重度脂血干扰干、湿化学方法检测部分生化指标的分析

Analysis of severe lipemia interfering partial biochemical indicators detected by dry and wet chemical methods

目的通过观察高速离心前后的脂血标本在干、湿化学两种仪器中14项生化指标检测结果的差异,比较干、湿化学方法对重度脂血的抗干扰能力。方法收集41例临床重度脂血标本,常规离心后分别用日立7600(H7600)全自动生化分析仪和Vitros-5600(V5600)干化学分析仪检测14项生化指标:天门冬氨酸氨基转移酶(AST)、肌酸激酶(CK)、肌酸激酶同工酶MB(CK-MB)、淀粉酶(AMY)、乳酸脱氢酶(LDH)、胆碱酯酶(CHE)、尿素(Urea)、肌酐(Cr)、HCO_(3)^(-)、葡萄糖(Glu)、Ca^(2+)、K^(+)、Na^(+)和Cl^(-);经高速离心后,吸取下层透亮血清再次检测以上指标,比较高速离心前后结果的差异。结果H7600全自动生化分析仪检测的41例脂血标本中,经高速离心后,AMY、CK和Ca^(2+)3项指标的检测结果比较,差异无统计学意义(P>0.05),而其他11项指标(AST、CK-MB、LDH、CHE、Urea、Cr、HCO_(3)^(-)、Glu、K^(+)、Na^(+)和Cl^(-))检测结果比较,差异有统计学意义(P<0.05)。V5600干化学分析仪检测的41例脂血标本中,经高速离心后,AMY、CK、Ca^(2+)、AST、LDH、Urea、Cr和K^(+)8项指标的检测结果比较,差异无统计学意义(P>0.05),而其他6项指标(CK-MB、CHE、HCO_(3)^(-)、Glu、Na^(+)和Cl^(-))的检测结果比较,差异有统计学意义(P<0.05)。结论在部分检测指标上,干化学方法对重度脂血的抗干扰能力优于湿化学方法,为了结果的准确性,建议重度脂血标本经高速离心后再上机检测。

Objective To compare the anti-interference ability of dry chemical method with that of wet chemical method on severe lipemia,the results of 14 biochemical indicators of lipemia specimens before and after high-speed centrifugation detected by the dry and wet chemical instruments were observed.Methods A total of 41 cases of clinical severe lipemia specimens were collected.After routine centrifugation,14 biochemical indicators which included aspartate aminotransferase(AST),creatine kinase(CK),creatine kinase isoenzyme MB(CK-MB),amylase(AMY),lactate dehydrogenase(LDH),cholinesterase(CHE),Urea,creatinine(Cr),HCO_(3)^(-)、glucose(Glu),Ca^(2+),K^(+),Na^(+) and Cl^(-) were detected by H7600 automatic biochemical analyzer and V5600 dry chemical analyzer,respectively.After high-speed centrifugation,the lower layer of transparent serum was absorbed to detect the above indicators again,and the results before high-speed centrifugation were compared with that after high-speed centrifugation.Results After high-speed centrifugation,there were no statistically significant differences in the results of 3 indicators which included AMY,CK and Ca^(2+) in 41 lipemia specimens detected by H7600 automatic biochemical analyzer(P>0.05),while the differences in the results of other 11 indicators which included AST、CK-MB、LDH、CHE、Urea、Cr、HCO_(3)^(-)、Glu、K^(+)、Na^(+) and Cl^(-) were statistically significant(P<0.05).After high-speed centrifugation,there were no statistically significant differences in the results of 8 indicators which included AMY、CK、Ca^(2+)、AST、LDH、Urea、Cr and K^(+) in 41 lipemia specimens detected by V5600 dry chemistry analyzer(P>0.05),while the differences in the results of the other 6 indicators which included CK-MB、CHE、HCO_(3)^(-)、Glu、Na^(+) and Cl^(-) were statistically significant(P<0.05).Conclusion The anti-interference ability of dry chemical method against severe lipemia is better than that of wet chemical method in some biochemical indicators.It is recommended that severe lipemia specimens be detected after high-speed centrifugation for the accuracy of the results.