血清指数分层设置在罗氏生化检测系统中的应用

Application of Serum Index Stratification in Roche Biochemical Detection System

目的探索在罗氏Cobas 8000检测系统上进行血清指数分层设置并评估不同溶血、黄疸、脂血程度对检测结果的影响。方法采用美国病理家学会(CAP)溶血、黄疸、脂血干扰物质(2014-IFS survey)加入不同浓度干扰物质对常规生化检测结果的影响。结果溶血标本对ALT、AST、TBIL、LDH、K等项目显正干扰影响,TG和CREA等项目显负干扰影响。黄疸标本对ALT、AST、TBIL、GGT、ALP、GLU、TG等项目显正干扰影响,TP、ALB、CHE、UREA、UA、PHOS、CHOL、HDL-C、LDL-C、CREA等项目显负干扰影响。脂血标本对ALT、AST、GGT、ALP、CHE、UREA、GLU、UA、PHOS、CHOL、TG、LDL-C、CREA等项目显正干扰影响,ALB、TBIL、HDL-C、ApoA1、LP(a)等项目显负干扰影响。结论 不同检测项目、不同检测系统试剂受溶血、黄疸、脂血的干扰程度不同,实验室应根据检测系统建立每个项目的溶血、黄疸、脂血指数界值,客观反映标本质量,及时辨别不合格标本,提高工作效率。

Objective To explore the stratified setting of serum index on Roche Cobas 8000 auto-analyzer and to evaluate the interference on clinical chemistry profiles by hemolysis,icterus and lipemia(HIL).Methods Interfering materials from the College of American pathologists (CAP 2014-IFS survey) were used to compare the effect on routine chemistry assays by HIL.Results Comparing to non-hemolyzed samples,hemolyzed samples had significant positive interference on ALT,AST,TBIL,LDH,K,while TG and CREA had significant negative interference.Comparing to non-icteric samples icteric samples had significant positive interference on ALT,AST,TBIL,GGT,ALP,GLU,TG,while significant negative interference on TP,ALB,CHE,UREA,UA,PHOS,CHOL,HDL-C,LDL-C,CREA.Comparing to non-lipemic samples,lipemic samples had significant positive interference on ALT,AST,GGT,ALP,CHE,UREA,GLU,UA,PHOS,CHOL,TG,LDL-C,CREA,while significant negative interference on ALB,TBIL,HDL-C,ApoA1,LP(a).Conclusions The interference degree of hemolysis,icterus and lipemia varies with analyzers and reagents.Clinical laboratory should establish HIL alert index values based on its own analyzers to monitor the quality of samples objectively.By this way report reviewer could identify unqualified samples timely and improve work efficiency.