CAJ | 학술논문

目的观察肝素锂对常规生化检测结果的影响,探讨肝素锂抗凝血浆能否用于生化检测以及能否用血清参考范围解释血浆检测结果.方法按美国临床实验室标准化委员会(NCCLS)的<用患者样本进行方法比对及偏倚评估:批准指南>(EP9-A方案),随机抽取40例患者和健康体检者静脉血样本,分别注入红色真空采集管和肝素锂抗凝管中,于同一生化仪中对34项生化项目进行检测,并对结果进行统计学分析.结果 34项测定指标中除脂蛋白(a)[Lp(a)]、前白蛋白(PA)、5'-核苷酸酶(5'-NT)、腺苷脱氨酶(ADA)外,其余各项目的相关系数(r)均≥0.975.34项指标中血浆与血清葡萄糖(Glu)、钾(K)、钠(Na)、氯(Cl)、磷(P)的平均偏倚>1/2美国临床医学检验部门修正法规(CLIA'88)允许误差.血浆Lp(a)、PA、5'-NT、ADA检测结果与其血清检测结果相比,差异有统计学意义(P<0.05),平均偏倚均较大,分别为-11.9%、27.68%、-37.03%、29.31%;其余25项指标血浆测定值与血清测定值之间差异均<1/2 CLIA'88允许误差.结论大部分常规生化检验项目可用肝素锂抗凝血浆代替血清,但Glu、K、Na、Cl、P应建立血浆参考范围,其余项目可用血清参考范围解释血浆检测结果.Lp(a)、PA、5'-NT、ADA项目不宜用肝素锂抗凝血浆作为样本进行测定.
목적 관찰간소리대상규생화검측결과적영향,탐토간소리항응혈장능부용우생화검측이급능부용혈청삼고범위해석혈장검측결과.방법 안미국림상실험실표준화위원회(NCCLS)적<용환자양본진행방법비대급편의평고:비준지남>(EP9-A방안),수궤추취40례환자화건강체검자정맥혈양본,분별주입홍색진공채집관화간소리항응관중,우동일생화의중대34항생화항목진행검측,병대결과진행통계학분석.결과 34항측정지표중제지단백(a)[Lp(a)]、전백단백(PA)、5'-핵감산매(5'-NT)、선감탈안매(ADA)외,기여각항목적 상관계수(r)균≥0.975.34항지표중혈장여혈청포도당(Glu)、갑(K)、납(Na)、록(Cl)、린(P)적평균편의>1/2미국림상의학검험부문수정법규(CLIA'88)윤허오차.혈장Lp(a)、PA、5'-NT、ADA검측결과여기혈청검측결과상비,차이유통계학의의(P<0.05),평균편의균교대,분별위-11.9%、27.68%、-37.03%、29.31%;기여25항지표혈장측정치여혈청측정치지간차이균<1/2 CLIA'88윤허오차.결론 대부분상규생화검험항목가용간소리항응혈장대체혈청,단Glu、K、Na、Cl、P응건립혈장삼고범위,기여항목가용혈청삼고범위해석혈장검측결과.Lp(a)、PA、5'-NT、ADA항목불의용간소리항응혈장작위양본진행측정.
Objective To observe the influence of heparin lithium on the results of routine biochemistry determination. To study the feasibility of plasma anticoagulated with heparin lithium used for biochemical assay and serum reference range used for analysing plasma results. Methods According to the method comparison and bias estimation using patient samples (Document EP9-A) approved by National Committee for Clinical Laboratory Standards (NCCLS), 40 blood samples of patients and healthy subjects were separately poured into the red vacuum tube and heparin lithium anticoagulant tube. 34 routine biochemistry indexes were determined by the same auto biochemistry analyzer and analyzed statistically. Results Except for apolipoprotein(a) [Lp(a)],prealbumin(PA) ,5'-nucleotidase (5'-NT) and adenosine deaminase (ADA) ,the correlation coefficient (r) of the other indexes was ≥0. 975. Among 34 indexes, the average bias of glucose (Glu), potassium (K), sodium (Na), chlorine (Cl) and phosphrous (P) with plasma was more than 1/2 the Clinical Laboratory Improvement Amendments (CLIA'88) allowable total error (Tea). The main biases of Lp(a), PA, 5'-NT and ADA were- 11.9% ,27.68%, -37.03% and 29.31% respectively. The results had significant difference between plasma and serum(P < 0.05). The bias of the other 25 indexes in serum and plasma was less than 1/2 CLIA'88 Tea. Conclusions Serum could be replaced by plasma with heparin lithium as anticoagulant for most of biochemistry assay. The serum reference range could be used for explaining plasma results except Glu, K, Na, Cl and P,which should establish their related plasma reference range. The plasma with heparin lithium as anticoagulant could not be used for Lp(a) ,PA,5'-NT and ADA determination.