肝素锂抗凝血浆与血清中常规生化检测结果一致性探讨

为探讨肝素锂抗凝血浆与血清中常规生化检测结果的一致性,分析肝素锂抗凝血浆能否替代血清进行常规生化检测,避免由于标本类别的不同而影响检验结果的准确性。应用日立H7600-20全自动生化分析仪对随机抽取的111例病人肝素锂抗凝血浆和血清中35项生化项目进行测定。结果表明,在肝素锂抗凝血浆与血清的35项生化项目结果中,ALB、GGT、TBA、TBIL、CL、Ca、Mg、CRE、BUN、UA、CysC、β2-MG、CK、CK-MB、LDH和HDL-C共16项结果无显著性差异（P＞0.05）,而Na、K、CO2、P、Fe、ALT、AST、ALP、TP、PA、AFU、TG、TCHO、LDL-C、ApoA1、ApoB、Lp（a）、GLU、DBIL共19项结果有显著性差异（P＜0.05）。研究表明,肝素锂抗凝血浆与血清中35项常规生化项目结果并不完全一致,检验科在常规生化项目测定时应首选血清。     

肝素抗凝血浆在急诊生化检验的应用研究

目的探讨肝素抗凝血浆用于急诊生化检验的可行性及原因分析。方法以2011年7月至2012年7月就诊于我院的50例门诊急诊患者作为研究对象,按照常规方法每人抽取血液4ml,不含抗凝剂管的2ml血液作为对照管,含肝素抗凝剂管的2ml血液作为实验管。两组试管经离心处理分离出血清、血浆后,采用OLYMPUSAU640全自动生化分析仪进行分析,同时测定50例急诊患者的肝素抗凝血浆和血清的15项急诊生化指标。每次测定重复三次,取平均值进行比较。结果经统计学分析得知,患者血清和血浆中钠、氯、钙、镁、葡萄糖、尿素、肌酐、谷丙转氨酶、谷草转氨酶、肌酸激酶、尿酸等11项生化指标的结果无显著性差异(P>0.05),而钾、磷、二氧化碳以及总蛋白等4项生化指标的结果有显著性差异(P<0.05)。结论肝素钠的抗凝能力强且不易溶血,还可以减少放置误差,分离血浆的速度也相当快。而且大部分生化指标都与血清相同,因而肝素钠抗凝血浆可替代血清作为标本,用于大部分临床生化项目的测定,特别适合急诊生化项目测定。但钾、磷、二氧化碳和总蛋白等项目应根据临床做出调整。     

肝素抗凝血浆在急诊生化检验的应用研究

目的探讨肝素抗凝血浆用于急诊生化检验的可行性及原因分析。方法选择本院就诊的50例门诊急诊患者,按照常规方法每人抽取4ml的血液,分别注入两支试管内,一支不含抗凝剂管2ml血液,另一支含肝素抗凝剂管2ml血液,轻轻充分摇晃均匀,经离心后分别检测血清、血浆。使用自动生化分析仪测定,全部采用原装配套试剂,每次测定重复两次,结果取平均值。结果40例患者中的氯、钠,钙、二氧化碳、钾、尿素在血清、血浆中的浓度基本一致。血浆钾的平均浓度低于血清钾的平均浓度,差异具有统计学意义（P〈0．01）。经回归分析和校正,血清葡萄糖低于血浆葡萄糖,差异具有统计学意义（P〈0．05）。结论肝素抗凝可以避开血液的凝固过程,能尽快分离标本,减少溶血的产生。血浆钾的测定值更可以反映出体内的真实情况,可用于急诊的生化检验分析,为纠正钾浓度的差异性,提供更准确和迅速的检验依据。     

肝素抗凝血浆用于检测十项酶活力生化指标研究分析

目的研究分析肝素抗凝血浆用于检测十项酶活力生化指标的结果,总结其临床价值。方法选取我院2009年5月至2011年5月154例受检者的静脉血标本,分为血清组和血浆组,进行十项酶活力生化指标检测,观察比较2组检测结果。结果 2组检测结果中,AFU、GGT、LDH比较有一定差异(P<0.05),具有统计学意义;其余7项检测结果比较均无明显差异(P>0.05),无统计学意义。结论使用肝素抗凝血浆能够满足临床急诊生化检验的需求,具有重要的临床应用价值。     

