生化检验中标本溶血对结果的影响及处理方法

基层检验工作中,由于采血不当、试管不洁、检验过程中未按操作规范进行操作等原因,均可引起不同程度的标本溶血,而标本溶血又成为日常检验工作中最常见的影响生化检验结果的原因。除此之外,反应时间和温度也可影响临床生化检验指标的测定。本文结合有关溶血对部分临床生化检验指标测定的影响,分析了溶血原因及其对策。     

Hemolysis: Mechanism and clinico-biological consequences

Hemolysis is a clinical entity, which can be severe. It is commonly of multifactorial etiology. The activity of a specialist in transfusion medicine consists in treating the patient with transfusion support in case of severe anemia. If the etiology is partly alloimmune this therapeutic strategy is more arduous. Immunohematological work-up must be very rigorous to ensure transfusion management with utmost safety. However, without the precise knowledge of both the clinical condition and the treatment (current and past) of the patient, such management is impossible.     

溶血现象对临床生化检验项目影响分析

目的:探讨溶血现象对临床生化检验项目影响。方法:选取体检健康者60例血液标本,采用全自动生化检验分析仪检验溶血前后的丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、血糖、总蛋白、总胆红素、尿素氮、钠离子、钾离子、肌酸激酶同工酶、肌酸激酶和高密度脂蛋白等生化项目。结果:溶血前后血液标本的天门冬氨酸氨基转移酶、血糖、总蛋白、总胆红素、尿素氮、钠离子、钾离子和肌酸激酶比较,差异有统计学意义(P<0.05)。结论:溶血现象对生化检验项目中大多结果产生影响,故临床操作时应严格遵循规章制度,避免误差。     

儿童G-6-PD缺乏症并发溶血70例临床分析

目的:回顾分析儿童G-6-PD缺乏症并发溶血的诱因、临床表现、实验室检查特征、治疗方式及转归,探讨预防措施。方法:对70例G-6-PD缺乏症患儿的临床资料进行总结分析。结果:G-6-PD缺乏症以男性患儿为主,急性溶血多发生在春季,诱因以进食蚕豆为主,其次为感染、药物,尚有以新生儿高胆红素血症为表现者。蚕豆病多数起病急,以贫血、黄疸、血红蛋白尿为主要表现,溶血为自限性。结论:避免G-6-PD缺乏症患儿溶血的发生,预防是关键,提倡对出院患儿家长做好健康宣教,且有必要对高危人群的新生儿进行G-6-PD缺乏症的筛查。     

生姜中一种新化合物的抗氧化活性

目的和方法:采用溶血实验,小鼠肝组织脂质过氧化物(MDA)测定,采用受辐射质粒构象改变等方法测定从生姜中分离得到的一新的环状二苯基庚烷类化合物(化合物1)的抗氧自由基损伤活性。结果:化合物1能显著抑制H₂O₂致人红细胞溶血作用(P＜0.01);明显抑制小鼠肝组织脂质过氧化物(MDA)的产生(P＜0.01);显著抑制受辐射质粒超螺旋构象百分率的下降(P＜0.05或P＜0.01)。结论:化合物1具有明显抗氧自由基损伤的作用。     

探讨标本状态对全血细胞检测结果的影响

目的:探讨标本状况对全血细胞分析结果的影响。方法:采用日本Sysmex KX-21N血细胞分析仪进行检测,对数例有脂血、黄疸、溶血、小红细胞等标本状况的检测结果进行分析;校正分别用白细胞和血小板稀释液稀释标本后,充入计数池内进行白细胞和血小板计数;脂血标本用等量生理盐水或稀释液洗涤后重测血红蛋白;由抽血引起的溶血标本重抽血,再行检测。结果:脂血标本血红蛋白明显升高,黄疸标本白细胞计数显著增高,小红细胞影响血小板假性增高,溶血标本红细胞和压积降低,与血红蛋白比例明显不符。结论:通过分析全血细胞检测结果各参数之间的关系,可找出影响其结果的因素,予以校正,加强审核结果的环节,为临床提供准确、可靠的检验结果。     

