标本放置时间对胰岛素测定的影响

目的探讨血清标本在4℃环境下放置不同时间对化学发光检测血清胰岛素水平的影响。方法用真空分离胶采血管抽取21份血液标本,冷冻离心分离血清,采用全自动化学发光仪即时检测胰岛素浓度,将血清标本于4℃分别放置1、3、24h后重复检测,并与即时检测结果进行比较。结果标本采集后即时检测与4℃下放置1、3、24h后检测胰岛素浓度分别为(6.88±4.38)、(6.87±4.44)、(7.05±4.68)、(7.57±4.60)mIU/L,经配对t检验,血清标本在4℃放置1h和3h所测结果与即时测定结果比较,差异无统计学意义(P=0.773、0.273),而放置24h后所测结果与即时测定结果比较,差异有统计学意义(P=0.009)。结论标本放置时间对胰岛素测定有影响,血清胰岛素在4℃条件下不能放置24h以上。     

标本因素对荧光定量PCR法测定乙肝病毒DNA的影响

目的探讨脂血、溶血标本及血清标本常温储存48小时和4℃保存7天对乙肝病毒DNA(HBVDNA)荧光定量测定结果的影响。方法将乙肝大三阳血清标本进行即时检测、4℃保存7d后检测、室温保存48h检测及高脂血和非脂血、溶血血清和未溶血血清同时作HBVDNA荧光定量PCR,并两两间进行配对t检验。结果乙肝大三阳溶血与未溶血血清标本、脂血和非脂血血清标本HBVDNA含量都在同一数量级。血清标本在室温下短期贮存(48h内)、4℃保存7d内分别与即时检测HBV-DNA含量比较均无统计学意义(P>0.05)。结论脂血、溶血,血清标本不同储存温度及时间对HBV-DNA定量结果测定尤影响。     

溶血对时间分辨免疫荧光分析法测定胰岛素的影响

目的：探讨溶血对时间分辨免疫荧光分析法测定胰岛素的影响。方法收集30例未发生溶血的血清标本,利用低渗溶血法分别制备轻度溶血、中度溶血、重度溶血标本各10例;采用时间分辨免疫荧光分析法分别测定各组标本溶血前（0 h）和溶血后0．5、2、18 h的胰岛素浓度;通过配对t检验、重复测量数据的方差分析对溶血程度和时间对胰岛素浓度检测结果的影响进行分析。结果轻度溶血、中度溶血、重度溶血标本之间胰岛素浓度检测结果比较差异无统计学意义（P＞0．05）;随着溶血时间的延长,胰岛素浓度呈明显下降趋势,0．5、2、18 h检测结果与0 h检测结果相比,比较差异均有统计学意义（P＜0．05）。结论溶血程度对时间分辨免疫荧光分析法测定胰岛素浓度的影响不明显,但溶血时间则对测定结果具有较为明显的影响;标本溶血和溶血时间均为影响胰岛素浓度检测结果的重要因素。     

血液标本保存方式对恶性肿瘤特异生长因子检测结果的影响

目的:探讨不同条件保存血液标本对恶性肿瘤特异生长因子(TSGF)检测结果的影响.方法:采集40名自愿受试者空腹静脉血,分为不离心组和离心组,分别放置4℃和25℃加盖保存,测定不同保存时间血清TSGF的浓度.结果:离心组血清加盖4℃保存48 h时与2 h测定组比较差异有统计学意义(P<0.01),25℃离心保存24、48 h与2 h测定组比较差异有统计学意义(P<0.01);不离心组全血加盖4℃保存24 h时与2 h测定组比较差异无统计学意义(P>0.05),25℃不离心加盖保存8、24 h与2 h测定组比较差异有统计学意义(P<0.05).结论:宜采集2h内分离血清及时检测TSGF;不能及时检测TSGF的血液标本须在4 h内分离血清并加盖4℃保存,于24 h内检测完毕,以保证结果的准确可靠.     

