钙试剂致血清磷测定结果假性升高的原因分析及处理方法

Causes and treatment of calcium reagent- induced pseudohyperphosphatemia

目的探讨血清钙试剂引起血清磷测定结果升高的原因及处理方法。方法随机选取20例健康体检者新鲜血清标本,先单独测定血清磷(P0组),再做钙、磷同测(P1组),接着分别做试剂针<from Ca to P>的加水清洗200μL(P2组)、加wash1 200μL/加水清洗200μL(P3组)、加wash2 200μL/加水清洗200μL(P4组),在以上3种情况下钙、磷同测,共得到5组血清磷的测定数据。将后4组数据分别与P0组用配对t检验的方法进行统计学分析;调整项目测试顺序并加清洗(Probe<R1>,From Test<All>,To Test P<water 200μL>)后,随机选择当天含钙、磷两个检测项目的病人标本20份记录血清磷测定结果,然后对这20份标本做血清磷的单独测定,再将两组数据用配对t检验的方法进行统计学分析。结果 P0组与P1组,P0组与P2组,P0组与P3组,P0组与P4组进行比较差异均存在显著性意义(P<0.01);调整项目测试顺序后差异无显著性意义,P>0.05。结论残留的血清钙试剂可对磷的测定造成非常严重的正干扰,通过加设特殊清洗的方法只能降低干扰程度,只有调整项目测试顺序才能彻底消除钙试剂可对磷的测定干扰。

Objective To study the causes and treatment of calcium reagent - induced pseudohyperphosphatemia. Method Fresh serum specimens were collected from randomly selected 20 healthy persons. First, only serum phosphorus （P0 group） was measured. Then, serum phosphorus and serum calcium were measured at the same time （P1 group）. The reagent probe （from calcium to phosphorus） was washed with 200 μL of water（P2 group）, 200μL of water and 200μL of washl （ P3 group） and 200 μL of water and 200 μL of wash2 （ P4 group）, respectively. Both serum phosphorus and serum calcium were detected at the same time in the above conditions, and five sets of serum phosphorus were obtained. The last four groups were compared to the P0 group the paired t - test. After adjusting detection sequence and special wash （ Probe 〈 R1 〉, From Test 〈 All 〉 , To Test P 〈 water 200 μL 〉 ）, 20 patients were randomly selected and their Calcium and phosphorus results were measured. And then serum phosphorus concentration of the 20 specimens were detect alone. Finally, the results of the two groups were statistically analyzed by paired t - test method. Results There were significant differences （P 〈 0.01 ） of the four groups （ P1, P2, P3 and P4 ） compared to P0. The results were similar while after adjusting the detection sequence （P 〉 0.05 ）. Conclusion Residual calcium reagent can cause very serious positive interference on the determination of phosphorus. Special wash can only reduce the degree of interference. Only adjustment of test sequence can completely eliminate the interference of calcium on the determination of phosphorus.