采集标本溶血等因素对临床生化检验指标的影响及预防策略

The influence of factors such as hemolysis of collected specimens on clinical biochemical test indicators and prevention strategies

目的分析采集标本溶血等因素对临床生化检验指标的影响及预防策略。方法采集2019年8月至2021年8月于东营市垦利区疾病预防控制中心检验科进行生化检验的100名健康体检者的血液标本,所有研究对象均抽取4ml血液样本,分为两份,每份2ml,一份正常存放(对照组:血液样本正常离心处理后检测),另一份经人工溶血处理(观察组:人工溶血处理后检测)。比较采血部位、采血时间、样本溶血、送检时间对生化指标检测结果的影响。结果输液手臂采血者钠、血糖(GLU)、天冬氨酸转氨酶(AST)水平均高于非输液手臂采血者,血尿酸(UA)、谷丙转氨酶(ALT)、IgM、甘油三酯(TG)均低于非输液手臂采血者,差异有统计学意义(P<0.05)。上午空腹采血者GLU、总胆固醇(TC)水平均高于其他时间采血者,TG水平低于其他时间采血者,差异有统计学意义(P<0.05)。观察组碱性磷酸酶(ALP)水平低于对照组,AST、ALT、乳酸脱氢酶(LDH)、钾离子(K+)、TC水平均高于对照组,差异有统计学意义(P<0.05);两组血肌酐(SCr)、TG、GLU、尿素氮(BUN)、UA水平比较差异无统计学意义。标准送检者肌酸激酶(CK)、AST、ALT水平均高于1h后送检者,LDH低于1h后送检者,差异有统计学意义(P<0.05)。结论采集标本溶血等因素会影响部分临床生化检验指标,为提高检验结果的科学性和准确性,应避免采集标本溶血等相关因素的干扰。

Objective To analyze the influence of factors such as hemolysis of collected specimens on clinical biochemical test indicators and prevention strategies.Methods Blood samples were collected from 100 healthy subjects who underwent biochemical tests in the Laboratory of the Kenli District Center for Disease Control and Prevention,Dongying City from August 2019 to August 2021.All subjects were extracted 4 ml of blood samples,divided into the two parts,each 2 ml,one normal storage(control group:blood samples were detected after normal centrifugation),and the other was treated with artificial hemolysis(observation group:artificial hemolysis was detected after treatment).The effects of blood collection site,blood collection time,sample hemolysis and submission time on the detection results of biochemical indicators were compared.Results The levels of sodium,blood glucose(GLU)and aspartate aminotransferase(AST)in the infusion arm blood collection were higher than those in the non-infusion arm blood collection,and the levels of uric acid(UA),alanine aminotransferase(ALT),IgM and triacylglycerol(TG)were lower than those in the non-infusion arm blood collection,the differences were statistically significant(P<0.05).The GLU and serum total cholesterol(TC)levels of fasting blood donors in the morning were higher than those of blood donors at other times,and the TG level was lower than that of blood donors at other times,the differences were statistically significant(P<0.05).The levels of alkaline phosphatase(ALP)in the observation group was lower than that in the control group,AST,ALT,lactate dehydrogenase(LDH),potassium ion(K+)and TC were higher than those in the control group,and the differ-ences were statistically significant(P<0.05).There was no significant difference in serum creatinine(SCr),TG,GLU,urea nitrogen(BUN)and UA levels between the two groups.The levels of creatine kinase(CK),AST and ALT in the standard examiners were higher than those in the examiners after 1 h,and LDH was lower than that in the examiners after 1 h,the differences were statistically significant(P<0.05).Conclusion Factors such as hemolysis of collected specimens will affect some clinical biochemical test indicators,in order to improve the scientificity and accuracy of the test results,the interference of related factors such as hemolysis of collected specimens should be avoided.