惰性分离胶管采集和保存样品在血糖检测中的应用

目的研究惰性分离胶管采集和保存血糖标本的可行性。方法随机选择患者标本40例,采用惰性分离胶管和干燥管(无抗凝)采集同一患者血液标本,待血液凝固后立即离心,各取出60μL血清到Eppendorf管(简称Ep管)冷冻保存;再分别于2、4、6、8、24 h后从惰性分离胶管中取出60μL血清到Ep管中冷冻保存,检测并比较上述血清的葡萄糖浓度。结果惰性分离胶管0、2、4、6、8、24 h血糖的检测结果与干燥管0小时血糖检测结果差异无统计学意义(P0.05),惰性分离胶管的2、4、6、8、24小时血糖检测结果与0小时惰性分离胶管血糖检测结果差异无统计学意义(P0.05)。结论使用惰性分离胶管不会影响血糖检测结果且可以防止糖酵解。     

溶血对电化学发光免疫分析法测定胰岛素的干扰

目的探讨电化学发光免疫分析法（ECLIA）测定血浆胰岛素浓度时,标本溶血程度及溶血标本放置时间对测定结果的干扰。方法将检测标本人为干预成5种不同溶血程度的溶血标本,置于室温环境下,分5个时间段（15、30、60、120、180 min）,分别用电化学发光免疫分析法测定各组标本的胰岛素浓度并作分析。结果溶血标本可使胰岛素浓度降低,标本溶血程度与溶血标本放置时间对胰岛素浓度测定均有影响,两者之间均呈负相关。结论在血标本的采集和分离时应尽可能避免溶血,临床工作中遇到溶血标本时,应在报告单上注明,并建议重新采血。     

氟化钠抗凝管与分离胶真空采血管在血糖中的应用评价

目的 探讨氟化钠抗凝管与分离胶真空采血管对保存标本血糖检测的稳定性.方法 同一体检者分别抽取氟化钠抗凝管与分离胶真空采血管静脉血各1支,连续测定即时及24、48、72、96、120、144 h血糖浓度,观察两种采血管保存标本不同时间段血糖浓度的变化.结果 检测即时及24、48、72、96、120、144 h氟化钠抗凝管与分离胶真空采血管中血糖浓度,两种采血管之间结果差异无统计学意义(P>0.05);同时分别对两种采血管即时与144 h血糖浓度进行比较,结果显示两者差异无统计学意义(P>0.05).结论 以氟化钠抗凝管与分离胶真空采血管保存的血液标本血糖浓度具有较好的稳定性.     

溶血对电化学发光免疫分析法测定胰岛素的干扰

目的探讨电化学发光免疫分析法(ECLIA)测定血浆胰岛素浓度时,标本溶血程度及溶血标本放置时间对测定结果的干扰。方法将检测标本人为干预成5种不同溶血程度的溶血标本,置于室温环境下,分5个时间段(15、30、60、120、180 min),分别用电化学发光免疫分析法测定各组标本的胰岛素浓度并作分析。结果溶血标本可使胰岛素浓度降低,标本溶血程度与溶血标本放置时间对胰岛素浓度测定均有影响,两者之间均呈负相关。结论在血标本的采集和分离时应尽可能避免溶血,临床工作中遇到溶血标本时,应在报告单上注明,并建议重新采血。     

