溶血指数监测39项免疫标志物的结果评估及溶血指数警告阈值的验证确立  

The Evaluation of Hemolytic Index Monitoring of 39 Immune Markers and Verification of the Warning Threshold of Hemolytic Index

作　　者：林博[1] 韩冉[1] 寿好长[1] 张省委 LIN Bo;HAN Ran;SHOU Haochang;ZHANG Shengwei(Clinical Laboratory,Dongfang Hospital of Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学东方医院检验科,北京100078

出　　处：《标记免疫分析与临床》2020年第10期1793-1796,共4页Labeled Immunoassays and Clinical Medicine

基　　金：北京中医药大学基本科研业务费基金资助项目(编号:2019-JYB-JS-110)。

摘　　要：目的通过监测溶血指数(H)评估不同程度溶血对39项免疫标志物的影响及影响程度,根据评估结果确定溶血指数警告阈值,为溶血样本的处理、报告审核及对结果的合理解释提供依据。方法将血液样本人为干预成不同程度的溶血样本,检测各组样本的溶血指数及39项免疫标志物,比较不同程度溶血样本与正常样本检测结果的差异,并进行评估确立溶血指数警告阈值。结果溶血对ACTH、Pro-GRP、PCT、PTH、INS检测结果产生负干扰;对NSE、FOL检测结果产生正干扰。警告阈值确定为:ACTH、INS、NSE、FOL的H>50mg/dL;Pro-GRP、PCT的H>400mg/dL;PTH的H>800mg/dL;FER重度溶血虽有结果偏高的趋势,但差异无临床意义,不受溶血干扰。结论溶血指数阈值的验证确立及监测有助于实验室检验人员获取更准确样本信息,减少不合格样本人工主观判断的误差,使检测人员更合理处置不同程度溶血的样本,减少不合格样本带来的医疗负担及对临床诊疗的误导。Objective To evaluate the influence of different degrees of hemolysis on 39 immune markers by monitoring hemolysis index(H),and to determine the warning threshold of hemolysis index according to the evaluation results,so as to provide a knowledge base for the treatment of hemolysis samples,procedures of report review and reasonable interpretation of the results.Methods The blood samples were artificially interfered into hemolytic samples of different degrees,and the hemolytic index and 39 immune markers of each group were detected.The differences between the detection results of hemolytic samples of different degrees and normal samples were compared,and the warning threshold of hemolytic index was evaluated and identified.Results Hemolysis produced a negative interference on the detection results of ACTH,Pro-GRP,PCT,PTH and INS,while a positive interference to NSE and FOL detection results.The warning thresholds were determined as following:ACTH,INS,NSE,FOL H>50 mg/dL;Pro-GRP,PCT H>400 mg/dL;PTH H>800 mg/dL.FER severe hemolysis showed a tendency of higher results,but had no clinical significance and was not disturbed by hemolysis.Conclusion The verification and monitoring of the threshold value of hemolysis index can help the laboratory inspectors to obtain more accurate specimen information,reduce the error of artificial subjective judgment of unqualified specimens,make the decision more reasonable to dispose samples with different degrees of hemolysis,and reduce the medical burden brought by unqualified samples and the misleading of clinical diagnosis and treatment.

关 键 词：溶血 溶血指数 干扰 电化学发光 免疫标志物 

分 类 号：R446.6[医药卫生—诊断学]