自然状态下溶血对生化检测结果的影响以及溶血指数警告值的确定  

Effect of hemolytic index in natural state on biochemical test results and determination of hemolysis index warning value

作　　者：宋彩红 朱勤惠 Song Caihong;Zhu Qinhui(Department of Clinical Laboratory,the Fifth People's Hospital of Huai'an,Huai'an 223300,Jiangsu,China)

机构地区：[1]淮安市第五人民医院检验科,江苏淮安223300

出　　处：《实用检验医师杂志》2023年第2期130-133,共4页Chinese Journal of Clinical Pathologist

摘　　要：目的分析自然溶血状态下不同溶血指数(HI)对生化检测结果的影响,确定贝克曼AU 5800生化分析系统的HI警告值,为生化标本拒收和报告审核提供依据。方法配对收集淮安市第五人民医院在2021年12月—2022年7月同一时间采集于同一患者符合要求的HI异常和HI正常血清标本,同时进行生化项目检测。分析不同HI对生化检测结果的影响是否具有统计学意义,并进一步与美国临床实验室改进法案修正案1988(CLIA’88)能力验证计划质量要求和国家卫生健康委临床检验中心(NCCL)室间质量评价标准进行比较,分析其是否具有临床意义。结果共配对收集到26对符合要求的血清样本。溶血造成直接胆红素(DBil)、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、肌酸激酶(CK)、血钾(K^(+))检测结果升高以及尿酸(UA)检测结果降低,具有临床意义。HI=1+时,溶血对DBil、LDH、CK-MB检测结果的影响具有临床意义,因此确定HI=1+为警告值;HI=2+时,溶血对AST检测结果的影响具有临床意义,因此确定HI=2+为警告值;HI=3~4+时,溶血对ALT、UA、CK、K^(+)检测结果的影响具有临床意义,因此确定HI=3+为警告值。对12个具有统计学意义而无临床意义的项目[总胆红素(TBil)、三酰甘油(TG)、血肌酐(SCr)、总蛋白(TP)、白蛋白(Alb)、血糖(Glu)、氯离子(Cl-)、血清淀粉酶(AMY)、血尿素氮(BUN)、总胆固醇(TC)、血磷(P)、谷氨酰转移酶(GGT)]确定HI=4+为警告值。结论不同程度溶血对生化检测结果的影响不同,确定适合本实验室的HI警告值有利于生化检测结果报告的准确发放。Objective To analyze the influence of different hemolytic index(HI)on biochemical detection results under natural hemolytic state,and determine the HI warning value of Beckmann AU5800 biochemical analysis system,so as to provide the basis for rejecting biochemical specimens and reviewing reports.Methods Abnormal and normal serum samples of HI meeting the requirements were collected from the same patient at the same time in the Fifth People's Hospital of Huai'an from December 2021 to July 2022,and biochemical tests were carried out at the same time.The influence of different HI on biochemical test results were statistically significant,and were compared with Clinical Laboratory Improvement Amendments 1988(CLIA'88)validation plan quality requirements and Capability Verification Program and the National Center for Clinical Laboratories(NCCL)requirements of external quality assessment to analyze whether they had clinical significance.Results A total of 26 pairs of serum samples were collected.The results of direct bilirubin(DBil),lactate dehydrogenase(LDH),creatine kinase isoenzyme(CK-MB),aspartate transaminase(AST),alanine transaminase(ALT),creatine kinase(CK)and potassium(K^(+))were increased in hemolysis,and the results of uric acid(UA)were decreased.When HI=1+,hemolysis had clinical significance on the results of DBil,LDH and CK-MB,and HI=1+was determined as warning value.When HI=2+,hemolysis had clinical significance on the results of AST,and HI=2+was determined as warning value.When HI=3-4+,it had clinical significance on the results of ALT,UA,CK and K^(+),and HI=3+was determined as warning value.HI=4+was determined as warning value for 12 statistically significant but not clinically insignificant items[including total bilirubin(TBil),triglyceride(TG),serum creatinine(SCr),total protein(TP),albumin(Alb),blood glucose(Glu),chlorine(Cl-),amylase(AMY),blood urea nitrogen(BUN),total cholesterol(TC),phosphorus(P)and glutamyltranspeptides(GGT)].Conclusion Different degrees of hemolysis have different effects on the r

关 键 词：溶血 溶血指数 警告值 生化检测 干扰分析 

分 类 号：R446.1[医药卫生—诊断学]