摘要
目的 探讨不同类型血液样本在生化检验项目中的结果差异.方法 选择2022年10—12月平湖市当湖街道社区卫生服务中心的117例健康体检者作为研究对象,收集所有受检者血清样本.比较不同送检时间(采血后15 min内或60 min后送检)所得的丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、空腹血糖(FBG)、乳酸脱氢酶(LDH)、肌酸激酶(CK)检测结果差异;对正常样本和溶血样本的LDH、CK、AST、尿酸(UA)、血肌酐(SCr)、总胆红素(TBil)检测结果进行分析;对血清样本进行不同抗凝处理(未处理、肝素锂抗凝处理、枸橼酸钠抗凝处理),比较各组ALT、AST、碱性磷酸酶(ALP)、总蛋白(TP)、白蛋白(ALB)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)检测结果的差异.结果 采血 60 min后送检所得ALT、AST、FBG、CK、LDH检测值均明显低于 15 min内送检[ALT(U/L):16.59±2.23 比 19.65±2.22;AST(U/L):16.74±2.80 比 20.71±2.85;FBG(mmol/L):4.92±2.64 比5.50±2.63;CK(U/L):70.05±2.80 比 95.66±2.34;LDH(U/L):163.81±2.30 比 205.32±2.21;均P<0.05].正常样本LDH、CK、AST、TBil检测值均明显低于溶血样本,UA、SCr检测值均明显高于溶血样本[LDH(mmol/L):169.40±3.12 比 297.20±3.26;CK(mmol/L):130.80±2.98 比 265.40±3.02;AST(U/L):20.00±2.25 比 102.10±2.30;TBil(mmol/L):12.22±2.33 比 19.02±2.36;UA(mmol/L):300.40±2.23 比205.63±2.15;SCr(mmol/L):63.00±2.50 比 34.58±2.23;均P<0.05].经肝素锂和枸橼酸钠抗凝处理的样本检测所得ALT、AST、ALP、ALB、TG、TC、HDL-C结果与未经抗凝处理样本比较差异均有统计学意义.结论 影响生化项目检验结果的因素较多,为进一步提高生化项目检验结果的准确性,需探讨血液检验中相关因素对结果造成的影响,加强专业水平培训,提高血液样本的检验效率.
Abstract
Objective To investigate the results of biochemical test in different blood samples.Methods The 117 healthy examinees in Pinghu Danghu Street Community Health Service Center from October to December 2022 were selected as research objects,and serum samples were collected.The differences in results of alanine transaminase(ALT),aspartate aminotransferase(AST),fasting blood glucose(FBG),lactate dehydrogenase(LDH)and creatine kinase(CK)obtained at different delivery time(within 15 minutes or after 60 minutes of blood collection)were compared.The results of LDH,CK,AST,uric acid(UA),serum creatinine(SCr)and total bilirubin(TBil)in normal and hemolytic samples were analyzed.Different anticoagulation treatments(untreated,heparin lithium anticoagulation and sodium citrate anticoagulation)were performed on serum samples,and the differences in results of ALT,AST,alkaline phosphatase(ALP),total protein(TP),albumin(ALB),triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C)among different groups were compared.Results The ALT,AST,FBG,CK and LDH results obtained after 60 minutes of blood collection were slower than those from qualified samples[ALT(U/L):16.59±2.23 vs.19.65±2.22;AST(U/L):16.74±2.80 vs.20.71±2.85;FBG(mmol/L):4.92±2.64 vs.5.50±2.63;CK(U/L):70.05±2.80 vs.95.66±2.34;LDH(U/L):163.81±2.30 vs.205.32±2.21;all P＜0.05].The results of LDH,CK,AST and TBil in normal samples were lower than those in hemolytic samples,while the results of UA and SCr were higher than those in hemolytic samples[LDH(mmol/L):169.40±3.12 vs.297.20±3.26;CK(mmol/L):130.80±2.98 vs.265.40±3.02;AST(U/L):20.00±2.25 vs.102.10±2.30;TBil(mmol/L):12.22±2.33 vs.19.02±2.36;UA(mmol/L):300.40±2.23 vs.205.63±2.15;SCr(mmol/L):63.00±2.50 vs.34.58±2.23;all P＜0.05].The ALT,AST,ALP,ALB,TG,TC and HDL-C results obtained from samples treated with lithium heparin and sodium citrate anticoagulation showed statistically significant differences compared to serum samples without anticoagulation treatment.Conclusions There are many factors that affect the results of biochemical tests.In order to further improve the accuracy of biochemical test results,it is necessary to explore the impact of relevant factors in blood tests on the results,strengthen professional training,and improve the efficiency of blood sample test.
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