肝素锂抗凝采血对FT_3、FT_4及TSH测定的影响  

Effect of heparin lithium as anticoagulant in assay of FT_3,FT_4 and TSH

作　　者：何国荣[1] 程蔚[1] 黄玉英[1] 

机构地区：[1]第一军医大学珠江医院核医学科,广东广州510282

出　　处：《第一军医大学学报》2002年第8期721-723,共3页Journal of First Military Medical University

摘　　要：目的探讨肝素锂抗凝标本能否取代或与普通干燥管标本通用。方法随机取受试者32例,一次性肘静脉穿刺采血6 ml,分装于肝素锂真空管(肝素管)和普通干燥真空管(干管)各3 ml,化学发光免疫分析常规测定各自的TSH、FT3及FT4。结果32例受试者2种试管采血测定的TSH及FT4值无明显差异(TSH:t=1.846,P=0.075;FT4:t= 1.649,P=0.110)且高度相关(TSH:r=1.000,P=0.000;FT4:r=0.999,P=0.000),临床诊断完全一致。FT3的结果则显著不同,肝素管测定的结果显著低于干管(t=-6.253,P=0.000),绝对值相差最大为16.44 pmol/L,最小为0.76 pmol/L;相对相差最大为57.5%,最小为15.6%;但2组FT3测定值具有高度相关性(r=0.999,P=0.000 0),若通过回归处理建立肝素管自己的正常值范围,则它们的诊断结果完全一致。结论肝素管与干管采血测定TSH、FT4,结果完全一致,可以通用;而肝素管与干管测定的FT3显著不同,不能通用,但两组数值高度相关,可以通过建立各自的正常值或回归方程进行数据处理后互相替代。Objective To evaluate the application of heparin lithium as anticoagulant in in vitro tests of thyroid function. Methods The blood samples obtained by venipuncture from 32 subjects (including 10 normal subjects and 22 patients with thyroid disorder) were collected in parallel dry vacuum tubes with one of them containing heparin lithium, for assay of TSH, FT 3 , FT 4 by chemoluminescence immunoassay. Results No difference was found in TSH and FT 4 levels determined separately from the parallel tubes (TSH: t=1.846, P=0.075; FT 4 : t=1.649, P=0.110) with closely correlated results (TSH: r=1.000, P=0.000; FT 4 : r=0.999, P=0.000), and the clinical diagnoses therefrom derived were perfectly matched. FT 3 level in ordinary dry vacuum tubes, however, was significantly higher than that in the tube containing heparin lithium (t=-6.253, P=0.000), but still close correlation was observed between them (r=0.999, P=0.000 0). Inconsistent clinical decisions occurred in 7 of the 32 subjects in respect of FT 3 levels respectively assayed in the 2 tubes, but when the normal ranges of FT 3 level were established for the 2 tubes separately, the same clinical diagnoses were reached. Conclusion TSH and FT 4 levels as determined in the 2 tubes are comparable, and even though FT 3 levels does not present this feature, close relation is obvious and therefore the 2 values can be equivalent after establishment of their respective normal limits or after linear regression processing.

关 键 词：甲状腺功能试验 化学发光免疫分析 抗凝剂 肝素锂 

分 类 号：R817.4[医药卫生—影像医学与核医学]