60℃加热1小时灭活病毒方法对常规临床检测指标的影响研究  

Effects of sample processing by heating at 60 ℃for one hour on routine clinical laboratory indicators

作　　者：李晓东[1] 廖昊 刘妍[1] 李乐[1] 陈容娟[1] 李奇[1] 陈丽[1] 黄鹏宇[1] 王学晶[2] 徐东平[1] 

机构地区：[1]解放军第三〇二医院临床研究管理中心,北京100039 [2]民航总医院检验科,北京100123

出　　处：《传染病信息》2016年第3期160-163,166,共5页Infectious Disease Information

基　　金：北京市科委科技计划项目(D131100005313016);全军医学科技"十二五"科研项目重点课题(BWS11J048);新发突发传染病研究北京市重点实验室资助项目(2014XFTF04)

摘　　要：目的基于60℃加热1 h可有效灭活埃博拉病毒的观点,探讨用该条件加热处理对常规临床检测指标的影响。方法对40例受检者用枸橼酸钠抗凝管和EDTA-K2抗凝管分别采集静脉血,标本分为2份,检测未进行加热灭活处理(灭活前)和进行了加热灭活处理(灭活后)样本的生物化学、免疫、凝血和血常规指标,比较热灭活前后各指标的差异。结果与灭活前相比,灭活后样本的生物化学和免疫项目中总蛋白、总胆红素、肌酐、总胆固醇、甘油三酯、钠、钾、氯、C-反应蛋白、尿素氮、葡萄糖、HBs Ab水平差异无统计学意义(P均>0.05);白蛋白、球蛋白、前白蛋白、丙氨酸氨基转移酶、天冬氨酸氨基转移酶和乳酸脱氢酶有较显著降低,但下降幅度不到80%且灭活前、后数据存在相关性(r>0.80,P<0.01),用回归方程校正后检测数据仍具有参考价值;碱性磷酸酶、γ-谷氨酰基转移酶、胆碱酯酶和肌酸激酶的测定值下降非常明显(P均<0.01),且灭活前后2组数据无显著相关性。凝血检测项目中,D-二聚体在2组间的差异无统计学意义(P>0.05);其余项目均受到热灭活严重影响。血常规项目中,血红蛋白、白细胞和血小板计数在2组间的差异无统计学意义(P>0.05),但样本须要事先稀释。结论 60℃加热1 h灭活处理对部分生物化学、免疫和血常规项目无明显影响,部分项目检测值明显降低,但其中有6项指标经校正后仍具参考价值。Objective To evaluate the influence of the heating procedure on clinical laboratory indicators based on the understanding that heating at 60 ℃ for 1 hour is an effective assay for inactivation of Ebola virus. Methods Blood samples of 40 subjects involved in this study were collected in sodium citrate anticoagulation tubes and EDTA-K2 anticoagulation tubes respectively, and divided into two equal aliquots. One aliquot was analyzed for biochemical, immunological, coagulation and blood routine examination parameters without preheating（prior-inactivation group）, and the other was analyzed for these parameters after heating at 60 ℃ for 1 hour（post-inactivation group）. The differences in these parameters between prior-inactivation group and post-inactivation group were compared. Results In terms of biochemical and immunological tests, as compared with prior-inactivation group, total protein, TBIL, CRE, TC, TG, NA, K, CL, CRP, BUN, GLU and HBs Ab in post-inactivation group were not significantly different（P〉0.05）; ALB, GLO, PAL, ALT, AST and LDH decreased significantly, but the decreased variations were less than 80% and there was a correlation between the levels of the two groups（r0.80, P〈0.01）, thus the data were still interpretable after calibration with regression equation; ALP, GGT, CHE and CK had a significant decrease（P 0.01） and no correlation was observed between the two groups. In terms of coagulation tests, D-dimer showed no significant difference between the two groups（P〉0.05）; the other coagulation indicators were significantly different between the two groups. In terms of blood routine tests, HGB, WBC and PLT had no significant differences between the two groups（P〉0.05）, provided that samples were diluted beforehand. Conclusions Heat inactivation at 60 ℃ for 1 hour has no significant influence on some biochemical, immunological and blood routine tests, but significantly affects some other tests, among which 6 items are still interpretable after calibration.

关 键 词：埃博拉病毒属 临床试验 检疫 

分 类 号：R512.62[医药卫生—内科学]