4种真空采血管对生化检测项目结果影响的评估
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摘要
目的:利用肝素锂分离胶试管采集临床血液标本,克服常规生化试管,如分离胶促凝试管血液凝固不完全,肝素锂抗凝试管葡萄糖(GLU)降解,钾离子(K+)从红细胞释放等不利于标本保存的缺点。比较4种真空采血管对生化检测项目结果的影响。方法:分别利用无添加剂真空试管、分离胶促凝试管、肝素锂抗凝试管和肝素锂分离胶试管收集100名志愿者早晨空腹静脉血液,1 hr内采用西门子自动生化仪进行常规17项生化指标检测。检测完毕将标本4℃保存6 hr,12 hr,24 hr,48 hr和72 hr后测定GLU、K~+和乳酸脱氢酶(LDH)。结果:1 hr内四种采血管的17项生化检验项目的结果比较,除总蛋白(TP)和K+之外无显著差异(P>0.05)。24 hr肝素锂分离胶管GLU和K~+与其1 hr测得结果无显著差异。肝素锂抗凝管和无添加剂真空管结果发生明显变化。48 hr后肝素锂分离胶管GLU和K~+值与其1 hr结果发生变化,但变化幅度小于肝素锂抗凝管和无添加剂真空管。LDH 24 hr后除分离胶促凝管外其余三种均发生变化。结论:肝素锂分离胶试管在保存GLU和K~+标本方面比肝素锂抗凝管和无添加剂真空试管具有优势,但与分离胶促凝试管相比仍有不足。但在一定范围内可克服分离胶促凝试管存在的因红细胞凝集而导致的一些问题,可以在临床急诊检测中酌情使用。
Objective: Using heparin-lithium separation gel tube to solve the negative influence of conventional blood collection tubes for specimen preservation,such as incomplete blood coagulation in separation gel procoagulant tube,glucose( GLU) degradation in heparin-lithium anticoagulant tube and potassium( K+)release from red blood cells. Methods: A total of 100 volunteers were included in our study. The fasting venous blood samples were collected in the morning with normal vacuum tubes( without additives),separation gel procoagulant tubes,heparin-lithium anticoagulant tubes and heparin-lithium separation gel tubes,respectively.Seventeen routine biochemical tests were performed within 1 hour using Siemens automatic biochemical analyzer.The specimens were stored in a 4 ℃ refrigerator,and the levels of GLU,K~+and lactate dehydrogenase( LDH)were measured at 6,12,24,48 and 72 hours after the tests were completed. Results: In addition to the total protein( TP) and K+levels,there were no significant differences in the findings of 17 biochemical tests of the four blood collection tubes within 1 hour( P>0.05). There were no significant differences in the GLU and K+levels of the heparin-lithium separation gel tubes at 24 hours compared with those at 1 hour,whereas there were significant changes in the findings of heparin-lithium anticoagulant tubes and normal vacuum tubes( without additives).There were changes in the GLU and K~+levels of heparin-lithium separation gel tubes at 48 hours compared with those at 1 hour,where the changes were less than those in the heparin-lithium anticoagulant tubes and normal vacuum tubes( without additives). In addition to the separation gel procoagulant tubes,there were changes in the LDH of the other three tubes at 24 hours. Conclusion: Heparin-lithium separation gel tube shows advantages over heparin-lithium anticoagulant tube and normal vacuum tube( without additives) in preservation of GLU and K+specimens,but it is still insufficient compared with separation gel procoagulant tube. In a certain range,it may overcome the disadvantages caused by RBC coagulation in separation gel procoagulant tube,and may be used as appropriate in clinical emergency tests.
Objective: Using heparin-lithium separation gel tube to solve the negative influence of conventional blood collection tubes for specimen preservation,such as incomplete blood coagulation in separation gel procoagulant tube,glucose( GLU) degradation in heparin-lithium anticoagulant tube and potassium( K+)release from red blood cells. Methods: A total of 100 volunteers were included in our study. The fasting venous blood samples were collected in the morning with normal vacuum tubes( without additives),separation gel procoagulant tubes,heparin-lithium anticoagulant tubes and heparin-lithium separation gel tubes,respectively.Seventeen routine biochemical tests were performed within 1 hour using Siemens automatic biochemical analyzer.The specimens were stored in a 4 ℃ refrigerator,and the levels of GLU,K~+and lactate dehydrogenase( LDH)were measured at 6,12,24,48 and 72 hours after the tests were completed. Results: In addition to the total protein( TP) and K+levels,there were no significant differences in the findings of 17 biochemical tests of the four blood collection tubes within 1 hour( P>0.05). There were no significant differences in the GLU and K+levels of the heparin-lithium separation gel tubes at 24 hours compared with those at 1 hour,whereas there were significant changes in the findings of heparin-lithium anticoagulant tubes and normal vacuum tubes( without additives).There were changes in the GLU and K~+levels of heparin-lithium separation gel tubes at 48 hours compared with those at 1 hour,where the changes were less than those in the heparin-lithium anticoagulant tubes and normal vacuum tubes( without additives). In addition to the separation gel procoagulant tubes,there were changes in the LDH of the other three tubes at 24 hours. Conclusion: Heparin-lithium separation gel tube shows advantages over heparin-lithium anticoagulant tube and normal vacuum tube( without additives) in preservation of GLU and K+specimens,but it is still insufficient compared with separation gel procoagulant tube. In a certain range,it may overcome the disadvantages caused by RBC coagulation in separation gel procoagulant tube,and may be used as appropriate in clinical emergency tests.