肝素抗凝血浆用于生化检验的可行性

目的:探讨肝素抗凝血浆在生化检验中是否可行.方法:选取2016年1月—2017年1月期间在我院就诊的76例急诊患者,抽取患者的静脉血,随机分成血清组和肝素抗凝血浆组,各38例.采取全自动生化分析仪对其10项急诊生化项目进行测定,并对检验结果进行分析.结果:肝素抗凝血浆组中钾离子浓度低于血清组,差异具有统计学意义(P<0.05).肝素抗凝血浆组中葡萄糖浓度高于血清组,差异具有统计学意义(P<0.05).肝素抗凝血浆组中钠离子、氯离子、钙离子、镁离子、肌酐、尿素氮、丙氨酸转氨酶、天冬氨酸转氨酶浓度与血清组比较,差异无统计学意义(P>0.05).结论:证实了肝素抗凝血浆在生化检验中的可行性,肝素抗凝血浆用于急诊生化检验速度相对要快,且结果准确,在临床上的应用价值较高,但在检验中应该注意钾离子、葡萄糖的差异.     

分析肝素抗凝血浆在生化检验中的可行性

目的分析肝素抗凝血浆在生化检验中的可行性。方法选取在2016年1月至2017年12月来我院进行体检的健康志愿者150例进行研究,将抽取的静脉血样本分别注入到干燥消毒后的真空试管和抗凝试管中,对所有志愿者进行生化检验,比较血清和血浆检测结果。结果血清检测结果和血浆检测结果中钾离子、钠离子、氯离子、葡萄糖有显著差异(P<0.05),其他如钙离子、镁离子、尿素氮、肌酐、磷酸肌酸激酶等水平两组检测结果无显著差异(P>0.05)。结论肝素抗凝血浆在生化检验中的可行性较高,可以有效抑制血溶现象的产生、防止放置、分离等造成的检验结果误差产生,在生化检验中存在明显优势。     

肝素抗凝血浆在生化检验中的应用价值

目的探讨生化检验时肝素抗凝血浆的应用效果。方法选取2014年5月—2015年5月自愿受试的生化检验患者100例作为研究对象,均采血6 ml,注入真空肝素抗凝血浆试管作为血浆组、注入真空普通试管作为血清组,分别行生化分析。测定对比两组K+、CK-MB、Na+、CK、CI-、LPS、CO2、LDH、GLU、CR等水平。计量资料采用t检验,P0.05为差异有统计学意义。结果血浆组K+、CO2、LDH、Na+、GLU水平分比为(3.81±0.33)、(22.87±2.86)mmol/L、(165.4±35.27)U/L、(137.76±3.33)、(5.28±1.35)mmol/L,与血清组的(4.08±0.34)、(24.30±2.51)mmol/L、(178.5±28.73)U/L、(135.92±3.21)、(4.67±1.31)mmol/L比较差异均有统计学意义(均P0.05)。血浆组LPS、CI-、CK-MB、CR、CK分别为(96.34±29.19)U/L、(102.00±2.59)mmol/L、(14.02±4.84)U/L、(57.49±7.30)μmol/L、(150.81±41.70)U/L,与血清组的(96.21±29.30)U/L、(101.91±2.50)mmol/L、(14.09±4.83)U/L、(57.48±7.31)μmol/L、(150.71±41.81)U/L比较差异均无统计学意义(均P0.05)。结论临床检验主要标本目前仍为静脉血清,但因各种因素均可对标本产生影响,故检测的数据并非均可作为临床诊断疾病参考的准确依据,取肝素抗凝血浆应用,可使检验过程时效性、准确性提高,在生化检测中,此技术具有较高可行性,需引起各级部门的重视。     

肝素抗凝血浆用于急诊生化检验的可行性分析

目的探讨肝素抗凝血浆用于急诊生化检验的可行性。方法选取我院2012年1月—2013年1月100例患者,对其血清及肝素抗凝血浆进行10项急诊生化项目检测,分析对比其含量差别。结果其中钠离子,葡萄糖存在明显差异具有统计学意义(P<0.05),而钾离子差异更为明显(P<0.01),其余指标并不存在明显差异性。结论肝素抗凝血浆在对10项生化急诊项目进行检验时比较合理,且检测速度较快,钾离子浓度差较为恒定,可以进行纠正。     

