血清DBIL、IBIL对选择性抑制法测定HDL-C浓度的影响

目的:探讨直接胆红素(DBIL)和间接胆红素(IBIL)对选择性抑制法(PPD)测定血清高密度脂蛋白胆固醇(HDL-C)浓度的影响程度。方法:制备不同浓度的DBIL (5.0、17.5、40.5、70.0、102.0μmol/L)、IBIL (5.0、17.0、40.0、71.5、104.0μmol/L)混合血清,且根据HDL-C含量分为高(2.54±0.22) mmol/L]、中(1.10±0.15) mmol/L]、低(0.50±0.08) mmol/L]3组,其中DBIL、IBIL均在日立7170A上检测;而每种血清标本中HDL-C均经PPD法和磷钨酸镁沉淀(PTA-Mg2+)法检测。结果:DBIL的干扰较为复杂,正常DBIL浓度范围的血清标本,PPD法测定结果为假性增高;DBIL浓度超过20.0μmol/L时所测结果均表现为降低;DBIL浓度达120.0μmol/L时HDL-C高、中、低3组标本中HDL-C偏差分别为-46.29%、36.89%、-22.73%。IBIL的干扰较小,当IBIL浓度达104.0μmol/L时各组偏差都在-5.0%以内。结论:临床实验室采用PPD法检测HDL-C时,当待检标本DBIL浓度高于40.0μmol/L时应稀释后再测定或通过其他实验方法消除DBIL的干扰。

Influence of direct bilirubin and indirect bilirubin on the determination of high-density lipoprotein cholesterol polyanion with polymer/detergent method

Objective：To study the influence of direct bilirubin （DBIL） and indirect bilirubin （IBIL） on the determination resuh of serum high-density lipoprotein cholesterol（HDL-C） polyanion by polymer/detergent （PPD） method. Methods：The serum mixed with different levels of DBIL （ 5.0,17.5,40.5,70.0,102.0 μmol/L ） and IBIL （ 5.0,17.0,40.0,71.5,104.0 μmol/L） was prepared and divided into high （ 2.54 ± 0.22 ） mmol/L ], middle （ 1.10 ± 0.15 ） mmol/L ] and low （ 0.50 ± 0.08 ） mmol/L ] groups according to the level of HDL-C. The level of DBIL and FBIL was determined by HITACHI 7170A automatic analyzer; the level of HDL-C of each serum specimen was determined by using both PPD method and phospho-wolframic acid magnesium precipitation （ PTA-Mg^2 ＋ ） method. Results：The interference of DBIL was complicated, the serum specimen within normal DBIL level scope manifested fake advance in the determination result by the PPD method;when the level of DBIL exceeded 20.0 μmol/L, the determination result showed remarkably reduction; when the level of DBIL was 120.0 μmol/L,the HDL-C deviation was -46.29% , -36.89% and -22.73% ,respectively in the high,middle and low groups of specimen. The interference of IBIL was not serious,when the level was 104.0 μmol/L,the deviation in each group was within -5.0%. Conclusions ：When the PPD method is used to determine HDL-C in clinical laboratory, the specimen should be diluted or treated with other experimental techniques to eliminate the interference if the level of DBIL is higher than 40.0 μmol/L.