6项临床化学指标适用血浆样本类型的研究

目的 研究不饱和铁结合力（UIBC）、β-羟丁酸（β-HB）、肌红蛋白（MYO）、丙氨酸氨基转移酶（ALT）、铁（Fe）和磷（P）试剂盒可接受的血浆样本类型.方法 使用血清、肝素血浆和EDTA血浆采血管,收集研究对象静脉血样本.样本离心处理后,在BS-800全自动生化分析仪上,分别检测血清和血浆样本中UIBC,β HB,MYO,ALT,Fe和P的水平,并对血清和血浆样本结果进行统计学分析.结果 血清样本组UIBC,β HB,MYO测定结果（34.4±9.8 μmol/L,0.41±0.92mmol/L和48.0±21.6 ng/ml）与肝素血浆样本组（34.6±10.2 μmol/L,0.41±0.92 mmol/L和46.7±20.1 ng/ml）比较差异无统计学意义（t=0.77, 0.88和1.33,P均＞0.05）,血清样本组MYO测定结果（113.2±118.0 ng/ml）和EDTA血浆样本组（113.0±116.3 ng/ml）比较差异无统计学意义（t=0.25,P＞0.05）.血清样本组ALT,Fe和P测定结果（76.9±155.7 U/L,17.7±16.3 μmol/L和1.14±0.15 mmol/L）与肝素血浆样本组（76.3±155.8 U/L,17.9±16.3 μmol/L和1.11±0.15 mmol/L）比较差异有统计学意义（t=2.99,-2.25和5.61,P均＜0.05）,血清样本组P测定结果（1.14±0.15mmol/L）和EDTA血浆样本组（1.09±0.14 mmol/L）比较差异有统计学意义（t=13.46,P＜0.05）.但血清和肝素血浆ALT,Fe和P测定结果,及血清和EDTA血浆P测定结果均呈正相关（相关系数分别为0.999 9,0.999 0,0.987 5和0.9936,P均＜0.01）,在医学决定水平处的偏差（4.2％-3.2％）均小于允许误差的50％.结论 肝素血浆样本类型适用于UIBC,β HB,MYO,ALT,Fe和P试剂盒的测定,EDTA血浆样本类型适用于MYO和P的测定.

Study on the Appropriate Plasma Sample Types of Six Clinical Chemistry Indexes

Objective To study the acceptable plasma sample types of UIBC,β HB,MYO,ALT,Fe and P kits.Methods Col lected venous blood samples from objects,using serum,heparin plasma and EDTA plasma tubes,and measured the level of UIBC,β HB,MYO,ALT,Fe and P in the centrifuged serum and plasma samples on the BS-800 automatic biochemistry ana lyzer.Last performed statistical analysis between the serum and plasma groups.Results For UIBC,β HB and MYO,the re sult difference between the serum （34.4± 9.8 μmol/L,0.41 ± 0.92 mmol/L and 48.0 ± 21.6 ng/ml） and heparin plasma groups （34.6 ± 10.2 μmol/L,0.41 ± 0.92 mmol/L and 46.7 ± 20.1 ng/ml） was not statistically significant （t=0.77,0.88 and 1.33,P＞0.05）.For MYO,the result difference between the serum （113.2 ± 118.0 ng/ml） and EDTA plasma groups （113.0 ± 116.3 ng/ml） was not statistically significant （t=0.25,P＞ 0.05）.For ALT,Fe and P,the result difference between the serum （76.9 ± 155.7 U/L,17.7 ± 16.3 μmol/L,1.14 ± 0.15 mmol/L） and heparin plasma groups （76.3 ± 155.8 U/L,17.9±16.3 μmol/L,1.11±0.15 mmol/L） was statistically significant （t=2.99,2.25 and 5.61,P＜0.05）.For P,the result difference between the serum （1.14±0.15 mmol/L） and heparin plasma groups （1.09±0.14 mmol/L） was statistically significant （t=13.46,P＜0.05）.However,the results of serum ALT,Fe and P were positively correlated with heparin plasma groups,the results of serum P were positively correlated with EDTA plasma groups （the four correla tioncoefficients were0.999 9,0.999 0,0.987 5 and0.993 6,respectively,P＜0.01）,and the biases （4.2％-3.2％） at the medical decision levels were less than 50 percent of the allowable error.Conclusion Heparin plasma type can be used for the tests of UIBC,β HB,MYO,ALT,Fe,and P kits,and EDTA plasma type can be used for the tests of MYO and P kits.