注射用盐酸吉西他滨的局部用药安全性评价

目的:通过对注射用盐酸吉西他滨的安全性试验研究,评价其用药的安全性.方法:分别进行豚鼠全身过敏性试验,家兔血管刺激性试验及溶血性试验,观察注射用盐酸吉西他滨是否可引起过敏和对血管的刺激性,是否具有溶血作用.结果:注射用盐酸吉西他滨给药后未出现过敏反应,静脉注射未见明显刺激性,亦未见溶血及凝集反应.结论:注射用盐酸吉西他...     

提高血氧分压对不同储存期血液红细胞影响的探讨

目的：探讨提高血氧分压在4℃保存条件下对不同储存期红细胞的影响。方法：在无菌条件下，分别对采集0d，7d，14d，21d的库存血进行无菌氧处理以提高血氧分压。分实验组和对照组，测定血液红细胞在提高血氧分压后的血浆游离Hb浓度，血浆K^＋离子浓度，红细胞超氧化物歧化酶（SOD）活性，谷胱甘肽过氧化物酶（GSH—Px）活性。结果：与对照组比较，在4℃保存条件下，血液红细胞在提高血氧分压初期（1—2d），血浆游离Hh浓度和血浆K^＋离子浓度无明显变化（p〉0．05），红细胞SOD活性、红细胞GSH—Px活性有所提高（p〈0．05）；随着储存时间的延长，血浆游离Hb浓度增加、血浆K^＋离子浓度增高（p〈0．01），红细胞SOD活性和红细胞GSH—Px活性降低（p〈0．01）。结论：（1）不同储存期红细胞能保持较高血氧分压和血氧保和度；（2）血液红细胞在提高血氧分压的初期不会产生明显的溶血反应和其它损伤，红细胞抗氧化酶活性有所提高。随着储存时间的延长，红细胞抗氧化酶活性下降，溶血反应加重，存在红细胞膜氧化损伤作用，这与氧自由基攻击红细胞膜发生过氧化反应及红细胞抗氧化酶活性降低有关。     

A preliminary study of microcapsule suspension for hemolysis evaluation of artificial organs

A microcapsule suspension, a substitute for animal blood in hemolysis tests, has been developed for evaluation of the absolute hemolytic properties of circulatory artificial organs. The microcapsule suspension was made by dispersing microcapsule slurry into an ethylene glycol sodium chloride solution. The microcapsule slurry was composed of a leuco dye solution and polyurethane membrane made by the reaction between aliphatic poly-isocyanate and polyamine by interfacial polycondensation. The microcapsule was a small particle containing dye inside. The microcapsule suspension was white; the diameter of the microcapsules was from 5 to 100 microns. The specific gravity of the suspension was 1.024, and the membrane was elastic. The fluid showed Newtonian characteristics, different from animal blood, and its viscosity was approximately 5.8 mPa.s. After the microcapsules were destroyed, the leuco dye was extracted with n-hexane from the suspension and was measured by spectroscopy after being colored with acid ethanol. Hemolysis can be regarded as a fatigue fracture of cell membranes rather than a static fracture. The destruction of microcapsules by a Potter type tissue grinder was observed at a low stroke number region and was compared to rat blood. Moreover, hemolysis tests of a commercially available centrifugal blood pump and the prototype of our centrifugal pump for mechanism checks were carried out with bovine blood. The hemolysis level of the prototype pump increased with time while the hemolysis level of the commercial blood pump did not change as much as that of the control when both pumps were tested with the microcapsule suspension. These results are similar to tests utilizing bovine blood. Therefore, hemolysis tests of circulatory artificial organs completed with microcapsule suspension are expected to provide results similar to tests with animal blood.