探讨干化学法检测肝素抗凝血浆用于急诊生化检验的可行性

目的：探讨干化学法检测肝素抗凝血浆用于急诊生化检验的可行性。方法：从我院的2012年3月到2013年3月接收的200例急诊患者随机的抽取100名患者，检测急诊患者的肝素抗凝血浆以及血清标本23项指标，利用统计学的方法对检测结果进行分析。结果：23项检测结果中包括清蛋白、钙、镁、乳酸脱氢酶、天门冬氨酸氨基转移酶（AST）等的检测结果差异具有统计学的意义，ALT、AST两项检测数据的结果差异较大不能被临床接受，其余项目误差均在可接受的范围之内。结论：干化学法检测肝素抗凝血浆浆可以用于急诊化验中，这种方法可以避免凝块的产生，可以快速的分离凝浆。     

某装饰公司油漆接触人员血常规和血清生化指标分析

目的探讨装饰公司油漆接触人员血常规和血清生化指标情况。方法选择2018年3月—2019年2月某装修公司油漆接触人员150人,设为接触组。接触组与未接触组均于体检当天空腹取静脉血3 mL,分别检测血常规、血清生化指标并比较。结果两组白细胞、中性粒细胞、淋巴细胞、尿素氮、肌酐水平差异无统计学意义(P>0.05);接触组Hb、TBIL、MCHC水平低于未接触组,差异有统计学意义(P<0.05);接触组血小板水平、RBC、ALT、GGT、白蛋白及球蛋白水平均高于未接触组,差异有统计学意义(P<0.05)。结论装饰公司员工长期油漆接触会对人体血红蛋白、肝功能水平产生明显的影响,应加强防护以改善健康水平。     

Feasibility of Routine Quality of Life Measurement for People Living With Dementia in Long-Term Care

ObjectivesMaximizing quality of life (QoL) is the ultimate goal of long-term dementia care. However, routine QoL measurement is rare in nursing home (NH) and assisted living (AL) facilities. Routine QoL measurement might lead to improvements in resident QoL. Our objective was to assess the feasibility of using DEMQOL-CH, completed by long-term care staff in video calls with researchers, to assess health-related quality of life (HrQoL) of NH and AL residents with dementia or other cognitive impairment.DesignCross-sectional study.Setting and ParticipantsWe included a convenience sample of 5 NHs and 5 AL facilities in the Canadian province of Alberta. Forty-two care staff who had worked in the facility for ≥3 months completed DEMQOL-CH assessments of 183 residents who had lived in the facility for 3 months or more and were aged ≥65 years. Sixteen residents were assessed independently by 2 care staff to assess inter-rater reliability.MethodsWe assessed HrQoL in people with dementia or other cognitive impairment using DEMQOL-CH, and assessed time to complete, inter-rater reliability, internal consistency reliability, and care staff ratings of feasibility of completing the DEMQOL-CH.ResultsAverage time to complete DEMQOL-CH was <5 minutes. Staff characteristics were not associated with time to complete or DEMQOL-CH scores. Inter-rater reliability [0.735, 95% confidence interval (CI): 0.712-0.780] and internal consistency reliability (0.834, 95% CI: 0.779-0.864) were high. The DEMQOL-CH score varied across residents (mean = 84.8, standard deviation = 11.20, 95% CI: 83.2-86.4). Care aides and managers rated use of the DEMQOL-CH as highly feasible, acceptable, and valuable.Conclusions and ImplicationsThis study provides a proof of concept that DEMQOL-CH can be used to assess HrQoL in NH and AL residents and provides initial indications of feasibility and resources required. DEMQOL-CH may be used to support actions to improve the QoL of residents.     

