探讨溶血对生化检验准确性的影响及纠正措施的方法分析

Effect of hemolysis on accuracy of biochemical test and analysis of corrective measures

目的探讨生化检验过程中溶血对检验结果准确性的影响及相关的纠正措施。方法依据溶血情况,将同一血清标本分为溶血标本组(溶血组)和未溶血标本组(未溶血组)。比较两组标本的生化检测值变化情况,并分析血红蛋白(Hb)浓度与溶血检测值的相关性。结果溶血组的总蛋白(TP)、天冬氨酸转氨酶(AST)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、羟丁酸脱氢酶(HBDH)、乳酸脱氢酶(LDH)、K^+检测值均明显高于未溶血组[TP(g/L):61.31±20.12比36.80±22.89、AST(U/L):80.12±4.63比71.79±3.78、CK(U/L):170.32±79.43比128.32±69.31、CK-MB(U/L):85.41±15.98比6.49±1.32、HBDH(U/L):357.21±139.87比143.21±60.76、LDH(U/L):402.45±81.56比171.93±53.98、K^+(mmol/L):5.87±1.98比4.03±0.99,均P<0.05],溶血组Na^+检测值明显低于未溶血组(mmol/L:122.78±6.64比141.76±5.53,P<0.05)。溶血标本中上述各检测值变化值与血清Hb浓度变化值之间具有相关性(r值分别为0.991、0.984、0.979、0.992、0.991、0.993、0.990、0.992,均P<0.05)。结论血液标本发生溶血会影响到检测结果;生化检测值变化情况与血清Hb浓度具有相关性,可以通过血清Hb浓度纠正出现偏差的检测值。

Objective To investigate the effect of hemolysis on accuracy of biochemical test and analysis of corrective measures. Methods According to the condition of hemolysis, the same serum specimens were divided into observation group and control group, the hemolytic specimens were the observation group, not hemolytic specimens were the control group. The changes of biochemical detection value of specimens in two groups were compared, and the correlation between hemoglobin concentration and the detection value was analyzed. Results The detection value of total protein （TP）, aspartate transaminase （AST）, creatine kinase （CK）, creatine kinase isoenzyme （CK-MB）, hydroxybutyrate dehydrogenase （HBDH）, lactate dehydrogenase （LDH）, K^＋ in the observation group were significantly higher than those of the control groupwith significant difference [TP （g/L）： 61.31±20.12 vs. 36.80±22.89, AST （U/L）： 80.12±4.63 vs. 71.79±3.78, CK （U/L）： 170.32±79.43 vs. 128.32±69.31, CK-MB （U/L）： 85.41 ± 15.98 vs. 6.49±1.32, HBDH （U/L）： 357.21±139.87 vs. 143.21±60.76, LDH （U/L）： 402.45±81.56 vs. 171.93±53.98, K^＋（mmol/L）： 5.87±1.98 vs. 4.03± 0.99, all P 〈 0.05]. The detection value of Na^＋ in the observation group was significantly lower than that of the control group with significant difference （mmol/L： 122.78±6.64 vs. 141.76± 5.53, P 〈 0.05）. The change of detection value in the observation group was correlated with the change of serum Hb concentration （r=0.991, 0.984, 0.979, 0.992, 0.991, 0.993, 0.990, 0.992, respectivly, all P 〈 0.05 ） . Conclusions The hemolysis of blood specimens will affect the detection results. The change of biochemical detection value is related to the serum Hb concentration, and the deviation of the detection value can be corrected through the serum Hb concentration.