使用添加剂处理标本对离子选择电极法测定血锂浓度的影响

Influence of sample treated with additive reagents on the measurement of blood lithium using ion selection electrode

目的 探讨使用肝素钠抗凝剂、促凝剂、分离胶等添加剂处理的标本是否适合锂盐(Li+ )浓度的监测。方法 选择临床服用碳酸锂治疗达稳态的住院患者,使用真空采血系统分别采集普通管血液标本和分别含有肝素钠抗凝剂、促凝剂、分离胶等添加剂的标本,在IMS 972电解质分析仪上测定Li+浓度,比较结果的差异。结果 (1)不同方式处理的标本间Li+浓度差异有显著性(P<0. 001),其中普通血清、肝素钠抗凝血浆、促凝剂处理的血清之间Li+浓度差异均无显著性(P>0. 05),分离胶处理的标本与普通血清、促凝剂和肝素钠处理的标本之间Li+浓度差异均有显著性(P<0. 001); (2)肝素钠抗凝剂和促凝剂处理的标本与普通血清Li+浓度之间呈高度线性相关(r=0. 988~0. 993, P<0. 001),分离胶处理的标本与普通血清、肝素钠抗凝剂、促凝剂处理标本的Li+浓度线性相关均无显著性(r=0. 203~0. 288,P>0. 05); (3)肝素钠抗凝剂、促凝剂、分离胶等添加剂处理标本和普通血液标本,不分离血凝块室温放置8h,Li+浓度较放置前增高(P<0. 05~0. 001)。结论 促凝剂和肝素处理标本适合用于锂盐的快速测定,而分离胶处理的标本不适合用于离子选择电极法测定Li+浓度,也不适于储存和标本运输;使用肝素钠抗凝剂和促凝剂处理的标本。

Objective To explore that blood sample treated with additive reagents is suitable or not for the measurement of lithium salt(Li^+) concentration. Methods Blood samples from inpatients treated with lithium carbonic acid were collected using common vacuum tube, or containing heparin sodium anti-coagulating reagent, promoting coagulating reagent, gel separator and determined for serum Li^+ concentration by IMS-972 electrolyte analyzer. Results (1) Li^+ concentrations of common serum, heparin anti-coagulated plasma and serum dealt with promoting coagulating reagent showed no difference (P>0.05). There were significant difference between sample dealt with gel separator and other samples(P<0.001); (2) Li^+ concentrations of samples dealt with anti-coagulating reagent, promoting coagulating reagent and common serum showed high linearity correlation (r=0.988-0.993, P<0.001). Li^+ concentrations of sample dealt with gel separator showed no obvious difference in linearity correlation with other samples(r=(0.203)-(0.288),P>0.05); (3) After placed 8 hours in room temperature, Li^+ concentrations of all samples increased obviously (P<0.05-0.001). Conclusions The samples dealt with promoting coagulating reagent and heparin sodium anti-coagulatnt are suitable to be used for the measurement of lithium salt while the sample dealt with gel separator is not suitable for the method of ion selection electrode.