酶比色法定量检测乳糜血标本三酰甘油的研究

A study on using enzyme chromatometry quantitative method to detect triglyceride in chylemia specimen

目的探讨血清浊度指数与反应速率法前带检查(PC)技术对三酰甘油(TG)酶比色法定量测定中假性低值的识别和消除作用,以期提高乳糜血标本中的TG浓度测定值的准确性。方法选取TG浓度为0.41mmol/L的健康体检者低值血清标本(L)与浓度为27.54mmol/L的急性胰腺炎患者高值乳糜血清标本(H)各1份,按照不同比例配制为21份系列稀释浓度样本;另外增量1.5倍与2倍高值样本(H)反应体积获得2份极高浓度值样本,共23份高低系列浓度样本。采用血清浊度指数与反应速率法PC技术对样本进行定量测定,计算系列样本理论浓度值,记录血清浊度指数值、反应过程吸光度(A)值和实测浓度值。结果系列稀释浓度样本中,血清浊度指数与样本中的乳糜程度呈正相关,并且随着TG浓度的增加而增加;低浓度样本1～12无PC报警,理论值与实测值相关性良好(R^2=0.999 3),相对偏差较小;高浓度样本13～23,理论值与实测值相关性较差(R^2=0.864 1),相对偏差较大,理论值与实测值曲线呈明显的偏离现象;而样本17～23出现前带报警,检测结果呈明显假性低值。结论 TG酶比色法检测高浓度样本(乳糜血)会出现明显的假性低值,应用血清浊度指数与反应速率法PC技术能够迅速有效地识别反应体系中的假性低值,并通过仪器自动稀释再检测功能正确测定样本浓度。

Objective To explore the application of serum turbidity（lipemia） index and reaction rate method prozone check（PC） technology to recognize and eliminate the ＂false low value＂ in quantitative detection of triglyceride（TG） in chylemia specimen by enzyme chromatometry method in order to elevate the accuracy of TG concentration measurement. Methods One of the 2 samples was collected from a healthy case [TG concentration 0.41 mmol/L, low serum concentration sample（L）] and another one, from a patient with acute pancreatitis [TG concentration 27.54 mmol/L, high chylemia serum sample（H）]. According to different dilution proportions, the samples were serially diluted into 21 samples different in concentrations; in addition, two extremely high level samples, 1.5 and 2 times in H volume, were prepared, resulting in totally 23 samples with a serial sequence from low to high TG concentrations. The serum turbidity（lipemia） index and reaction rate method PC technology were used to carry out quantitative determination; the theoretic concentration values of the serial samples were calculated, the serum turbidity index values, the absorbance（A） values in the reaction process and the actual measurement concentrations were recorded. Results In the serial diluted concentration samples, the serum turbidity（lipemia）index was positively correlated with the sample chyle content, and the index and chyle content was increased along with the increase of TG concentration; the prozone check alarm was not found in the low concentration samples（1-12）, and the theoretical concentration values were well coincident with the actual measurement concentration values（R^2 = 0.999 3）, the bias being relatively low; in the high concentration samples（13-23）, the correlation between theoretical value and actual measurement value was relatively poor（R^2 = 0.864 1）, and the theoretical and actual measurement curves presented obvious bias phenomena; while in samples 17-23, prozone check alarm appeared and the measurement results showed obvious false low value. Conclusion When enzyme chromatometry method is used to detect triglyceride in high concentration samples（chylemia）, false low value of TG often appears; the application of serum turbidity（lipemia） index and reaction rate method prozone check technology can quickly and effectively recognize the false low value in the reaction process, and via the instrument automatic dilution and once more the function tested, the sample concentration was accurately determined.