| 艾丽皮热·帕尔哈提,王琳,苏看看,张炳峰,穆原,张世昌,张洁心.标本溶血对阵发性睡眠性血红蛋白尿症患者血生化项目检测影响的实验室处理路径研究[J].中国医药导报,2024,21(4):25-29 |
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| 标本溶血对阵发性睡眠性血红蛋白尿症患者血生化项目检测影响的实验室处理路径研究 |
| Study on the influence of sample hemolysis on the detection of blood biochemical items in patients with paroxysmal nocturnal hemoglobinuria laboratory processing path |
| 收稿日期： 修订日期：2023-05-29 |
| DOI：10.20047/j.issn1673-7210.2024.04.06 |
| 关键词: 阵发性睡眠性血红蛋白尿症 溶血 校正方程 血浆参考区间 |
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| 基金项目:江苏省大学生创新创业训练计划项目（202110 312052Y） |
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| 摘要:目的 探讨标本溶血对阵发性睡眠性血红蛋白尿症患者血生化项目检测结果的影响及这类患者血标本的实验室处理路径。 方法 选取南京医科大学第一附属医院体检中心2022年11月至2023年4月健康体检者共275例。使用25例血标本制备模拟溶血液。根据溶血指数筛选溶血检测偏倚（BH）大的血生化项目，分别建立血清溶血校正方程。收集250例血浆和血清标本，计算各指定生化项目在不同标本类型间的血清检测偏倚（BS），再与规定的项目分析偏倚（BA）比较，分别建立血浆参考区间。 结果 11个血生化项目的检测结果易受标本溶血影响。以溶血指数为横坐标，BH均值为纵坐标，建立了天门冬氨酸氨基转移酶（AST）、谷氨酰转肽酶、乳酸脱氢酶（LDH）、肌酸激酶、α-羟丁酸脱氢酶、总蛋白（TP）、肌酐和钾离子（K+）共计8个项目的血清溶血校正方程，R2值均＞0.90。由于AST、LDH、TP、磷和K+的BS均＞适当BA，分别建立血浆参考区间，依次为（21.9±10.5） U/L，（166±58） U/L，（71.3±10.8） g/L，（1.14±0.37） mmol/L和（3.66±0.61） mmol/L。 结论 在一定溶血程度内，可使用血清溶血校正方程纠正部分血生化项目检测结果。建议优先使用患者血浆进行检测，再参照各项目的血浆参考区间以获得更准确的报告结果。 |
| Abstract:Objective To explore the study on the influence of sample hemolysis on the detection of blood biochemical items in patients with paroxysmal nocturnal hemoglobinuria laboratory processing path. Methods A total of 275 health check-ups were selected from the Physical Examination Center of the First Affiliated Hospital of Nanjing Medical University from November 2022 to April 2023. Simulated blood lysate was prepared by using 25 blood samples. Serum hemolysis correction equations were established by screening the blood biochemical items with large hemolysis serum detection bias (BH) according to the hemolysis index. Plasma and serum samples were collected from 250 cases, and the detection bias (BS) of each specified biochemical item was calculated among different specimen types, and then compared with the specified item analysis bias (BA) to establish the plasma reference interval respectively. Results The results of 11 blood biochemical items were easily affected by hemolysis. The serum hemolysis correction equations of aspartate aminotransferase (AST), glutamyltranspeptidase, lactate dehydrogenase (LDH), creatine kinase, α-hydroxybutyrate dehydrogenase, total protein (TP), creatinine, and potassium ion (K+) were established using the hemolysis index as the horizontal coordinate and the mean value of BH as the vertical coordinate, and the R2 values were all greater than 0.90. As the BS of AST, LDH, TP, phosphorus’ and K+ were all higher than the appropriate BA, the plasma reference intervals were established, which were (21.9±10.5) U/L, (166±58) U/L, (71.3±10.8) g/L, (1.14±0.37) mmol/L and (3.66±0.61) mmol/L, respectively. Conclusion In a certain degree of hemolysis, the serum hemolysis correction equation can be used to correct the results of some blood biochemical items. It is recommended to preferentially use patient plasma for testing, and then refer to plasma reference intervals for each item for more accurate reporting results. |
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