血浆稀释法和高速离心法消除凝血项目检测标本脂肪血干扰的实验研究  

Experimental Study on Eliminating Fat Blood Interference by Plasma Dilution and High Speed Centrifugation

作　　者：代超 刘亚鑫 岳晋魏 邸师红 祝茜 杨秀莲 DAI Chao;LIU Ya-xin;YUE Jin-wei;DI Shi-hong;ZHU Qian;YANG Xiu-lian(Department of Cardiology and Cerebrovascular Disease,General Hospital of Ningxia Medical University,Yinchuan 750000,China)

机构地区：[1]宁夏医科大学总医院心脑血管病医院检验科,银川750000

出　　处：《现代检验医学杂志》2021年第2期126-131,共6页Journal of Modern Laboratory Medicine

基　　金：宁夏医科大学科学基金资助(一般)项目:高脂血对凝血四项结果的干扰及不同消除方法效果对比的临床研究(XZ2016194)。

摘　　要：目的研究脂肪血标本对凝血结果的干扰,并探讨血浆稀释法和高速离心法消除脂肪血标本的效果对比研究。方法收集2017年1月~2019年12月期间健康体检者血浆标本100份(正常对照组),用脂肪乳配制成轻度脂肪血组(TG为3.955±1.053mmol/L)、中度脂肪血组(TG为8.020±3.126mmol/L)及重度脂肪血组(TG为22.712±5.013 mmol/L),分别检测三酰甘油(TG)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血浆纤维蛋白原定量测定(FIB)和D-二聚体(DD)的浓度;再选取临床脂肪血标本78份(研究组),包括中度脂肪血组42例和重度脂肪血组36例,通过血浆稀释法和高速离心法对其进行处理并检测,运用t检验分析对比处理前后各组的差异性。结果在不同程度模拟脂肪血中,中度脂肪血组和重度脂肪血组中PT,APTT,FIB检测水平均高于正常对照组(TG<1.7mmol/L)和轻度脂肪血组,DD检测结果均低于正常对照组和轻度脂肪血组,差异均有统计学意义(t=-6.318~2.106,均P<0.05)。用血浆稀释法和高速离心法对78例中度、重度脂肪血标本进行处理,两种方法与处理前检测结果比较PT,APTT,FIB和DD检测结果差异有统计学意义(t=-4.225~8.655,均P<0.05),但这两种方法之间各项指标检测结果差异均无统计学意义(均P>0.05);用血浆稀释法对血凝仪器进行线性及精密度验证,结果都满足实验室要求。结论血浆稀释法和高速离心法都能有效消除中度和重度脂肪血标本对凝血检测结果的干扰,但血浆稀释法无需高速离心,操作更简单,避免了基质效应,在消除脂肪血标本中有巨大的潜能。Objective To study the interference of fat blood samples on coagulation results,and explore the effect of plasma dilution method and high-speed centrifugation method in eliminating fatty blood samples.Methods A total of 100 plasma samples(normal control group)from January 2017 to December 2019 were collected and made into mild fatty blood group(TG=3.955±1.053mmol/L),moderate fatty blood group(TG=8.020±3.126mmol/L)and severe fatty blood group(TG=22.712±5.013).The levels of triglyceride(TG),prothrombin time(PT),activated partial thromboplastin time(APTT),quantitative determination of plasma fibrinogen(FIB)and concentration of D-Dimer(DD)were detected respectively.Then 78 fatty blood samples from clinical(Study Group),including moderate fatty blood group(42cases)and severe fatty blood group(36 cases)were treated and detected by plasma dilution method and high-speed centrifugation method,and the differences among the groups were analyzed by t test.Results The levels of PT,APTT and FIB in moderate and severe fatty blood groups were higher than those in normal control group(TG<1.7mmol/L)and mild fatty blood group,and the level of DD was lower than that of normal control group and mild fatty blood group(t=-6.318~2.106,all P<0.05).78 cases of moderate and severe fatty blood samples were treated by plasma dilution method and high-speed centrifugation method,and the detection results of PT,APTT,FIB and DD between the two methods were statistically significant(t=-4.225~8.655,all P<0.05),but there was no significant difference between the two methods(all P>0.05).The linearity and precision of hemagglutination instrument were verified by plasma dilution method,and the results met the laboratory requirements.Conclusion Both plasma dilution and highspeed centrifugation can effectively eliminate the interference of moderate and severe fatty blood samples on coagulation test results.However,plasma dilution method does not need high-speed centrifugation and is simpler to operate,which avoids matrix effect and has great potentia

关 键 词：凝血项目 脂肪血 血浆稀释法 高速离心法 

分 类 号：R446.112[医药卫生—诊断学]