引文
[1]赵立飞,徐建华,解传芬,等.临床应用分离胶采血管需注意的问题[J].临床检验杂志,2012,30(07):543-545.
[2]张伦军,丁晓琳,陈庆书,等.分离胶采血管对部分临床生化检验测定结果的影响[J].中华全科医学,2010,8(06):773+777.
[3]陈寿林,蔡彩君,杨胜利,等.不同类型真空采血管对22项生化检验项目的影响分析[J].现代实用医学,2013,25(10):1180-1182.
[4]陈海斌,郑慕阳. 3种真空采血管在临床生化检验中的应用和评价[J].检验医学与临床,2010,7(05):428-430.
[5]代莉,苏适.应用血清分离胶与肝素锂血浆真空采血管采集血标本对急诊生化检验结果的影响[J].解放军医药杂志,2016,28(02):100-102.
[6]田红.肝素抗凝血浆用于急诊生化检验的可行性探讨[J].当代医学,2016,22(14):84-85.
[7]任继欣.两种肝素抗凝血浆对检测8项生化指标的影响[J].国际检验医学杂志,2012,33(16):2047-2048.
[8] Miles RR,Roberts RF,Putnam AR,et al. Comparison of serum and heparinized plasma samples for measurement of chemistry analytes[J]. Clin Chem,2004,50(9):1704-1706.
[9]阴斌霞,黄芳,高宁,等.肝素锂抗凝血浆与血清样品28项生化检验项目的可比性分析[J].实用医技杂志,2006(18):3167-3169.
[10]程涌江,冯敛.肝素抗凝血浆与血清常用生化指标检测结果的比较[J].实用医技杂志,2007(33):4529-4531.
[11]黄浩,戴芳,黄玲莎,等.肝素锂抗凝血浆与血清54项生化检验项目结果的对比分析[J].国际检验医学杂志,2014,35(15):2040-2041+2044.
[12]闫存玲,李志艳,燕容,等.分离胶采血管制备血清对血糖、补体C3和NSE测定结果及稳定性的影响[J].检验医学,2009,24(4):260-263.
[13]许云虎.分离胶采血管保存标本对血糖测定结果的影响[J].临床和实验医学杂志,2010,9(07):530-531.
[14]邝桂星,刘伟旗,赖韶钦,等.氟化钠抗凝管与分离胶真空采血管在血糖中的应用评价[J].国际检验医学杂志,2012,33(16):2015-2016.
[15]任碧琼,邹国英,徐飞.肝素锂抗凝管在临床化学分析中的合理应用[J].湖南师范大学学报(医学版),2011,8(2):41-43.
[2]张伦军,丁晓琳,陈庆书,等.分离胶采血管对部分临床生化检验测定结果的影响[J].中华全科医学,2010,8(06):773+777.
[3]陈寿林,蔡彩君,杨胜利,等.不同类型真空采血管对22项生化检验项目的影响分析[J].现代实用医学,2013,25(10):1180-1182.
[4]陈海斌,郑慕阳. 3种真空采血管在临床生化检验中的应用和评价[J].检验医学与临床,2010,7(05):428-430.
[5]代莉,苏适.应用血清分离胶与肝素锂血浆真空采血管采集血标本对急诊生化检验结果的影响[J].解放军医药杂志,2016,28(02):100-102.
[6]田红.肝素抗凝血浆用于急诊生化检验的可行性探讨[J].当代医学,2016,22(14):84-85.
[7]任继欣.两种肝素抗凝血浆对检测8项生化指标的影响[J].国际检验医学杂志,2012,33(16):2047-2048.
[8] Miles RR,Roberts RF,Putnam AR,et al. Comparison of serum and heparinized plasma samples for measurement of chemistry analytes[J]. Clin Chem,2004,50(9):1704-1706.
[9]阴斌霞,黄芳,高宁,等.肝素锂抗凝血浆与血清样品28项生化检验项目的可比性分析[J].实用医技杂志,2006(18):3167-3169.
[10]程涌江,冯敛.肝素抗凝血浆与血清常用生化指标检测结果的比较[J].实用医技杂志,2007(33):4529-4531.
[11]黄浩,戴芳,黄玲莎,等.肝素锂抗凝血浆与血清54项生化检验项目结果的对比分析[J].国际检验医学杂志,2014,35(15):2040-2041+2044.
[12]闫存玲,李志艳,燕容,等.分离胶采血管制备血清对血糖、补体C3和NSE测定结果及稳定性的影响[J].检验医学,2009,24(4):260-263.
[13]许云虎.分离胶采血管保存标本对血糖测定结果的影响[J].临床和实验医学杂志,2010,9(07):530-531.
[14]邝桂星,刘伟旗,赖韶钦,等.氟化钠抗凝管与分离胶真空采血管在血糖中的应用评价[J].国际检验医学杂志,2012,33(16):2015-2016.
[15]任碧琼,邹国英,徐飞.肝素锂抗凝管在临床化学分析中的合理应用[J].湖南师范大学学报(医学版),2011,8(2):41-43.