肝素抗凝血浆在临床化学检测中的应用

目的探讨肝素在不同抗凝浓度下对临床化学检测指标的影响。方法模拟临床工作中出现的4种肝素浓度抗凝血浆与血清标本在相同条件下配对检测27项临床化学指标。结果肝素不同抗凝浓度血浆与血清比较:总蛋白(TP)、白蛋白(ALB)、总胆汁酸(TBA)、葡萄糖(GLU)、碱性磷酸酶(ALP)、肌酐(Cr)、直接胆红素(D-Bil)和尿酸(UA)无影响或在肝素正常抗凝浓度下(肝素浓度<20 U.ml-1血液)无影响(P>0.05);丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(-γGT)、乳酸脱氢酶(LDH)、胆碱酯酶(CHE)、α-羟丁酸脱氢酶(-αHBDH)、α淀粉酶(-αAmy)、肌酸激酶(CK)、肌酸激酶同功酶-MB(CK-MB)、总胆红素(T-Bil)、前白蛋白(P-AlB)、总胆固醇(T-CHO)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-Cho)、载脂蛋白A1(ApoA1)、载脂蛋白B100(ApoB100)、糖化血清蛋白(GSP)、D-3羟丁酸(D3)和尿素(Urea)等19项生化指标均有显著性差异(P<0.05~P<0.01)。结论TP、ALB、TBA、GLU、ALP、Cr、D-Bil和UA的化学检测可使用肝素抗凝血浆,但需建立正常参考范围使结果具有可朔源性;目前条件下ALT、AST、-γGT、LDH、CHE、-αHBDH、-αAmy、CK、CK-MB、T-Bil、P-ALB、T-CHO、TG、HDL-Cho、ApoA1、ApoB100、GSP、D3和Urea运用肝素有局限性。

Effects of plasma with different concentration of heparin on indexes of clinical chemistry

Objective To study the effects of plasma with different concentration of heparin on indexes of clinical chemistry.Methods Twenty-seven kinds of indexes of clinical chemistry in serum with 4 different concentration of anticoagulant heparin to be used clinically were detected.Results Comparisons were made on 27 kinds of indexes of clinical chemistry between serum and plasma of different concentration of heparin.The results showed that TP,ALB,TBA,GLU,ALP,Cr,D-Bil and UA had no significantly difference between serum and plasma of 5 kinds of concentration of heparin or normal concentration(no more than 20 U·ml~(-1) heparin)(P>0.05),while ALT,AST,γ-GT,LDH,CHE,α-HBDH,α-Amy,CK,CK-MB,T-Bil,P-ALB,T-CHo,TG,HDL-Cho,ApoA1,ApoB100,GSP,Urea and D3 had significantly difference(P<0.05 or P<0.01).Conclusion The TP,ALB,TBA,GLU,ALP,Cr,D-Bil and UA levels may be detected by using the plasma samples with the different concentration of heparin,but their test should be performed at the basis of establish of normal reference limits.The test of ALT,AST,γ-GT,LDH,CHE,α-HBDH,α-Amy,CK,CK-MB,T-Bil,P-ALB,T-CHO,TG,HDL-Cho,ApoA1,ApoB100,GSP,D3 and Urea levels are limited by using heparin.