光散射法检测脂血标本血红蛋白的应用评价  

Evaluation on the application of light scattering method to detect hemoglobin in lipoblood samples

作　　者：窦敏[1] 林燕辉[1] 郭小未 曹鹏驹 Dou Min;Lin Yanhui;Guo Xiaowei;Cao Pengju(Department of Clinical Laboratory,Fujian provincial hospital,Fuzhou 350001,China)

机构地区：[1]福建省立医院检验科,福州350001

出　　处：《中华检验医学杂志》2021年第12期1182-1189,共8页Chinese Journal of Laboratory Medicine

摘　　要：目的评估光散色法检测脂血标本中血红蛋白(Hb)的能力, 探索替代实验室常用的血浆置换法的可行性。方法收集福建省立医院2020年7月至2021年7月福建省立医院住院患者血常规标本276份。其中男169例, 女107例, 年龄16~97岁。其中非脂血标本183份、脂血标本93份。(1)非脂血和脂血标本 Hb低值、中值、高值各1份, 检测光散射法精密度和线性。(2)非脂血标本分为Hb低值组、Hb中值组、Hb高值组, 分别用光散射法和比色法测Hb, 并对两者进行比较。(3)非脂血标本分为Hb低值组、Hb中值组、Hb高值组, 分别用不同浓度脂肪乳进行血浆置换, 采用MedCalc19.1软件分析Hbc2与Hbc1、Hbo2与Hbc1的偏倚及线性;计算Hbc2与Hbc1偏倚(CV%)、Hbo2与Hbc1偏倚(CV%), 应用SPSS 24软件t检验, 分析不同浓度甘油三脂对Hb结果偏倚的影响。(4)脂血标本分为HB低值组、Hb中值组、Hb高值组, 对光散色法Hb与血浆置换后比色法Hb进行比较。结果 (1)非脂血和脂血标本光散射法批内精密度在允许范围内(CV<1.5%), 线性良好(R2=1.000)。(2)3组非脂血标本光散射法HB与比色法HB偏倚均<3.5%(-0.58±2.34, 0.16±1.52, 1.15±1.56), 在允许总误差范围内;2种方法具有等效性和良好的线性关系(r=0.999)。(3)血浆置换后光散射法(Hbo2)低值组(除4.1 mmol/L)、中值组、高值组各浓度与非脂血比色法(Hbc1)具有等效性, 且2种方法具有良好的相关性。光散射法检测结果与脂血浓度无关。(4)3组脂血标本光散射法HB与血浆置换法Hb结果差异无统计学意义(P>0.05), 两者具有等效性和良好的相关性(R^(2)=0.968, 0.948, 0.870)。结论光散色法能够有效排除脂血对血红蛋白测定的影响, 能替代传统的血浆置换法, 具有较高的临床应用价值。Objective To evaluate the ability of light dispersive colorimetry to detect hemoglobin(Hb)in lipid blood samples and its feasibility as an alternative to plasmapheresis commonly used in the laboratory.Methods Routine blood samples of 276 inpatients in Fujian Provincial Hospital from July 2020 to July 2021 were collected.Routine blood samples of 276 inpatients were collected.There were 169 males and 107 females,aged from 16 to 97 years.183 non-lipid blood samples and 93 lipid blood samples were collected.(1)One case each of low,medium and high Hb value in non-lipid blood and lipid blood samples were collected,and the precision and the linearity of light scattering method was detected.(2)Non-lipid blood samples divided into Hb low-value group,median-value group and high-value group,which were measured by light scattering method and colorimetric method to compare Hb values.(3)Non-lipid blood samples were divided into Hb low-value group,median-value group and high-value group.Plasma exchange was carried out with different concentrations of fat emulsion.The bias and linearity of Hbc2 and Hbc1,Hbo2 and Hbc1 were analyzed by MedCalc19.1 software.The Hbc2 and Hbc1 bias(CV%)and Hbo2 and Hbc1 bias(CV%)were calculated.T test was used to analyze the influence of different concentrations of triglyceride on Hb bias.(4)Blood samples were divided into Hb low-value group,median-group and high-value group.The Hb of light scattering method was compared with the colorimetric method after plasma exchange.Results(1)The intrabatch precision of light scattering method for non-lipid blood and lipid blood specimens was within the allowable range(CV<1.5%),and the good linearity(R2=1.000).(2)The bias of Hb measured by light scattering method and colorimetric method in the three groups was below 3.5%(-0.58±2.34,0.16±1.52,1.15±1.56),within the allowable total error range.The two methods have the equivalence and good linear relationship(r=0.999).(3)The concentrations of Hbo2 in the low(except 4.1 mmol/L),medium and high Hbo2 groups were equ

关 键 词：光散射法 血红蛋白 脂血 血浆置换 

分 类 号：R446.1[医药卫生—诊断学]