进餐及血样溶血和静置时间对变应原检测的影响

Effects of Food Intake and Hemolysis and Sitting Time of Blood Sample on Allergen Detection

目的分析空腹血糖血脂正常者和升高者进餐、血样溶血及采血后血样静置时间对变应原检测结果的影响。方法选取2019年3月在首都医科大学附属北京世纪坛医院变态反应科门诊就诊的患者,分别筛选出空腹血糖血脂正常者26例和空腹血糖血脂(两者任一)升高者12例。所有入组人员均在进餐前后采集静脉血,分别将空腹血糖血脂正常者和升高者血样分为空腹及餐后2组,其中空腹血糖血脂正常者:空腹血样为A组,餐后血样为B组;空腹血糖血脂升高者:空腹血样为C组,餐后血样为D组。在所有入组人员中,随机抽取26例血样进行人工溶血(溶血组),将与之对应的26例未溶血血样予以常规处理(常规处理血清组);随机抽取12例血样静置5 min即离心备检。所有血样均检测变应原特异性免疫球蛋白E(sIgE)抗体,并分别比较A组和B组、C组和D组以及溶血组和常规处理血清组(常规处理血样)的血清sIgE水平。结果A组和B组、C组和D组的变应原(屋尘螨、粉尘螨、艾蒿、普通豚草、蟑螂、猫上皮、犬上皮、屋尘、交链孢霉、柳树)血清sIgE检测水平比较差异均无统计学意义(P>0.05);溶血组的猫上皮血清sIgE水平高于常规处理血清组[0.05(0.04,0.06)kUA/L比0.04(0.03,0.05)kUA/L,P<0.05],交链孢霉及柳树血清sIgE水平低于常规处理血清组[0.06(0.05,0.07)kUA/L比0.07(0.06,0.11)kUA/L,0.08(0.06,0.10)kUA/L比0.11(0.07,0.13)kUA/L,P<0.05];血样静置时间过短,可以导致溶血或产生凝胶块(丝),干扰变应原检测。结论空腹血糖血脂正常者和升高者进餐均不影响变应原检测,空腹及餐后均可行变应原检测;溶血和采血后静置时间过短是变应原检测的干扰因素,在血液标本采集、分离、运送以及保存过程中一定要严格按照操作规程操作。

Objective To analyze the effects of food intake,hemolysis and blood sample sitting time on allergen detection results of the patients with normal and elevated fasting blood glucose and blood lipid.Methods Patients were selected from Department of Allergy of Beijing Shijitan Hospital Affiliated to Capital Medical University in Mar.2019.26 patients with normal fasting blood glucose and lipids and 12 patients with elevated fasting blood glucose or blood lipid were included.Venous blood samples were taken from all the participants before and after meals,and blood samples of the patients with normal and elevated fasting blood glucose lipids were divided into a fasting group and a postprandial group respectively.Normal:fasting blood samples as group A,postprandial blood samples as group B;elevated:fasting blood samples as group C,postprandial blood samples as group D.Among all the enrolled cases,26 blood samples were randomly selected for artificial hemolysis(hemolysis group),and corresponding 26 unhemolytic blood samples were routinely treated(serum routine treatment group);12 blood samples were randomly selected and left for 5 minutes for centrifugation.Allergen specific immunoglobulin E(sIgE)antibody was detected in all blood samples,the serum sIgE levels of group A and group B,group C and group D,hemolysis group and serum routine treatment group were compared.Results There was no significant difference in allergen(Dermatophagoides pteronyssinus,Dermatophagoides farina,Artemisia argyi,ragweed,cockroach,act epithelium,dog epithelium,house dust,Alternaria alternata,and willow)serum sIgE levels between group A and group B,group C and group D(P>0.05).The level of serum sIgE in hemolytic group was higher than that in serum routine treatment group[0.05(0.04,0.06)kUA/L vs 0.04(0.03,0.05)kUA/L,P<0.05],but sIgE level in serum of Alternaria alternata and willow was lower than that in serum routine treatment group[0.06(0.05,0.07)kUA/L vs 0.07(0.06,0.11)kUA/L,0.08(0.06,0.10)kUA/L vs 0.11(0.07,0.13)kUA/L,P<0.05].Insufficient sitting time of blood sample could lead to hemolysis or gel block(spinning),which interfered with allergen detection.Conclusion Food intake does not affect the allergen detection in patients with either normal or elevated fasting blood glucose and blood lipids,so the test can be done on fasting or after meals;hemolysis and short blood sitting time are the interfering factors of allergen detection,so the procedures must be strictly followed in the process of blood sample collection,separation,transportation and preservation.