影响生化指标检测结果的危险因素分析

Analysis of risk factors affecting biochemical test results

目的 探究影响生化指标检测结果的危险因素.方法 回顾性分析聊城市第三人民医院在2016年9月至2017年11月期间进行生化检查的120例患者的资料,运用Logistic回归线对影响生化检测结果的影响因素进行分析,同时,观察比较患者在初检和复检的肌酸激酶、乳酸脱氢酶、血钾的水平,观察不同采血方式血钠、血糖和血钾的水平,并观察血标本处理血糖、尿素和氯离子的水平.结果 通过分析可得,在分析前年龄、性别、饮食、运动以及药物和环境可以影响生化检测结果,在分析时标本的采集时间、操作以及保存和送检可对生化检测结果产生影响,在分析后标本的处理、仪器、生化试剂可影响生化检测结果;初检溶血血钾的含量为（7.1±1.8） mmol/L,乳酸脱氢酶含量为（713.6±50.9）U/L,肌酸激酶含量为（263.1±30.8） U/L;复检出血血钾的含量为（4.1±0.6） mmol/L,乳酸脱氢酶含量为（143.6±20.9） U/L,肌酸激酶含量为（52.1±10.8） U/L,初检时溶血的血钾、乳酸脱氢酶和肌酸激酶的含量明显高于复检时（P＜0.05）;对侧采血血钠的含量为（132.1±15.3） mmol/L,血糖含量为（6.6±0.9）mmol/L,钾离子含量为（4.1±0.3） mmol/L;同侧采血血钠的含量为（152.3±13.2） mmol/L,血糖含量为（23.6±4.9） mmol/L,钾离子含量为（7.2±1.8） mmol/L,采取同侧采血患者血液中钠、钾离子和血糖的含量明显高于采用对侧采血的患者（P＜0.05）;纤维蛋白未析出时,氯离子的含量为（28.6±4.6） mmol/L,血糖含量为（0.8±0.1）mmol/L,尿素的含量为（0.5±0.1）mmol/L;纤维蛋白析出时,氯离子的含量为（104.2±16.5）mmol/L,血糖含量为（6.5±1.3） mmol/L,尿素的含量为（6.1±1.5） mmol/L,血样标本纤维蛋白未析出的氯离子、血糖和尿素的含量明显低于纤维蛋白析出的含量（P＜0.05）.结论 生化检测分析的前、中、后都存在影响临床生化检测结果的因素,所以,要加强生化检测的质量,有效地提高生化检测结果的准确率.

Objective To explore the risk factors affecting biochemical indicators.Methods The data of 120 patients undergoing biochemical examinations in Liaocheng Third People＇s Hospital during the period of September 2016 and November 2017 was analyzed retrospectively.The factors affecting the results of biochemical tests were analyzed by the Logistic regression line.At the same time,the levels of creatine kinase,lactate dehydrogenase,and blood potassium were observed and compared at the initial examination and reexamination.The levels of blood sodium,blood sugar,and blood potassium were observed under the different blood sampling methods.And the blood sugar,urea,and chloride levels were observed.Results Age,sex,diet,exercise,medicine,and environment could affect the biochemical test results before the examination;the time of specimen collection,operation,preservation,and inspection could affect the biochemical test results during the examination;the treatment of specimens,instrument,and biochemical reagent could affect the biochemical test results after the examination.The contents of hemolytic blood potassium,lactate dehydrogenase,creatine kinase at the initial examination were （7.1±1.8） mmol/L,（713.6±50.9） U/L,（263.1±30.8） U/L,those at the reexamination were （4.1±0.6） mmol/L,（143.6±20.9） U/L,（52.1±10.8） U/L,those at the initial examination were significantly higher （P〈0.05）.The contents of blood sodium,blood sugar,and blood potassium under the contralateral blood sampling were （132.1±15.3） mmol/L,（6.6±0.9） mmol/L,（4.1 ±0.3） mmoFL,those under the ipsilateral blood sampling were （152.3±13.2） mmol/L,（23.6±4.9） mmol/L,（7.2±1.8） mmol/L,those under the ipsilateral blood sampling were significantly higher （P〈0.05）.The contents of chlorine ion,blood sugar,urea were （28.6±4.6） mmol/L,（0.8±0.1）mmol/L,（0.5±0.1） mmol/L when the fibrin had not been precipitated,those were （104.2± 16.5） mmol/L,（6.5± 1.3）mmol/L,（6.1±1.5） mmol/L when the fibrin had been precipitated,those were obviously lower when the fibrin had not been precipitated （P〈0.05）.Conclusion There are factors that affect the results of clinical biochemical testing before,during and after biochemical analysis.Therefore,the quality of biochemical testing should be strengthened and the accuracy of biochemical test results should be improved effectively.