标本溶血对葡萄糖氧化酶-过氧化物酶法测定血糖的影响

The influence of specimen hemolysis on the determination of blood glucose by Glucose Oxidase-Peroxidase method

目的探讨采用葡萄糖氧化酶-过氧化物酶法(GOD-POD法)测定血糖(Glu)时标本溶血对测定结果的影响及其干扰机制,以提高Glu检测结果的准确性。方法使用一次性真空分离胶采血管采集门诊30例成年患者的空腹静脉血,每个患者共采集2管,每管各3 mL,分别编号A管、B管。使A管血液自然凝固,作为非溶血组;用力震荡B管血液,人为造成标本溶血,使用全血细胞分析仪检测血红蛋白(Hb),确定其血清中Hb测定浓度为1~4 g/L,作为溶血组。将全部标本分离血清,采用GOD-POD法在生化仪中检测60份标本的Glu值,每份样本重复检测5次,取平均值进行对比。结果溶血组的Glu值较非溶血组明显降低(mmol/L:3.80±0.51比5.30±0.41,P<0.05)。结论标本溶血会使Glu测定值偏低,影响Glu测定的准确性,实际工作中应尽量避免使用溶血标本进行生化检测。临床工作者在采集血液标本时应严格按照规范操作,认真做好标本的采集、运送和分离工作,以防止标本溶血。

Objective To explore the influence of specimen hemolysis on the result of blood glucose determination using the Glucose Oxidase-Peroxidase(Glu-POD)method,and its interference mechanism in order to improve the accuracy of the result.Methods The fasting venous blood samples were collected from 30 adult patients by using one-off vacuum separation gel tube,each tube containing 3 mL of blood,2 tubes for each person,and one was assigned as A tube and another one,as B tube.Let 30 blood specimens of A tubes coagulate naturally to be the non-hemolytic group;while the 30 B-specimens were oscillated forcefully to make them artificially hemolyze,then the hemoglobin(Hb)was detected by using Complete Blood Cell Analyzer,when the Hb concentration in B group serum was 1-4 g/L,the hemolytic group specimen was formed.The serum was separated from all the specimens,the GOD-POD method was used to detect the blood glucose of 60 specimens in biochemical analyzer,each specimen was tested for 5 times to get an average value,and the average results of the two groups were compared and statistically analyzed.Results The blood glucose in hemolytic group was significantly lower than that in non-hemolytic group(mmol/L:3.80±0.51 vs.5.30±0.41,P<0.05).Conclusions Using the hemolytic specimen for the determination of blood glucose may make the glucose level lower than that of the real patient's concentration and affect the accuracy of detection.In practical works,it is necessary to make great effort to avoid using hemolytic specimens for biochemical detection.While collecting blood specimens,clinical workers should strictly follow the Standard Operating Procedures(SOP)and seriously collect,transport and separate blood specimens in order to prevent hemolysis.