脂类物质对血清总胆汁酸检测的干扰和携带污染分析

目的：探讨脂类物质对循环酶法测定血清总胆汁酸（TBA）的干扰和试剂可能携带的污染，寻找减少和消除干扰和污染的方法。方法采用循环酶法测定血清 TBA，观察高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、胆固醇（TC）、三酰甘油（TG）试剂对 TBA 检测的携带污染，以及高血脂样本对 TBA 检测的干扰，并尝试通过设置不同的冲洗程序和检测顺序来减少对 TBA 的干扰和携带污染。结果用低值和高值混合血清进行 TBA 检测，研究结果表明，在检测 TBA 前后清洗过程中，用水做冲洗液比酸性洗液做冲洗液，血清 TBA 检测结果的准确更高，设置清洗和不设置清洗对检测结果的影响显著（P ＜0．01）。以脂类试剂为样品重复检测其 TBA 浓度，取均值，发现 HDL-C 对 TBA 检测稳定性的影响最大[（476．06±1．88）μmol/L]，其次是 TC 和 TG，分别为[（127．78±1．18）、（121．05±1．08）μmol/L]，而 LDL-C 影响最小[（2．23±0．51）μmol/L]。干扰 TBA 检测结果稳定性的严重程度由大到小依次为 HDL-C、TC、TG 和 LDL-C。设置检测顺序，冲洗程序。再用多干扰项目混合样本/TBA，结果表明血脂样本对 TBA 的干扰大大降低（P ＜0．01），但是不能完全排除干扰。结论生化分析仪的分析顺序和冲洗程序以及试剂成分的外源性物质干扰严重影响测定结果的准确性。要想保证结果准确、可靠，不但需要设置合理的冲洗和反应顺序，还要熟练掌握仪器操作和项目的反应原理，了解试剂的成分，更加要掌握仪器的定期维护和保养等方面的知识。

Interference of lipid compositions and carry-over contamination of lipid reagents on measurement of serum total bile acid

Objective To investigate whether lipids and reagents would interfere the results when serum total bile acid（TBA） was measured by enzymatic cycling assay.Methods The serum TBA was measured by enzymatic cycling assay.The carry-over contaminations of high density lipoprotein（HDL-C）,low density lipoprotein（LDL-C）,cholesterol（TC）,and triglyceride（TG）reagents were evaluated.In order to reduce the interference and carry-over contaminations,different washing procedures and detection sequence were set.Results By measuring the levels of TBA in pooled serums with low and high levels of lipids,the results showed that there was statistically significant difference between the groups with and without the addition of cleaning process before and after TBA measurement（P 〈0.01）.Cleaning with water might be more effective on reducing interference than those with acid solution.Moreover,the mean of TBA levels in HDL-C,TC,TG and LDL-C reagents were （476.06 ± 1.88 ）,（127.78 ± 1.18 ）, （121.05±1.08）,and （2.23±0.51）μmol/L,respectively.The stability of TBA level was greatly affected by HDL-C regents,fol-lowing by TC and TG reagents,and was little affected by LDL-C reagent.Setting up proper detection sequence and flushing proce-dures could obviously reduce the interference（P 〈0.01）,but not completely rule out.Conclusion Analysis sequence and flushing procedures of biochemical analyzer as well as exogenous substance from reagents may seriously affect the accuracy of determination results.To ensure the accuracy and reliability of the results,it is necessary not only to set up reasonable irrigation and reaction sequence,but also to master the instrument operation,to know the principle of test reaction and the components of reagents as well as equipment maintenance.