[乳酸脱氢酶水平过高的溶血性贫血]。

Fumihiko Nakamura, Asumi Koyama, Tomonari Kuribayashi, Masamichi Yoshika
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引用次数: 0

摘要

使用电子病历系统,从临床实验室获取患者的临床信息变得更加容易。然而,当患者的临床信息来自电子病历时,临床实验室在阐明患者疾病的病理机制时可能没有考虑异常的实验室数据。在这次反向临床病理会议上,我们分析了一位乳酸脱氢酶(LD)水平升高并贫血的患者的实验室数据。虽然从LD水平升高、贫血和触珠蛋白水平下降可以清楚地看出溶血的存在,但LD水平的过度升高提示了溶血的特殊机制。根据凝血酶原时间延长和部分凝血活酶激活时间正常来预测药物摄入。在会议上,这些发现引发了深入的讨论。我们仅根据实验室数据阐明该患者的病理机制,有意限制临床信息,并再次认识到彻底分析实验室数据的重要性。为临床实验室的医疗技术人员和医生提供关于利用实验室数据阐明病理机制的信息的培训模块,可能有助于改进实验室数据报告中评论的性质。此外,临床医生还应该接受培训,仅根据实验室数据阐明疾病的病理机制,以及根据临床信息和体检结果诊断患者。(审查)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Hemolytic Anemia with Excessively Elevated Lactic Dehydrogenase Levels].

It has become easier to acquire patients' clinical information from clinical laboratories using the electronic medical record system. However, it is possible that clinical laboratories do not consider abnormal laboratory data when elucidating the pathological mechanism of diseases in patients when their clinical information is obtained from the electronic medical records. In this reversed clinicopathological conference, we analyzed the laboratory data of a patient with elevated lactate dehydrogenase (LD) levels and anemia. Although the presence of hemolysis was clear from the elevated LD levels, anemia, and decreased haptoglobin levels, the ,excessive increase in the LD level suggested a particular mechanism of hemolysis. Drug intake was sus- pected on the basis of a prolonged prothrombin time with a normal activated partial thromboplastin time. At the conference, these findings led to in-depth discussions. We elucidated the pathological mechanism in this patient based only on the laboratory data, with intentionally restricted clinical information, and again recog- nized the importance of analyzing laboratory data thoroughly. Training modules for medical technologists and doctors in clinical laboratories that provide information regarding elucidating pathological mechanisms using laboratory data may prove useful for improving the nature of comments in laboratory data reports. In addition, clinicians should also receive training to elucidate the pathological mechanism of a disease on the basis of only laboratory data, as well as training for diagnosing patients on the basis of clinical information and physical examination findings. [Review].

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