Effect of Repeated Freezing and Thawing on Biomarker Stability in Plasma and Serum Samples

Objectives

The stability of circulating proteins can be affected by repeated freezing and thawing. The aim of our study was to identify the effect of repeated freezing and thawing on the plasma and serum concentrations of eight proteins [interferon-γ, interleukin (IL)-8, IL-15, IL-17A, matrix metalloproteinase (MMP)-7, tumor necrosis factor-α, vascular endothelial growth factor (VEGF), and VEGF receptor 2 (VEGF-R2)].

Methods

We assessed the concentration changes of these proteins in 30 plasma and serum samples subjected to three, four, or five freeze–thaw cycles, and compared these with the concentration changes in the samples that were subjected to two freeze–thaw cycles before analysis.

Results

Repeated freezing and thawing by up to five cycles did not modify the plasma and serum concentrations of interferon-γ, IL-8, and VEGF-R2, while levels of MMP-7, tumor necrosis factor-α, and VEGF were significantly changed in both plasma and serum samples. Moreover, MMP-7 and VEGF concentrations tended to increase with freeze–thaw cycles. They were more elevated in plasma samples (up to about 15%) than in serum samples (up to about 7%), suggesting that serum is the preferred sample type for the analysis of circulating proteins.

Conclusion

This is the first report on the effect of repeated freezing and thawing on plasma concentrations of MMP-7 and VEGF-R2. Our findings propose that researchers should consider the number of freeze–thaw cycles to select plasma or serum samples, depending on the type of analyte.     

急诊生化检测样本周转时间分析与改进

目的 探讨急诊生化样本周转时间对急诊生化报告时间的影响.方法 分析解放军总医院急诊生化检验标本样本周转时间（TAT）,分为3个时间段TAT1、TAT2和TAT3,并进行比对.结果 住院急诊生化样本3个时间段的平均时间分别是798.3分钟、111.8分钟和104.9分钟.门诊急诊生化样本3个时间段的平均时间分别是105.0分钟、35.0分钟和72.7分钟,其中TAT1时间最长,而且住院急诊病人的TAT1是门诊病人的7倍多,占整个TAT中最大比例.结论 优化标本运送流程和提高参与人员的责任心,增强检验科与临床科室的联系和沟通,可以有效降低TAT,确保危重病患者得到及时治疗.     

Comparison of Solvent/Detergent-Inactivated Plasma and Fresh Frozen Plasma under Routine Clinical Conditions

Background: Reduced levels of protein S (PS) and alpha(2)-antiplasmin alpha(2)-AP) in solvent/detergent virus-inactivated plasma (S/D-VIP) might induce an imbalance of plasma coagulation factors and inhibitors in patients transfused. We investigated 40 patients (23 fresh frozen plasma (FFP), 17 S/D-VIP, random distribution by a list calculated by statisticians) who suffered from dilution coagulopathy, liver disease, disseminated intravascular coagulation (DIC), polytrauma or were connected to extracorporeal circulation. Study Design and Methods: The following markers of activated coagulation (MAC) were measured: Prothrombin fragment F1+2 (F1+2), fibrin monomers (FM), D-dimers (DD), thrombin-antithrombin (TAT) and plasmin-antiplasmin (PAP) complexes as well as fibrinogen degradation products (FgDP), and additionally antithrombin III (antithrombin), protein C (PC), PS and alpha(2)-AP. Blood was taken only just before and 1 h after the first plasma replacement (2 units). No additional blood products were transfused before the second blood withdrawal. Pre- and posttransfusion (pre/post) values of all parameters measured were compared within the same group and between both groups. Statistical evaluation of the data was done by Wilcoxon's paired test for data in the same plasma group and by the test of Mann and Whitney for data comparison between both plasma groups. Results: Average pretransfusion values of all inhibitors for both plasma groups were in the same range and increased after transfusion, except for PS in both groups. Whereas the pre/post values did not differ significantly in the FFP group, antithrombin (p = 0.02), PC (p = 0.0005), and alpha(2)-AP (p = 0.02) showed a significantly higher increase in the S/D-VIP group. Considering the pre/post differences between both plasma groups, there were no significant differences. The same was true for MAC measured pre- and posttransfusion. Conclusion: Data showed no significant difference between both plasma groups, indicating that S/D-VIP plasma behaves as FFP under the study conditions employed. Copyright 2000 S. Karger GmbH, Freiburg