溶血对27项西门子ADVIA 2400生化检验项目的影响及纠正  

The effect of hemolysis on 27 biochemical items tested in automatic biochem analyzer of ADVIA 2400 of SIEMENS and correcting analysis

作　　者：倪莉 叶悦荻 徐晓杰[1] 葛海峰[1] 陈允国 朱丽丹[1] NI Li;YE Yuedi;XU Xiaojie;GE Haifeng;CHEN Yunguo;ZHU Lidan(Department of Laboratory Medicine,the Second Affiliated Hospital&Yuying Children’s Hospital of Wenzhou Medical University,Wenzhou 325027,China;Department of Pathology,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,China)

机构地区：[1]温州医科大学附属第二医院育英儿童医院医学检验中心,浙江温州325027 [2]温州医科大学附属第一医院病理科,浙江温州325015

出　　处：《温州医科大学学报》2020年第10期834-838,共5页Journal of Wenzhou Medical University

摘　　要：目的:利用溶血指数探讨标本溶血对常规生化检验项目的影响。方法:参考美国临床实验室标准化委员会(CLSI)制定的评价方案EP7-A2文件标准程序,在西门子全自动生化分析仪ADVIA 2400上对40份标本的27项生化常规检测项目及溶血指数进行检测。利用机械破坏法对这40份标本的血球进行不同程度的破坏,得到溶血程度分别为+、++、+++、++++标本各10份,再对这40份人工溶血标本进行27项生化项目及溶血指数检测,计算各项目溶血前后的结果偏倚,并与CLIA’88能力比对的最大允许误差比较。以每份测试血清的△H为X轴、其对应的检测项目干扰值为Y轴绘制干扰曲线。结果:不同溶血程度对DBil、TBil、PA、TP、TG、UA、Alb、ALP、ALT、BUN、ChE、TC、Cr、GGT、HDL、LDL、Ca、P、Mg、Na+和Cl-这21个生化项目无明显干扰;溶血程度为+时,Glu存在明显负干扰,AST、K+和LDH存在明显正干扰;CK在溶血程度为++时出现明显正干扰;Fe在溶血程度为+++时出现明显正干扰。结论:溶血程度为+时,对西门子ADVIA 2400测定AST、K+、Glu和LDH存在明显干扰;若无法重新采集血标本,需根据相应的溶血指数将检测结果校正后报告。Objective:To explore the effect of hemolysis on the results of important biochemical items by hemolysis index(H).Methods:Referring to the standard procedure of the EP7-A2 file of the evaluation program formulated by the CLSI,27 biochemical items and H of 40 samples were detected at automatic biochem analyzer of ADVIA 2400 of SIEMENS.The 40 samples were averagely divided as 4 groups whose hemolysis were+,++,+++and++++respectively after their RBC were crushed by tallies.The 27 items and H of 40 samples were tested after hemolysis.The bias of the results of 27 items after hemolysis were compared with the corresponding TEa of tests of CLIA’88.△H was taken for X axis and the corresponding interference value of every test was taken for Y axis,and the interference curves were drawn.Results:Hemolysis had no obvious interference on the 21 biochemical items,including DBil,TBil,PA,TP,TG,UA,Alb,ALP,ALT,BUN,ChE,TC,Cr,GGT,HDL,LDL,Ca,P,Mg,Na+and Cl-.There were obvious positive bias to AST,K+and LDH when hemolysis was+,and there was obvious negative bias of Glu when hemolysis was+.There was obvious positive bias to CK when hemolysis was++and there existed obvious positive bias to Fe when hemolysis was+++.Conclusion:There are obvious bias to Glu,AST,K+and LDH when hemolysis is+,which are tested at automatic biochem analyzer of ADVIA 2400 of SIEMENS.If new samples can not be collected,the results of the items which are interfered obviously should be corrected according to corresponding hemolysis indexes before report.

关 键 词：溶血 血红蛋白 溶血指数 生化项目 偏倚 

分 类 号：R774[医药卫生—眼科]