血浆与血清标本生化项目检测结果的比较分析  

A Comparative Analysis of Biochemistry Tests Between Plasma and Serum Specimens

作　　者：梅景曌 冯杰[1] 高艳红[1] MEI Jingzhao;FENG Jie;GAO Yanhong(Department of Clinical Laboratory,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心检验科,北京100853

出　　处：《标记免疫分析与临床》2024年第11期2041-2046,2065,共7页Labeled Immunoassays and Clinical Medicine

基　　金：国家重点研发计划课题(编号:2017YFF020501)。

摘　　要：目的研究生化项目在血浆与血清之间的差异以及血浆标本的稳定性。方法随机选取62例在我院就诊的患者,同时采用肝素锂抗凝管和血清管抽取静脉血,离心分离出血浆和血清。在同一生化分析仪上,检测29项生化项目并对结果进行比较。将血浆标本在4℃储存24h进行相同检测,结果与储存0h的血浆标本进行对比分析。结果血浆组的钙(Ca)、氯(Cl)、二氧化碳(CO_(2))、葡萄糖(GLU)、总蛋白(TP)、乳酸脱氢酶(LDH)、肌红蛋白(MYO)、乳酸脱氢酶同工酶1(LDH1)明显高于血清组,差异具有统计学意义(P<0.01)。血清组的白蛋白(ALB)、钾(K)、镁(Mg)、磷(P)、尿酸(UA)、钠(Na)、碱性磷酸酶(ALP)、淀粉酶(AMY)、天门冬氨酸氨基转移酶(AST)、肌酐(CREA)、脂肪酶(LIP)、肌酸激酶同工酶MB(CKMB)、直接胆红素(DBIL)明显高于血浆组,差异具有统计学意义(P<0.01)。所有项目的r>0.75,P<0.01,说明血浆组与血清组之间存在相关性。依据国家卫生行业标准和本实验室质量要求,对差异进行偏倚分析,Ca、LDH、ALB、K、P、Na、AST、CREA、DBIL之间的差异超过可接受范围。血浆在4℃储存24h上机检测,与储存0h检测结果相比较,ALB、K、Mg、UA、AST、CREA、LDH、LIP、CKMB、MYO、LDH1、总胆红素(TBIL)、γ-谷氨酰基转移酶(GGT)、心脏型脂肪酸结合蛋白(HFABP)升高,Ca、Cl、CO_(2)、GLU、ALP、肌酸激酶(CK)、脑利钠肽前体(proBNP)降低,差异有统计学意义(P<0.01)。偏倚分析显示,ALB、Cl、CO_(2)、GLU、K、AST、GGT、LDH、proBNP、LDH1的差异超过可接受范围。结论血浆组和血清组的Ca、LDH、ALB、K、P、Na、AST、CREA、DBIL这9项生化指标的检测存在明显差异。血浆储存24h,ALB、Cl、CO_(2)、GLU、K、AST、GGT、LDH、proBNP、LDH1会发生明显变化。Objective To evaluate differences in biochemistry tests results between plasma and serum,as well as the stability of plasma specimens.Methods 62 patients who visited our hospital were randomly selected for the study.Venous blood samples were collected using both lithium heparin anticoagulant tubes and serum tubes,and plasma and serum were separated by centrifugation.29 biochemistry tests were performed on the same biochemical analyzer,and the results were compared.Plasma specimens were stored at 4℃ for 24 hours before undergoing the same tests,and the results were compared with those of the plasma specimens tested immediately after the collection(0 hours storage).Results The levels of Ca,Cl,CO_(2),GLU,TP,LDH,MYO,and LDH1 in the plasma group were significantly higher than those in the serum group(P<0.01).Conversely,the serum group showed significantly higher levels of ALB,K,Mg,P,UA,Na,ALP,AMY,AST,CREA,LIP,CKMB,and DBIL compared to the plasma group(P<0.01).The correlation coefficient(r)for all items was>0.75,with P<0.01,indicating a correlation between the plasma group and the serum group.Based on the national health industry standards and the quality requirements of this laboratory,a bias analysis was conducted for identified differences.The differences in Ca,LDH,ALB,K,P,Na,AST,CREA,and DBIL exceeded the allowable range.After storing plasma at 4℃ for 24 hours and then testing on the analyzer,the results were compared with those of the 0-hour storage specimens.The levels of ALB,K,Mg,UA,AST,CREA,GGT,LDH,LIP,TBIL,CKMB,MYO,LDH1,and HFABP increased,while the levels of Ca,Cl,CO_(2),GLU,ALP,CK,and proBNP decreased.The differences were statistically significant(P<0.01).The bias analysis showed that the differences in ALB,Cl,CO_(2),GLU,K,AST,GGT,LDH,proBNP,and LDH1 exceeded the allowable range.Conclusion There are significant differences in the detection results of Ca,LDH,ALB,K,P,Na,AST,CREA and DBIL between the plasma group and the serum group.After storing plasma for 24 hours,there are notable changes in ALB,Cl,CO_(2

关 键 词：肝素锂 血清 血浆 生化检测 允许偏倚 

分 类 号：R446.1[医药卫生—诊断学]