探讨时间、温度及光照对干化学检测血清胆红素结果的影响

Effects of time,temperature and light on the results of serum bilirubin detected by dry chemistry

目的探讨时间、温度及实验室光照3种因素对本实验室干化学检测血清胆红素结果的影响,以指导检测流程的合理安排和保证检测结果的准确性。方法选取我院不同胆红素水平的48名新生患儿血清,分装为四组保存(a组冷藏不避光,b组冷藏避光,c组室温不避光,d组室温避光),分别于0h,2h,4h,6h,8h,12h,24h检测总胆红素、非结合胆红素水平,采用SPSS多因素方差重复测定功能对数据进行分析。结果时间、光照和温度对胆红素的交互效应显著,根据美国CLIA′88能力验证计划分析质量要求:胆红素检测值在靶值±6.84mmol/L(0.4mg/dL)或±20%(取大者)为可接受范围,本实验室采用的比对认可标准为1/3TEa,在冷藏或室温避光条件下保存的样本其总胆红素和非结合胆红素水平可以稳定24h以上无明显变化,室温不避光条件下的总胆红素8h内稳定,8h后降解迅速,超过比对认可标准;非结合胆红素12h内不会有明显变化,12h后由于降解速率过快,其样本结果仍不具溯源性。结论建议我实验室采集检测胆红素的标本使用避光真空管,以便保存更长时间,若是使用不避光真空管应在采集或检测样本后在冷藏条件下保存。

Objective To investigate the effects of three factors such as time,temperature and laboratory light on the results of serum bilirubin in the laboratory in order to guide the rational arrangement of the testing process and to ensure the accuracy of the test results.Methods 48 newborns with different levels of bilirubin in our hospital were selected and divided into four groups,which were divided into four groups ( A cold storage with light,B refrigerated avoiding light,C at room temperature with light,D at room temperature avoiding light).Total bilirubin and unbound bilirubin were detected in 0,2,4,6,8,12,24 h.Data were analyzed by SPSS multivariate variance repeated measurement function.Results The interaction effect of time,light and temperature on bilirubin was significant.Analyze the quality requirements according to the US CLIA′88 proficiency test plan:the bilirubin test value is within the acceptable range of ±6.84 mmol/L (0.4 mg/dL) or ±20%(whichever is greater),which is used in our laboratory.The comparison standard is one-third TEa.Samples preserved under refrigeration or at room temperature without light,the levels of total bilirubin and unconjugated bilirubin can be stabilized for at least 24 h without significant changes.The total bilirubin was stable within 8 h at room temperature with light,and the degradation quickly exceeded the standard of comparison after 8 h.Unbound bilirubin did not change significantly within 12 h.Because the degradation rate was too fast after 12 h and the sample results were still not traceability.Conclusion It′s suggested that the specimens of bilirubin detection in our laboratory use the Vacuum collector tube in order to keep for longer time,or to save the samples in the cold storage condition after using the ordinary vacuum tube to collect the samples.