precisions of dRVVT and SCT were <2.50%. The between-run precisions of dRVVT and SCT were 2.76%-3.53% and 6.23%-7.02%,respectively. The precision of normalized ratio was < the other 2 expressions. The absolute values of carryover rates of the 2 assays were < 3.00%. The RI/cut-off value of dRVVT was 1.24,which was higher than that provided by manufactures' instructions (1.20). The RI/cut-off value of SCT was 1.16,which was as the same as that provided by manufactures' instructions. The r of the same assay in different instruments and different assays in the same instrument were >0.900. There was no statistical significance for NR between the 2 assays in the same instrument(P=0.248),and there was no statistical significance between 2 methods in the evaluation of positive and negative results. Conclusions The 2 LA assays based on dRVVT and SCT have good performance. Every laboratory should establish local LA RI/cut-off values.

目的 探求综合性医院住院患者凝血项目异常结果的原因,为临床治疗提供指导.方法 收集2013年1月至3月间北京协和医院东院所有常规送检凝血四项试验中活化部分凝血活酶时间(aPTT)或/和凝血酶原时间(PT)延长者的临床资料和血浆标本,分析其原因.结果 2个月间东院常规送检凝血四项者3596例,异常结果1304例,其中以aPTT合并PT延长比例最高(35.3％).aPTT或/和PT延长者701例,原因明确者319人,以抗凝治疗、慢性肝病为主;不明者382人.临界值范围内aPTT独立延长最常见原因为FⅫ缺乏(占54.7％);PT独立延长为维生素K依赖性因子的联合缺乏(占22.9％);aPTT合并PT延长以各种凝血抑制物最多(占59.5％),其次为狼疮抗凝物阳性者(占21.4％).结论 我院凝血四项检查异常结果以aPTT或/和PT延长最为常见.临界值范围内aPTT独立延长最常见的原因为FXⅡ缺乏;PT独立延长最常见的原因为维生素K依赖性因子的联合缺乏.aPTT或/和PT延长处于临界值范围内的患者也有存在凝血因子缺乏可能性,临床医生应警惕.检验前误差是导致异常结果的一个重要部分,应当尽量避免.