Abstract

The Clauss assay is the assay most often used for measuring plasma fibrinogen levels. However, the FIBTEM-assay, determined using thromboelastometry (ROTEM) can also be used to estimate fibrinogen levels. A major advantage of the FIBTEM is that it can provide information about fibrinogen levels within minutes, while the Clauss assay needs 30–60 min before the result is available. The aim of this study was to investigate the correlation between fibrinogen levels measured by the Clauss assay and results from the FIBTEM-assay. We included 111 patients ≥18 years for whom both ROTEM analyses and a fibrinogen measurement using the Clauss assay were available. In addition, ROTEM and Clauss measurements from 75 healthy subjects were included. Spearman correlation was used to determine the association between the results of both assays. The patients included were mostly patients with major trauma or undergoing large surgery (e.g. cardiac surgery or liver transplantation). Strong correlations were found between FIBTEM clot firmness parameters and fibrinogen levels measured by the Clauss assay in patients (Spearman’s correlation coefficients (r_s) above 0.80 (p < .001) for all subgroups) and healthy subjects (r_s = 0.66, p < .001). The correlation between early FIBTEM parameters (clot firmness at 5 or 10 min) and the maximum clot firmness was almost perfect (r_s above 0.96). Also, the correlation between the α-angle and FIBTEM parameters was strong (r_s above 0.7). In conclusion, strong correlations were found between early FIBTEM parameters and fibrinogen levels.

摘要

克劳斯试验是最常用于测量血浆纤维蛋白原水平的试验。然而，使用血栓弹力测定法 (ROTEM) 确定的 FIBTEM 测定也可用于估计纤维蛋白原水平。FIBTEM 的一个主要优点是它可以在几分钟内提供有关纤维蛋白原水平的信息，而 Clauss 检测需要 30-60 分钟才能获得结果。本研究的目的是调查 Clauss 测定法测量的纤维蛋白原水平与 FIBTEM 测定法结果之间的相关性。我们纳入了 111 名≥18 岁的患者，这些患者的 ROTEM 分析和使用 Clauss 测定法进行的纤维蛋白原测量均可用。此外，还包括来自 75 名健康受试者的 ROTEM 和 Clauss 测量值。斯皮尔曼相关性用于确定两种测定结果之间的关联。纳入的患者多为严重外伤或接受大手术（如心脏手术或肝移植）的患者。发现 FIBTEM 凝块硬度参数与通过 Clauss 测定法测量的患者纤维蛋白原水平之间存在强相关性（Spearman 相关系数（r_s ) 高于 0.80（ 所有亚组的p < .001）和健康受试者（r _s = 0.66，p  < .001）。早期 FIBTEM 参数（5 或 10 分钟时的凝块硬度）与最大凝块硬度之间的相关性几乎是完美的（r _s高于 0.96）。此外，α 角和 FIBTEM 参数之间的相关性很强（r _s高于 0.7）。总之，在早期 FIBTEM 参数和纤维蛋白原水平之间发现了很强的相关性。