血浆与血清同型半胱氨酸在不同检测条件下比较及稳定性研究

目的分析同型半胱氨酸(Hcy)水平在血浆与血清中的差异及放置不同时间检测的稳定性。方法分别以EDTA-K2抗凝管和分离胶管收集42例健康体检人员血液,于即刻及放置3h后分离血浆及血清。选EDTA-K2抗凝管立即离心分离血浆后于室温放置1h、3h、6h及2-8℃24h;分离胶管放置30min待血液凝固后离心分离血清于室温放置1h、3h、6h及2-8℃24h,使用直接化学发光法检测同型半胱氨酸浓度。结果分离胶管取血放置30min后离心分离血清同型半胱氨酸浓度较即刻分离的血浆同型半胱氨酸浓度高13.24%,结果差异有统计学意义(P<0.05);取血放置3h后离心检测血清或血浆同型半胱氨酸浓度明显高于取血后即刻离心检测的同型半胱氨酸浓度,两者相差12.47%和12.56%,结果差异有统计学意义(P<0.05)。分离后血浆与血清在室温放置1h、3h、6h及2-8℃24h检测同型半胱氨酸浓度,结果差异均无统计学意义(P>0.05)。结论血清同型半胱氨酸水平明显高于血浆,分离血清或血浆前标本放置时间对检测同型半胱氨酸浓度有影响,分离后血浆或血清在2-8℃保存,24h内同型半胱氨酸检测结果差异无统计学意义。在临床工作中,应尽可能快速分离血浆标本进行同型半胱氨酸检测或分别设立血浆与血清同型半胱氨酸浓度的正常参考范围。     

血液标本中葡萄糖稳定性的动态观察

目的动态观测血液标本中葡萄糖的稳定性,为葡萄糖测定标本的采集及处理提供实验依据。方法用NaF管、肝素钠管、凝胶促凝管采集血样在室温或4℃放置不同时间后分离血浆(清)测定葡萄糖。血清标本在室温放置不同时间后测定葡萄糖,观察其变化规律。结果室温下肝素钠管中葡萄糖浓度随时间延长不断下降,NaF管中葡萄糖浓度在前90min下降与肝素钠管中一致,90～180min葡萄糖浓度保持稳定。凝胶促凝管中葡萄糖浓度在前60min下降与在肝素管及NaF管中一致,但60～150min葡萄糖浓度下降较前两管慢。血清标本在室温下至少保持3h稳定。凝胶促凝管在4℃放置葡萄糖浓度至少保持3h不变。结论防止血液中葡萄糖浓度降低最有效的途径不是使用NaF管采血而是将血样低温保存或及时分离血清(浆)。     

标本溶血对常规生化检验结果的影响

目的了解临床标本溶血对丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆固醇(TC)等11项常规生化检验结果的影响,探讨影响因素并在此基础上提出相应对策。方法抽取100例体检者空腹血液标本5mL,分别置于2支试管中,每支2.5mL,其中1支试管中的标本采用人工方法使其溶血,检测正常标本和溶血标本血清中ALT、AST、三酰甘油(TG)、尿素(UREA)、肌酐(Cr)、葡萄糖(GLU)、尿酸(UA)等11项临床常规生化检验指标的含量并进行比较。结果溶血标本血清ALT、AST、总蛋白、清蛋白测定结果明显高于正常标本血清,差异有统计学意义(P<0.05),溶血后总胆红素、Cr、TC、TG及GLU较溶血前均有明显降低,差异有统计学意义(P<0.05),溶血对UREA、UA测定结果影响较小。结论标本溶血对一些常规生化检验项目有明显的干扰作用,临床检验工作中应采取一切可能的措施避免标本溶血的发生。     

Use of insulin immunoassays in clinical studies involving rapid-acting insulin analogues: Bi-insulin IRMA preliminary assessment.

