脂肪乳对PT、APTT和Fib凝血结果的影响与对策  

Interference of lipid milk on the PT,APTT and Fib and the solution

作　　者：刘振杰[1] 李涛[1] 曹永坚[1] 钟伟国[1] 吴子安[1] 徐宁[1] 

机构地区：[1]广东省中医院芳村医院检验科,510370

出　　处：《职业与健康》2015年第9期1182-1186,共5页Occupation and Health

摘　　要：目的探讨减少脂肪乳对凝血酶原(PT)、部分凝活酶时间(APTT)和纤维蛋白原(Fib)干扰的方法。方法制备正常新鲜混合血浆并检测PT、APTT、Fib;在正常新鲜混合血浆中加入不同浓度的脂肪乳并检测其PT、APTT和Fib,取均值计算干扰物影响度,同时在强生干化学分析仪VITRO FS5.1上检测血浆指数,并分析血浆指数与脂肪乳干扰之间的关系。通过CS2000i自带的稀释功能,寻找最佳的稀释倍数,减少脂肪乳对Fib的干扰。结果当添加干扰物脂肪乳<4.76%体积分数时,对PT、APTT和国际标准化比值(INR)影响均<7.5%,未超过1/2 CLIA’88规定的允许误差;脂肪乳添加的体积与血浆指数存在良好的线性相关:y=18.284x+4.557 9,R2=0.993 3;脂肪乳添加的体积与衍算纤维蛋白原(PT-der fibrinogen,PT-DFbg)添加前后的差值也存在良好的线性相关:y=0.146 9x-0.891 4(x≥6),R2=0.961 7;标本稀释可以很好地消除脂肪乳对Fib检测结果的干扰。结论利用血浆指数,可以减少一定浓度内脂肪乳对PT、APTT和Fib的干扰,标本稀释可以很好地消除脂肪乳对Fib检测结果的干扰。[ Objective ]To investigate the anti-interference solution of lipid milk on the plasma prothrombin time（PT） and activated partial thromboplastin time（APTT） and fibrinogen（Fib）. [Methods]Fresh plasma of healthy person were pooled, PT, APTF and Fib were measured. The disruptors of lipid milk at different concentration were added into the normal mixed fresh plasma for PT, APTF and Fib measurement, averaged to calculate the interference effects. The plasma index was detected by VITRO FS5.1. The relationship between plasma index and lipid milk was analyzed. The disruption of lipid milk on Fib was lowered by the CS2000i＇s best dilution.[ Results]When the final concentration of lipid milk added was 〈4.76%（v/v）, The average interference of PT, APTF and INR were〈7.5%, which were lower than allowable deviation given by 1/2CLIA′ 88. The volume of lipid milk showed good linear correlation with plasma index y=18.284x＋4.557 9,R2=0.993 3, so as the difference before and after adding the lipid milk of PT-DFbg y=0.146 9x-0.891 4 （x ≥6）, R2=0.961 7. The disruption of lipid milk with Fib can be eliminated by diluting. [Conclusion] By using plasma Index, interference of lipid milk on PT, APTT and Fib can be decreased in a certain degree. The disruption of lipid milk on Fib detection can be eliminated by diluting.

关 键 词：脂肪乳 凝血酶原(PT) 部分凝血活酶时间(APTT) 纤维蛋白原(Fib) 对策 

分 类 号：R446.11[医药卫生—诊断学]