不同稀释介质对15个生化项目测定的影响

The influence of different diluents on measurement of 15 items of biochemical parameters

目的探讨生理盐水、蒸馏水及人灭活血清作稀释介质对部分生化项目测定的影响。方法选取丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)、碱性磷酸酶(ALP)、γ-谷氨酰转肽酶(GGT)、肌酸激酶(CK)、乳酸脱氢酶(LD)、α-羟丁酸脱氢酶(HBDH)、总胆红素(TBIL)、直接胆红素(DBIL)、胆汁酸(TBA)、肌酐(Cr)、尿酸(UA)、胆固醇(CHO)、糖(GLU)、尿素(BUN)等15个项目分析范围内不同浓度的标本各45份,分别用生理盐水、蒸馏水及人灭活血清稀释后用全自动生化分析仪进行测定,计算均值并进行统计学分析。结果待测血清经生理盐水、蒸馏水或人灭活血清等不同介质稀释后,结果存在一定的差异。ALT、AST、GGT、DBIL、HBDH用10倍生理盐水、蒸馏水、人灭活血清稀释均可。ALP、TBA只能选人灭活血清,否则会使结果偏低。GLU、TBIL选择蒸馏水和人灭活血清稀释均可。BUN、CR、UA、CK、LDH、CHO选择生理盐水和人灭活血清更好,若选蒸馏水,除UA外其他结果均会降低。BUN不宜用蒸馏水稀释。用生理盐水稀释的项目5倍与10倍稀释的结果差异无统计学意义,可视具体情况选择。15个项目均可用人灭活血清作稀释介质。结论为尽量减少稀释介质对测定的影响,上述生化项目应首选人灭活血清作稀释介质,若无备用人灭活血清可依上述结果进行相应稀释。

Objective To investigate the influence of different diluents（physiologic saline, distilled water and human inactivated serum） on measurement of 15 items of biochemical parameters. Methods Fifteen items of biochemical parameters [alanine transaminase（ALT）, aspartic transaminase （AST）, alkaline phosphatase（ALP）, gamma glutamyl transpeptidase （ GGT）, ereatine kinase （CK）, lactate dehydrogenase（LD）, hydroxybutyrate dehydrogenase（HBDH）, total bilirubin（TBIL）, direct bilirubin（DBIL）, total bile aeid（TBA）, creatinine（Cr）, uric acid（UA）, cholesterol（CHO）, glucose （GLU）, and blood urea nitrogen（BUN）] were chosen. For each parameter, 45 serum samples with different concentrations of the parameter were collected. After diluted with different diluents（physiologic saline, distilled water or human inactivated serum）, the serum samples were detected by applying the fully automated biochemical analyzer. The mean value was calculated and statistical analysis was performed. Results There were some differences of detection results when the specimens were diluted with different diluents. ALT, AST, GGT, DBIL, and HBDH serum samples could be diluted by 10 times with physiologic saline, distilled water or human inactivated serum; ALP and TBA serum samples could only be diluted with inactivated serum, otherwise its result would be lower; GLU, TBIL samples could be diluted with distilled water and inactivated serum; for BUN, CR, UA, CK, LDH, and CHO samples, physiologic saline or human inactivated serum might be optimal; if distilled water was chosen, the results of other parameters tented to decline except UA. It was BUN was improper to dilute the BUN samples with distilled water. In addition, there was no significant difference between the items diluted by 5 times and 10 times with physiologic saline. All the 15 items could be diluted with inactivated serum. Conclusion The inactivated serum should be the first choice of diluents to enure the accurate results of biochemical parameters. If the prepared inactivated serum is absent, we may choose other diluents according to the above-mentioned results.