不同水平三酰甘油对血红蛋白测定的影响及3种校正方法的研究

Study on influence of different triglyceride concentrations on determination of hemoglobin and three methods of its correction

目的分析不同水平三酰甘油(TG)对血红蛋白(Hb)及相关检测指标平均红细胞血红蛋白(MCH)、平均红细胞血红蛋白浓度(MCHC)测定的影响,并对3种校正方法进行比较。方法将新鲜正常全血标本在Mindary BC-6800全血细胞分析仪上进行全血细胞计数(CBC)后,低速离心后用相同体积的脂肪乳液置换出血浆,使血液中的TG>1.70mmol/L,制成人工脂血标本,再用相同的方法对其进行CBC分析,了解脂血对Hb及其相关参数的影响;对进行了CBC分析的标本进行二次低速离心后分别用等量生理盐水和仪器配套的稀释液替代上层浑浊脂血血浆,混匀后进行二次CBC分析,同时根据Hb估算公式进行估算并对3种校正方法进行比较。结果正常标本和加入TG后标本(TG>4.14 mmol/L)Hb、MCH、MCHC测定值分别是(143.90±3.68)g/L、(29.40±1.28)pg、(316.20±9.90)g/L和(149.30±4.01)g/L、(30.10±1.34)pg、(327.40±8.24)g/L,脂血标本测定值高于正常标本,差异均有统计学意义(P<0.05)。通过生理盐水和仪器稀释液置换及公式法校正之后的Hb、MCH、MCHC测定值分别是(146.60±3.23)g/L、(29.70±1.39)pg、(322.80±6.29)g/L和(145.10±3.65)g/L、(29.60±1.42)pg、(321.20±13.54)g/L及(145.20±2.93)g/L、(29.70±1.60)pg、(318.30±12.56)g/L,生理盐水置换法校正结果与正常标本测定值及另外两种校正方法的结果比较差异具有统计学意义(P<0.05)。结论当血液中TG>4.14mmol/L时,Hb及相关检测指标会假性增高,需要进行校正且仪器稀释液置换法与公式估算法较生理盐水置换法可靠。

Objective To investigate the influence of different triglyceride(TG)concentrations on determination of hemoglobin(Hb)and its related parameters,and compare the difference of three methods of its correction.Methods To determine normal fresh whole blood samples for complete blood cell(CBC)count by Mindary BC-6800 whole blood analyzer,and the plasma were replaced by same volume of fat emulsion after centrifugal separation to make artificial lipemia(TG>1.70 mmol/L).These samples were analyzed for CBC by the same methods to estimate the effect on Hb and its related parameters by lipemia;The analyzed whole blood samples were centrifuged to replace the cloudy plasma by equal volume of normal saline and dilution solution of the instruments respectively.After mixture,these samples were analyzed for CBC by the same methods,and estimated the Hb content according to estimation formula at the meanwhile,compare the three methods of its correction.Results The measured values of Hb,MCH and MCHC in normal samples and after adding TG(TG>4.14 mmol/L)were(143.90±3.68)g/L,(29.40±1.28)pg,(316.20±9.90)g/L and(149.30±4.01)g/L,(30.10±1.34)pg,(327.40±8.24)g/L,respectively.The measured values of Lipemia samples were higher than those in normal samples.The differences were statistically significant(P<0.05).The values of Hb,MCH and MCHC corrected by saline replacement,diluent replacement and formula method were(146.60±3.23)g/L,(29.70±1.39)pg,(322.80±6.29)g/L and(145.10±3.65)g/L,(29.60±1.42)pg,(321.20±13.54)g/L and(145.20±2.93)g/L,(29.70±1.60)pg,(318.30±12.56)g/L,respectively.The results of saline replacement method were different from those of normal samples and the other two methods,with statistical significance(P<0.05).Conclusion When blood TG >4.14 mmol/L,the false increase of Hb and related indicators needs to be corrected.The diluent replacement method and formula estimation method are more reliable than saline replacement method.