红细胞比容对全血C反应蛋白结果影响及校正方案的探讨  

The investigation of hematocrit influence on CRP detection using whole blood samples and corresponding corrective measure

作　　者：田野[1] 陶恬 张岩[1] 李佩[1] 郑芳芳[1] 聂秋燕 刘晴[1] 王晓宁[1] 古媛[1] 李卓敏 谭延国[1] 

机构地区：[1]首都医科大学附属复兴医院检验科,北京100038 [2]首都医科大学医学检验系本科,北京100050

出　　处：《检验医学与临床》2017年第23期3425-3427,3434,共4页Laboratory Medicine and Clinic

基　　金：国家卫生和计划生育委员会医药卫生科技发展研究中心专项课题资助(28-5-5);首都临床特色应用研究(吴阶平)基金项目(Z141107006614008)

摘　　要：目的分析使用快速C反应蛋白(CRP)测定仪时,在全血模式下,红细胞比容(HCT)对结果的影响,并初步探讨校正方案。方法 (1)使用乙二胺四乙酸(EDTA-K2)抗凝的全血,配制两组HCT系列梯度的标本,用快速CRP测定仪测定其CRP水平,同时用血细胞分析仪测定其HCT,探讨HCT对全血CRP水平的影响;(2)检测120例患者的血液标本,每例患者同时测定其HCT、快速法测定全血CRP,IMMAGE 800测定血清CRP(作为参照检测系统),以后者为因变量、前两者为自变量做线性回归,推导校正公式;(3)使用50例HCT处于不同范围的标本验证校正公式。结果 (1)全血CRP水平与HCT值呈显著负相关关系(P<0.05);(2)以120例标本的全血CRP水平和HCT值推导出的校正公式为:CRP校正=49.3×HCT+0.84×CRP全血-14.17(R2=0.991,P<0.05);(3)Bland-Altman分析法显示,校正前全血CRP水平与参照结果无一致性,而校正后则一致性很好。结论 HCT值显著地影响全血CRP测定结果,有必要对全血模式下测定的CRP结果结合HCT进行校正,以使结果更准确。Objective To investigate the influence of hematocrit（HCT）on C reactive protein（CRP）level under the whole blood mode of a Point of Care Test（POCT）CRP analyzer,and to discuss preliminarily corrective measure.Methods Two sets of samples of serial HCT gradients were respectively prepared with routine blood samples collected into EDTA-K2 tubes from two patients,whose CRP levels and HCT were tested with POCT CRP analyzer under whole blood mode and blood cell analyzer,respectively,so as to show the impact of HCT on CRP levels.CRP levels were tested by POCT CRP analyzer using whole blood samples（CRP whole blood）from the same patients,and Immunochemistry system（IMMAGE 800,as reference system）using serum samples（CRP serum）,respectively,from a total of 120 patients,whose HCT values were also tested.Then linear regression was performed to deduce correction formula,with CRP whole blood and HCT as independent variables,and CRP serum as dependent variable.The correction formula was further validated with samples of different HCT values from 50 patients.Results The CRP levels of whole blood samples negatively correlated with HCT values（all P0.05）.The correction formula：CRPcorrection=49.3×HCT＋0.84×CRPwhole blood-14.17（R2=0.991,P0.05）.Bland-Altman Analysis method showed that the original CRPwhole bloodlevels were incomparable with CRP serum levels,but after correction,a comparable outcome was observed.Conclusion HCT values affect CRPwhole blood levels remarkably,which needs to be corrected based on their corresponding HCT values,so as to obtain more accurate results.

关 键 词：C反应蛋白 红细胞比容 校正公式 

分 类 号：R446.11[医药卫生—诊断学]