影响保存血铅标本检测的分析前因素分析

Analysis of Pre-analytical Factors in Stored Blood-Lead Sample Testing

目的 探讨标本前处理因素对临床全血标本血铅测定结果的影响.方法 使用钨舟原子吸收光谱仪技术测定全血标本血铅浓度,比较标本浓度、保存时间、标本管类型、反复冻融次数等因素对检测结果的影响,评价可能对血铅定量检测结果的标本前处理因素.结果 ①相同的保存条件下,不同浓度的标本显示出不同的稳定性;②大于三次的反复冻融将导致血铅测定结果偏高;③2～8℃保存130天未见血铅测定结果出现升高或降低.④应用两种厂家肝素抗凝管采集的标本进行血铅检测,结果无统计学差异,提示使用同一抗凝剂的不同厂家的抗凝管不影响检测结果.结论 影响血铅检测结果特别是冻融后检测结果的因素较多,检测前需要考虑标本浓度水平,保存温度,冻融次数等多种情况,严格控制这些因素能够保证血铅检测结果稳定再现.

Objective To analyze the influences of pre-analytical factors on the results of clinical blood-lead testing of stored samples. Methods Measured the clinical blood-lead concentrations with tungsten boat atomic absorptive spectrometer technology,to compare the influences of specimen concentrations,storage time,specimen tube types and times of repeated freez- ing and thawing of specimens on testing results, to evaluate possible pre-analytical factors influencing clinical blood-lead quantitative test results. Results First of all, different concentrations of specimens showed different stability in the same storage conditions. Second,more than three times of freezing and thawing induced higher blood-lead testing results. Third, there were no changes of blood-lead testing results when the specimens had been stored in 2;8;2 for more than 100 days. Last but no least, there were no changes of blood-lead testing results when we test blood-lead collected with heparin antico- agulant tubes from different companies, which indicated that there were no influences on blood-lead testing with heparin anti- coagulant tubes, no matter where the tubes came from. Conclusion There are many influencing factor on the clinical blood- lead tests, especially for the specimens going repeated freezing and thawing, and should take care Of specimen concentrations, storage temperatures,times of freezing and thawing,and so on,to ensure blood-lead testing results could reproduced stably.