血脂相关指标测定方法的比较研究

目的对比研究肝素抗凝、方法选择等因素对血脂指标测定值的影响。方法⑴随机抽样体检者130人,采血后离心分离血浆(肝素抗凝)和血清。按试剂盒方法(直接法),分别测定两组的甘油三酯(TG),总胆固醇(TC),低密度脂蛋白胆固醇(LDL-C),高密度脂蛋白胆固醇(HDL-C),载脂蛋白A(ApoA),载脂蛋白B(ApoB)等指标,并对两组差异进行统计性分析。⑵随机抽样心血管患者320人,按直接法测定血清TG,TC,LDL-C,HDLC,ApoA,ApoB等指标。将患者分为TG<1.5mmol/L(n=170),1.5≤TG<2.5mmol/L(n=96),2.5≤TG<3.5mmol/L(n=29),3.5≤TG<4.5mmol/L(n=10),TG≥4.5mmol/L(n=15)等5组,根据Friedewald、Planella公式,分别计算两组的LDL-C值,并与直接法比较统计学差异。结果⑴血浆、血清测定指标中,TG分别为2.63±2.03mmol/L,2.56±2.06mmol/L,P<0.05;TC,LDL-C,HDLC,ApoA,ApoB相互比较,P>0.05。⑵Friedewald公式所得的5组LDL-C值与直接法比较,P<0.01;Planella公式所得的5组LDL-C值与直接法比较,P>0.1,P<0.01,P<0.002,P<0.01,P>0.05。结论直接法测定TC,LDL-C,HDLC,ApoA,ApoB时,可用肝素抗凝的血浆替代血清,但直接法测定TG及公式法计算LDL-C时不能替代;Friedewald、Planella公式计算LDL-C误差较大,TG<1.5mmol/L时可采用Planella公式,TG>1.5mmol/L时建议采用直接法。

The comparative studies on the measurement methods for blood lipids

Objective The effects of some factors,including plasma (anticoagulated with heparin) or serum,formula methods or direct methods,on the blood lipids measurement were studied comparatively. Methods ⑴130 healthy people were selected randomly,their fasting blood was collected,their plasma (anticoagulated with heparin) and serum were separated. The plasma and serum were used to measure some lipids respectively,including triglyceride (TG),total cholesterol (TC),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDLC),apolipoprotein A (ApoA) and apolipoprotein B (ApoB),according to kit specifications (called direct methods). ⑵ 320 patients with cadiovascular diseases were selected randomly,their TG,TC,LDL-C,HDLC,ApoA and ApoB were measured according to kit specifications. The patients were divided into 5 groups,including TG<1.5mmol/L(n=170),1.5≤TG<2.5mmol/L(n=96),2.5≤TG<3.5mmol/L(n=29),3.5≤TG<4.5mmol/L(n=10) and TG≥4.5mmol/L(n=15). LDL-Cs were calculated according to Friedewald formula and Planella formula,respectively. The differences between these LDL-Cs and serum LDL-Cs from direct methods were analysed. Results ⑴In the groups of plasma and serum,TG were 2.63±2.03,2.56±2.06 mmol/L,respectively,P<0.05; While TC,LDL-C,HDLC,ApoA and ApoB were compared between the two groups,P>0.05. ⑵In the 5 groups of TG,while compared LDL-Cs calculated from Friedewald formula and that resulted from direct methods,P<0.01; While compared LDL-Cs from Planella formula with that from direct methods,P>0.1,P<0.01,P<0.002,P<0.001,P>0.05. Conclusions Plasma (anticoagulated with heparin) can be used to replace serum when TC,LDL-C,HDLC,ApoA and ApoB were measured,whereas it can not do when TG was measured; Planella formula can be used to calculate blood lipids when TG<1.5mmol/L,whereas direct methods were recommended to measure blood lipids when TG>1.5mmol/L instead of Friedewald or Planella formula because of their errors.