不同溶血程度标本对生化指标检测结果的影响及对策

目的探讨不同溶血程度的血清标本对生化指标检测结果的影响及对策。方法抽取我院48例健康体检者血液标本6ml分别置于2支试管中(每支3.0ml)。其中1支标本采用人工方法使其溶血,采用血细胞分析仪测定其血清血红蛋白(Hb)的含量作为判定溶血的程度(Hb 3.0g/L与Hb6.0g/L);采用全自动生化分析仪检测正常标本和溶血标本血清中谷丙转氨酶(ALT)、谷草转氨酶(AST)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBD)、总胆固醇(CHOL)、甘油三酯(TG)、肌酐(Scr)、葡萄糖(GLU)、血尿酸(SUA)、肌酸激酶(CK)、总胆红素(TB)、直接胆红素(DB)、总蛋白(TP)、白蛋白(ALB)、钾(K+)离子、Ca2+等16项生化指标的含量并进行比较。结果溶血标本的AST、LDH、α-HBD、CK、TP、ALB、TB、DB、K+测定结果明显高于正常血清标本,差异有统计学意义(P<0.05～0.01);溶血程度为Hb 6.0g/L时AST、LDH、α-HBD、CK、TP、ALB、TB、DB、KI+各指标的测定结果明显高于Hb 3.0g/L时的测定值,差异有统计学意义(P<0.05～0.01);Scr和GLU的测定值随溶血程度严重而明显降低,差异有统计学意义(P<0.05～0.01);溶血对ALT、CHOL、TG、SUA、Ca2+等指标的测定结果影响较小,差异无统计学意义(P>0.05)。结论溶血是临床生化检验中最常见的一种影响因素。临床检验工作中应采取一切可能的措施避免标本发生溶血,如发生了标本溶血,可设置样品空白及双波长或双试剂以减少影响,必要时重新采集标本。

Effects and countermeasures of test results with different degrees of sera hemolysis on determination of biochemical indexes

Objective To explore the effects and countermeasures of test results with different degrees of sera hemolysis on determination of biochemical indexes.Methods 48 cases of blood samples were collected from the healthy check-up in our hospital from 6.0mL respectively in two test tubes(each 3.0mL).The specimen used artificial method to make the hemolysis.The serum hemoglobin(Hb) contents as the extent of the judge hemolysis(Hb3.0g/L and Hb6.0g/L) which was determined by the blood cells analyzer.The content and compare of 16 biochemical indexes of normal sera and hemolysis sera were determined by the automatic biochemistry analyzer,such as alanine aminotransferase(ALT),aspertate aminotransferase(AST),lactate dehydrogenase(LDH),α-butyric acid dehydrogenase(α-HBD),total cholesterol(CHOL),triglycerides(TG),creatinine(Scr),glucose(GLU),blood uric acid(SUA),creatine kinase(CK),total bilirubin(TB),direct bilirubin(DB),total protein(TP),albumin(ALB),K+ and Ca2+.Results Hemolysis specimens as AST,LDH,α-HBD,CK,TP,ALB,TB,DB,K+ were obviously higher than normal serum samples and the difference was statistically significant(P<0.05~0.01).The measured results in Hb6 g/L hemolysis degree of AST,LDH,α-HBD,CK,TP,ALB,TB,DB,K+ were significantly higher than that of the Hb3g/L and the difference was statistically significant(P<0.05~0.01).The determination of Scr and GLU was seriously reduced with hemolysis degree and the difference was statistically significant(P<0.05~0.01).The measured results of ALT,CHOL,TG,SUA,Ca2+ were less influence with hemolysis and the difference was not statistically significant(P>0.05).Conclusions Hemolysis was the most common factors of the clinical biochemistry examines.Clinical inspection work should be taken all possible measures to avoid the specimen which hemolysis happens.If the hemolysis happens,the sample can be set to blank and double wavelength or double reagent to reduce impact.If necessary,we should do specimens re-collection.