降低脂肪血浆乳糜程度方法的探讨

The evaluation and comparison of three methods for lipaemia removal in plasma

目的探讨不同的方法对于降低脂肪血浆乳糜程度的效果,减少血液报废,节约血液资源。方法收集乳糜指数>5的重度脂肪血浆50袋,运用滤器过滤法、高速离心法和4℃倒置冷藏法去除脂肪血浆中的乳糜微粒,分析检测处理前、后血浆的乳糜指数、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血浆总蛋白的含量,并进行统计学分析,评价各处理方式降低血浆乳糜程度的效果,分析各组血浆符合成分血质量标准情况。结果脂肪血浆试验前及经滤器过滤或高速离心处理后,检测值CI分别为13.5(8.5)vs3.0(2.25)vs3.0(2.0);TC(mmol/L)3.53±0.80vs3.23±0.77vs3.14±0.75;TG(mmol/L)19.34±12.65vs 13.07±9.42vs11.78±8.01;HDL(mmol/L)0.68±0.19 vs0.69±0.18vs 0.71±0.18;LDL(mmol/L)2.21±0.60 vs2.01±0.61vs1.98±0.64;TP(g/L)54.2±3.3vs56.5±2.6vs 57.2±2.6,P<0.05;脂肪血浆经4℃冷藏后,CI、TG、HDL的检测值分别为12.0(9.25)、17.40±11.47 mmol/L、0.68±0.18 mmol/L与对照组P<0.05,TC、LDL、TP的检测值与对照组,P>0.05。经处理后的血浆,其综合达标符合率分别为:滤器过滤法90%、高速离心法92%、4℃冷藏法10%。结论应用滤器过滤法和高速离心法可以有效处理去除脂肪血浆中的乳糜微粒,4℃倒置冷藏法处理脂肪血浆能力有限。脂肪血浆经适当处理后可以提高其质控达标符合率,减少血液浪费,节约血液资源。

Objective To evaluate and compare the efficiency of high speed centrifugation,filtration method and upside down separation for lipemia removal in plasma samples,so as to reduce the blood waste and save the blood resources.Methods 50 bags of plasma with chyle index(CI)above 5 were each divided into three aliquotes.The lipemia was removed from the aliquotes by three methods,that is high speed centrifugation,filtration using filter,and manual separation of lipaemia after plasma hanging upside down at 4℃overnight.Such parameters as CI,TC,TG,HDL,LDL and TP were determined in lipemic plasma and in samples after lipemia removal,and statistically analyzed to compare the efficiency of lipemia removal.Results The CI levels in lipemic plasma and in samples after filtration and high speed centrifugation were 13.5(8.5 vs 3.0(2.25)vs 3.0(2.0),respectively;TC(mmol/L)3.53±0.80 vs 3.23±0.77 vs 3.14±0.75;TG(mmol/L)19.34±12.65 vs 13.07±9.42 vs 11.78±8.01;HDL(mmol/L)0.68±0.19 vs 0.69±0.18 vs 0.71±0.18;LDL(mmol/L)2.21±0.60 vs 2.01±0.61 vs 1.98±0.64;TP(g/L)54.2±3.3 vs 56.5±2.6 vs 57.2±2.6(P<0.05).Three parameters as CI(12.0,9.25),TG(17.40±11.47 mmol/L)and HDL(0.68±0.18 mmol/L)in plasma after upside down separation were statistically different from those before removal,while other three parameters as TC,LDL and TP were not.The passing rates of lipemic plasma treated by filtration,high-speed centrifugation and upside down separation were 90%,92%and 10%,respectively.Conclusion Both filtration and high-speed centrifugation can remove lipemia in plasma samples effectively.They exceeded manual separation,which is unsuitable owing to its poor removal ability.Lipemic plasma can treated in appropriate ways to avoid blood discarding.