BACKGROUND: In clinical studies involving rapid-acting analogues (RAAs), insulin immunoreactivity is frequently measured, including endogenous, regular insulin (RI) and RAA immunoreactivities. Such a procedure implies equivalent cross-reactivities of all insulins present in serum. Commercially available human insulin immunoassays have been widely used, but their limitations (including hemolysis and anti-insulin antibodies) were not fully investigated. The aims of our study were to compare cross-reactivities of RI and RAAs in buffer and in serum and to investigate insulin immunoassay pitfalls. METHODS: Cross-reactivities were assessed using Bi-insulin IRMA (Schering Cis-Bio International) in phosphate-buffered saline (PBS)-1% bovine serum albumin (BSA) and in pools of sera spiked with RI and RAAs (lispro and aspart). To investigate the influence of hemolysis, a pool of sera spiked with RAA was mixed with a concentrated hemolysate (final hemoglobin concentration 10 g/L) and incubated for 3 h at room temperature. To determine interference by anti-insulin antibodies, insulin was removed using charcoal from 18 sera with anti-insulin antibodies and from 17 sera without detectable anti-insulin antibodies. These insulin-free samples were then spiked with RI and RAAs and the immunoreactivity was determined. RESULTS: Compared with buffer, cross-reactivity in serum for RI, lispro and aspart was lower (35%, 29% and 26% lower, respectively). Hemolysis degraded almost all RI and RAAs contained in the serum (>or=95%). Anti-insulin antibody interference was significant for RI and RAAs (p相似文献   

血常规标本存放条件对血细胞计数的影响

目的 探讨血常规标本存放条件对检测结果的影响.方法 所有全血标本室温或4 ℃条件下存放,连续5 d应用Sysmex KX-21全自动血细胞分析仪进行检测,并进行统计学分析.结果 室温下存放标本,白细胞(WBC)于48 h、红细胞(RBC)于96 h、血小板(PLT)于24 h、血红蛋白(Hb)于120 h、血细胞比容(...     

肝硬化患者红细胞膜抗溶性增强对淋巴细胞亚群检测的干扰及纠正

目的探讨肝硬化患者标本抗溶性增强条件下淋巴细胞亚群检测时标本制备的最佳溶血条件。方法用不同剂量的溶血素在不同溶血时间处理34例抗溶性增强的肝硬化患者标本,观察在不同溶血条件下流式细胞仪获取的前向散射光(FSC)和侧向散射光(SSC)下白细胞散点图的清晰程度,同时测定T淋巴细胞、B淋巴细胞和自然杀伤(NK)细胞的百分比。结果肝硬化患者红细胞膜抗溶性增强,采用溶血素用量为1 350μL、溶血时间为10min淋巴细胞分群效果较好。结论制备肝硬化患者淋巴细胞亚群标本时,增加溶血素用量,检测结果的准确性增强。     

ELISA法检测抗-HIV结果影响因素的研究

目的探讨标本中溶血、脂血、血液保存液对抗-HIV ELISA法检测结果的影响。方法采用模拟对照实验,用溶血、脂血、血液保存液和小牛血清分别对抗-HIV阳性质控血清进行系列梯度稀释,用ELISA法检测,观察溶血、脂血、血液保存液对检测结果的影响。结果含有血液保存液的抗-HIV阳性质控血清的检测结果均明显低于小牛血清对照组(P<0.01),且在60%稀释度内,随血液保存液浓度逐步增加,降幅有加大趋势;而溶血、脂血对抗-HIV阳性质控血清的检测结果影响差异无统计学意义(P>0.05)。结论血液保存液对ELISA法检测抗-HIV结果影响明显;而溶血、脂血对抗-HIV ELISA法检测结果无影响。     

标本溶血对电化学发光免疫法结果的影响

目的探讨标本不同程度溶血对电化学发光免疫法(ECLIA)测定结果的影响。方法将血液标本人为干预成不同程度的溶血标本,使用ECLIA检测各组标本中的甲状腺功能、肿瘤标志物、内分泌激素等共28项指标的浓度并做分析。结果标本溶血可使胰岛素(INS)浓度降低,使叶酸(FA)、神经元特异性烯醇化酶(NSE)浓度升高,重度溶血有使铁蛋白测定结果偏高的趋势,但差异无统计学意义,其余指标测定结果不受溶血的影响。结论除某些项目外大部分溶血标本的ECLIA测定结果没有受到影响。测定INS、FA、NSE时应绝对避免使用溶血标本,以确保结果准确。     

