甘油醛与氟化钠抑制离体血血糖降低作用的评价

Stability of glyceraldehydes and sodium fluoride to the measurement of glucose and lactic acid in whole blood specimens

目的用电极法直接测定全血血糖及乳酸,比较甘油醛与氟化钠对血葡萄糖的保护作用和对血乳酸生成的抑制作用。方法采集20份血标本,每份分别用肝素抗凝加甘油醛抗糖酵解处理、草酸钾抗凝加氟化钠抗糖酵解处理及肝素抗凝加生理盐水对照,观察甘油醛组、氟化钠组和对照组在4、25、37℃时即刻、2 h、4 h与8 h血中葡萄糖、乳酸的变化情况。结果离体肝素抗凝全血血糖下降及乳酸上升的速度与放置时间、温度成正比。传统的氟化钠保护剂作用缓慢,在4 h后才完全发挥作用,25℃2 h加与未加氟化钠的抗凝全血血糖下降率基本相同(7.40%、7.36%)。25℃时,甘油醛组在8 h内血糖基本稳定。4℃氟化钠组乳酸基本稳定。结论在4℃和25℃的温度下,甘油醛能在8 h内保持血糖基本稳定,对血糖的保护效果明显优于氟化钠,应取代氟化钠用于临床血糖的准确测定,但不能作为乳酸测定抑制剂。

Objective To compare the effect of glyceraldehydes with that of sodium fluoride to preserve glucose and lactic acid in whole blood specimens. Methods Twenty whole blood specimens of volunteers collected in tube containing three series： sodium heparin as anticoagulant were treated with glyceraldehydes and normal saline respectively, potassium oxalate as anticoagulant were treated with sodium fluoride. The glucose and lactic acid concentration in blood were determined at 4℃, 25℃ and 37℃ when immediate, 2 h, 4 h and 8 h. Results The speed of glucose decrease and lactic acid increase correlate with storing time and temperature when sodium heparin as anticoagulant. As preserver, stdium fluoride＇s action was slowly, it acted after 4 h. The rates of glucose decrease were the same （7.40%, 7.36%） when sodiam fluoride was used or not at 25℃, 2 h. At 25℃, the glucose concentration in specimens treated with glyceraldehydes remained nearly constant throughout the 8 h period. At 4℃ the lactic acid remained nearly constant as treated with sodium fluoride. Conclusion It suggest that glyceraldehydes is better than sodium fluoride to preserve glucose against antiglycolysis, the glucose concentration in specimens treated with glyceraldehydes can remain nearly constant troughout 8 h when 4℃ and 25℃. But the effect of inhibition of lactic acid is bad, so it cannot serve as inhibition reagent of lactic acid measurement.