脂肪乳输注对血红蛋白测定的影响研究  

Influence of fat emulsion infusion on determination of hemoglobin

作　　者：黄浩[1] 黄玲莎[1] 朱波[1] 梁艺华[1] 任宁毅[1] 徐茜[1] 

机构地区：[1]广西医科大学附属肿瘤医院检验科,南宁530021

出　　处：《检验医学与临床》2015年第7期897-899,共3页Laboratory Medicine and Clinic

基　　金：广西壮族自治区卫生厅自筹经费科研课题(Z2014587)

摘　　要：目的探讨脂肪乳输注对血红蛋白(Hb)及相关指标检测结果的影响。方法选取10例输注脂肪乳的自愿者,于脂肪乳输注后1、2、4、8、12h采集静脉血2mL,离心后检测血浆三酰甘油(TG)及Hb水平,并将不同时间点的血浆标本混合制备5份混合乳糜血浆。选择1例O型血健康自愿者,采集静脉血6mL,离心后吸去血浆,制备健康浓缩红细胞(RBC),在200μL各时间点混合乳糜血浆中分别加入200μL浓缩RBC,以200μL生理盐水加入200μL健康浓缩红细胞为对照。选择1例O型血小细胞低色素贫血自愿者,采集静脉血6mL,离心后吸去血浆,制备小细胞低色素浓缩RBC,将100μL浓缩红细胞加入100、200、300、400μL TG浓度为15.23mmol/L的乳糜血浆中,以100μL浓缩红细胞加入等体积生理盐水为对照。采用迈瑞公司BC-6800型血细胞分析仪对各试验管进行Hb及相关指标检测,每管测2次,计算均值。结果输注脂肪乳后自愿者血浆TG水平迅速升高,最高可达25.89mmol/L,乳糜血浆直接测定Hb水平最高可达19g/L。各时间点乳糜血浆对健康浓缩RBC和小细胞低色素浓缩RBC中的RBC、红细胞比容(HCT)、平均红细胞体积(MCV)检测结果影响不大,对Hb、平均红细胞血红蛋白含量(MCH)、平均红细胞血红蛋白浓度(MCHC)造成假性增高,输注后4h内影响程度尤为明显;贫血越严重,Hb、MCH、MCHC受影响程度越大。脂肪乳输注12h后,血浆对Hb及相关指标检测结果影响较小。结论输注脂肪乳后4h内尽量避免检测Hb及MCH、MCHC,特别是严重贫血的患者,输脂肪乳后12h的检测结果则相对可靠。Objective To study the influence of fat emulsion infusion on the detection of hemoglobin（Hb）and related indexes.Methods Ten cases of volunteers receiving fat emulsion infusion were selected and taken 2mL venous blood,at 1,2,4,8and 12 hafter infusion.Plasma levels of triglyceride（TG）and Hb were detected.Then,plasma samples of the five time points were prepared.One healthy volunteer with blood type of O was selected and taken6 mL venous blood.Condense red blood cells（RBC）suspension was prepared by removing plasma.Then,200μL of1,2,4,8and 12 hmixed chylous plasma was mixed with 200μL healthy condense RBC suspension respectively,and200μL healthy condense RBC suspension was mixed with 200μL normal saline to prepared control tube.One volunteer with low pigment anemia and blood type O was selected and taken 6 mL venous blood.Condense low pigment RBC suspension was prepared.Then,100μL condense low pigment RBC suspension was mixed with 100,200,300 and 400μL chylous plasma,TG concentration of which was 15.23mmol/L,and 100μL condense low pigment RBC suspension was mixed with 100μL normal saline to prepare control tube.Levels of Hb and related indicators of each tubes were detected by using Mindray BC-6800 analyzer.Every indicator was detected for twice,and average was calculated.Results Plasma levels of TG rapidly increased after fat emulsion infusion,and the peak value was 25.89mmol/L.The peak plasma levels of Hb was 19g/L.The influences of chylous plasmas of different time points on levels of RBC,haematocrit（HCT）and mean corpuscular volume（MCV）were not obvious,but the false increase of Hb,mean corpuscular hemoglobin（MCH）and mean corpuscular hemoglobin concentration（MCHC）,especially with4 hafter infusion.With the increasing of severity of anemia,the degree of influences on Hb,MCH and MCHC were more obvious.Fat emulsion was with little influence on Hb and related indexes,12 hafter infusion.Conclusion Hb,MCH and HCHC should not be detected within 4hafter fat emulsion infusion,especially in

关 键 词：脂肪乳 血红蛋白 血细胞分析 

分 类 号：R556[医药卫生—血液循环系统疾病]