溶血对心包液中N末端脑利钠肽前体检测影响的实验研究

Experimental study on the interference of hemolytic pericardial fluid on the detection of NT-proBNP

目的死后心包液中N末端脑利钠肽前体(NT-proBNP)水平对客观判定死前心功能状态有极大的帮助。由于死后自溶、溶血及冷冻尸体对死后体液生化值造成严重干扰,故本研究旨在对比电化学发光法和干式免疫荧光法检测溶血性心包液中NT-proBNP以评估检测结果及两种方法的准确性。方法人工制备了分别含15g/L、30g/L、45g/L、60g/L血红蛋白(Hemoglobin, Hb)的溶血性心包液,每组10例。采用干式免疫荧光法及电化学发光法检测其NT-proBNP的浓度,与其理论浓度对比,计算偏倚%(Bias%),以±30%为最大可接受偏倚%。同时,测定溶血性心包液中NT-proBNP在体外不同储存条件下的稳定性。结果随着溶血程度增加两种检测方法所受干扰逐渐增大,电化学发光法|偏倚%|<5.5%,免疫荧光法|偏倚%|<20%。溶血性心包液中NT-proBNP在-20℃保存15天、4℃保存3天内降解少于10%。结论两种方法对溶血血红蛋白干扰均具有良好的抗干扰能力,电化学发光法优于免疫荧光法。随着心包液储存时间延长,心包液NT-proBNP逐步降解。

Objective The level of NT-proBNP in postmortem pericardial fluid is of great help in objectively determining the state of cardiac function before death. Because post-mortem autolysis, hemolysis and frozen corpses cause serious interference with the biochemical values of post-mortem body fluids, this study aimed to compare NT-proBNP in hemolytic pericardial fluid by electrochemiluminescence and immunofluorescence methods in accuracy.. Methods Hemolytic pericardial fluid containing 15 g/L, 30 g/L, 45 g/L, and 60 g/L hemoglobin(Hb) was prepared manually,with 10 cases in each group. The concentration of NT-proBNP was measured by immunofluorescence(5 cases) and electrochemiluminescence(5 cases) methods, and compared with the theoretical concentration, the Bias% was calculated,and the maximum acceptable Bias% was ±30%. At the same time, the stability of NT-proBNP in hemolytic pericardial fluid under different storage conditions in vitro was determined. Results As the degree of hemolysis increases, the interference is gradually increased. ECL method(| Bias%|< 5.5%) is better than immunofluorescence(| Bias%|< 20%). NT-proBNP in hemolytic pericardial fluid was degraded by less than 10% within 15 days of storage at-20 °C and within 3 days of storage at 4 °C. Conclusion Both methods have good anti-interference ability against hemolytic hemoglobin interference, and electrochemiluminescence method is superior to immunofluorescence method. As the pericardial storage time prolonged, the pericardial fluid NT-proBNP gradually degraded.