血清56℃加热30 min灭活对生化指标检测结果的影响研究

Effects of inactivation of serum at 56℃for 30 min on biochemical test results

目的探讨血清56℃加热30 min病毒灭活对生化指标检验指标的影响。方法采集患者标本35例,离心后分离出血清,检测灭活前和灭活后标本的38项生化指标,并比较灭活对生化检测的影响。结果(1)与新型冠状病毒肺炎相关的生化指标中,丙氨酸氨基转移酶(ALT)、γ-谷氨酰转肽酶(GGT)、肌酸激酶(CK)、碱性磷酸酶(ALP)和胆碱酯酶(CHE)在灭活前、后的检测值差异有统计学意义(P<0.05),与灭活前相比,灭活后检测值分别平均下降了16.76%、2.53%、56.77%、34.39%和7.31%,天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)和C-反应蛋白(CRP)在灭活前、后的检测值差异无统计学意义(P>0.05),但AST、LDH两个指标20.00%以上的标本灭活前后检测值偏差超过最大允许偏差。(2)其他的生化指标中,二氧化碳总量(TCO2)、血清球蛋白(GLO)、总胆红素(TBIL)、间接胆红素(IBIL)、高密度脂蛋白(HDL)、血清前清蛋白(PA)和血清β2微球蛋白(β2-MG)在灭活前、后的检测值差异有统计学意义(P<0.05),与灭活前相比,灭活后的检测值分别平均下降了11.09%、2.55%、4.08%、4.89%、6.16%、2.08%和3.65%;TP和ALB灭活前、后的检测值差异无统计学意义(P>0.05),但20.00%以上的标本灭活前后检测值偏差超过最大允许偏差。结论56℃加热30 min灭活处理对22项生化指标无影响,TCO2、GLO、TBIL、IBIL、HDL、PA、β2-MG、血清总蛋白(TP)、清蛋白(ALB)和酶类指标受灭活影响,临床应用时应进行校正。

Objective To investigate the effects of virus inactivation on serum biochemical test indexes after heating at 56℃for 30 min.Methods After centrifugation,35 patients were collected to separate haemorrhagic serum,38 biochemical indexes were detected before and after inactivation,and the effect of inactivation on biochemical test was compared.Results(1)Among the biochemical indicators related to neo-coronary pneumonia,there were significant differences in the detection value of alanine aminotransferase(ALT),γ-glutamyl transpeptidase(GGT),creatine kinase(CK),alkaline phosphatase(ALP).and cholinesterase(CHE)before and after inactivation(P<0.05),compared with that before inactivation,the detection value after inactivation decreased by 16.76%,2.53%,56.77%,34.39%and 7.31%respectively.There was no significant difference in the detection value of AST,LDH and CRP before and after inactivation(P>0.05),but the detection value deviation of AST and LDH before and after inactivation exceeded the maximum allowable deviation.Among the other biochemical indexes,there were significant differences in the total carbon dioxide(tCO2),serum globulin(GLO),total bilirubin(TBIL),indirect bilirubin(IBIL),high density lipoprotein(HDL),serum prealbumin(PA)and serumβ2-microglobulin(β2-MG)before and after inactivation(P<0.05),compared with that before inactivation,the detection value after inactivation decreased by 11.09%,2.55%,4.08%,4.89%,6.16%,2.08%and 3.65%on average;there was no significant difference between the detection values before and after inactivation of TP and ALB(P>0.05),but the detection value deviation before and after inactivation of more than 20.00%samples exceeded the maximum allowable deviation.Conclusion Inactivation treatment at 56℃for 30 min has no effect on 22 biochemical indicators.tCO2,GLO,TBIL,IBIL,HDL,PA,β2-MG,TP,ALB,and enzyme indicators are affected by inactivation,and should be corrected for clinical application.