溶血标本对48项生化检验结果的影响

目的探讨标本溶血对生化检验结果的影响,为检验人员和临床医生对溶血标本的生化检验结果进行正确的分析提供依据。方法取未溶血标本的血清进行48项生化项目检验,然后经搅拌使标本发生轻度溶血、中度溶血、重度溶血,3 000r/min离心10min,进行相同的生化项目检验,对未溶血、轻度溶血、中度溶血及重度溶血标本的检验结果进行统计分析。结果轻度溶血血清测定中共有16项结果与未溶血标本比较差异有统计学意义(P0.05);中度溶血与未溶血标本检验结果的比较有25项差异有统计学意义(P0.05);重度溶血标本检验有28项结果与未溶血标本比较差异有统计学意义(P0.05)。结论标本溶血对大部分生化检验项目的结果可产生显著性影响,在生化检测分析中遇到标本溶血但又必须报告时应在报告单上注明,提醒医师和患者引起注意;分析引起标本溶血的原因,避免溶血现象的发生,保证检验结果的真实、准确。     

Hemolytic activity of leukemic sera: the role of complement and sucrose

In sera of patients with acute myeloblastic leukemia (AML), hemolytic activity can be demonstrated in vitro in the presence of sucrose. To investigate the nature and the mode of action of this hemolytic activity, serum samples from 24 patients with AML were studied by incubation of normal human erythrocytes together with patient serum in the presence of sucrose at low ionic strength (inverse sucrose hemolysis test, ISHT). Fifty-five percent of the serum samples collected during the active stage of the disease gave a hemolysis rate of greater than 4%, whereas in remission only 15% of the samples lysed erythrocytes. Substitution of raffinose, lactose, or polyethylene glycol 400 for sucrose resulted in an almost complete failure of hemolysis under standard conditions, indicating a minor role of the low ionic strength in the ISHT. Heat inactivation, preincubation with inulin, and addition of EDTA, Mg2+-EGTA, or heparin completely abolished hemolytic activities of AML sera when the incubation was carried out for 30 minutes (standard conditions of the ISHT). A prolongation of the incubation time resulted in delayed hemolysis only with the Mg2+-EGTA-treated AML sera. The kinetics of this hemolysis by Mg2+-EGTA-treated AML sera were similar to those of normal human serum in the presence or absence of Mg2+-EGTA. Hemolysis was also obtained by performing the ISHT with normal sera and erythrocytes preincubated with AML sera. These observations suggest a mediation of membrane modification of normal human erythrocytes by AML sera in the presence of sucrose, resulting in an activation of the classical pathway of complement.     

Monoject Samplette capillary blood container with serum separator evaluated for collection of specimens for therapeutic drug assays and common clinical-chemical tests

The Monoject Samplette (Sherwood) capillary serum-separator tube was evaluated for use in pediatric capillary blood collection. When patients' values for eight common clinical-chemical tests and five therapeutic drugs were compared with values from specimens concomitantly collected in plain Caraway tubes, only chloride and total CO2 were significantly different. The chloride differences (range 0-2 mmol/L) were considered to be clinically insignificant. Higher CO2 values in Samplette specimens were apparently ascribable to decreased loss to the atmosphere. Samplette values for therapeutic drugs were higher than corresponding Caraway values, but only the differences for digoxin were judged to be clinically significant. Both recoverable serum and the incidence of hemolysis were lower in Samplette specimens than in Caraway specimens. Storage of serum over the clots (with separator material interposed) in Samplettes for 24 h had no clinically significant effect on results for glucose or potassium. Storage of specimens for as long as 24 h had no effect on theophylline, phenytoin, and gentamicin concentrations, but phenobarbital reproducibly decreased after 24 h. We conclude that the Samplette serum-separator tube is suitable for the collection of capillary blood for many of the chemical tests commonly ordered for pediatric patients.