溶血对肌钙蛋白检测的影响：贝克曼库尔特 UniCel Dxl 800 Accu-TnI 的研究及文献综述。

Influence of hemolysis on troponin testing: studies on Beckman Coulter UniCel Dxl 800 Accu-TnI and overview of the literature.

机构信息

UO Diagnostica Ematochimica, Dipartimento di Patologia e Medicina di Laboratorio, Azienda Ospedaliero- Universitaria di Parma, Italy.

出版信息

Clin Chem Lab Med. 2011 Sep 6;49(12):2097-100. doi: 10.1515/CCLM.2011.703.

DOI:10.1515/CCLM.2011.703

PMID:21892912

Abstract

BACKGROUND

Hemolyzed specimens are the leading pre-analytical problem in the laboratory practice, and exert a negative impact on test results. We assessed the reliability of Beckman Coulter UniCel Dxl 800 Accu-TnI testing on hemolyzed specimens.

METHODS

Twelve non-hemolyzed K2EDTA-anticoagulated samples displaying Accu-TnI values >0.20 μg/L and nine with values <0.04 μg/L were selected and three aliquots were obtained from each. The first ("#A") was processed without further manipulation, whereas the second ("#B") and third ("#C") were hemolyzed by aspirating anticoagulated blood through a thin needle. Plasma was separated and tested for hemolysis index (HI) and Accu-TnI.

RESULTS

As compared with aliquot #A (HI: 0), a progressive increase of hemolysis occurred in aliquots #B (HI: 25) and #C (HI: 45). The concentration of Accu-TnI gradually decreased from aliquots #A (0.89 μg/L, 0.20-20.16 μg/L), to aliquots #B (0.81 μg/L, 95% CI 0.17-18.37 μg/L; p=0.041) and #C (0.78 μg/L, 95% CI 0.15-17.48 μg/L; p=0.026). In 0/12 (aliquots #B) and 3/12 cases (aliquots #C) the percent decrease exceeded 20% variation. The values remained unchanged in nine samples with Accu-TnI <0.04 μg/L.

CONCLUSIONS

Accu-TnI values decrease in hemolyzed samples, but the bias might not be clinically significant in samples with hemoglobin <14.5 g/L.

摘要

背景

溶血标本是实验室实践中的主要分析前问题，对检测结果有负面影响。我们评估了贝克曼库尔特 UniCel Dxl 800 Accu-TnI 检测在溶血标本中的可靠性。

方法

选择 12 份非溶血的 K2EDTA 抗凝样本，Accu-TnI 值>0.20μg/L，9 份<0.04μg/L，每份样本均取 3 份等分。第一份（“#A”）未经进一步处理，第二份（“#B”）和第三份（“#C”）则通过细针抽吸抗凝血液来溶血。分离血浆并检测溶血指数（HI）和 Accu-TnI。

结果

与等分#A（HI：0）相比，等分#B（HI：25）和#C（HI：45）的溶血程度逐渐增加。Accu-TnI 的浓度逐渐从等分#A（0.89μg/L，0.20-20.16μg/L）下降到等分#B（0.81μg/L，95%CI 0.17-18.37μg/L；p=0.041）和#C（0.78μg/L，95%CI 0.15-17.48μg/L；p=0.026）。在 0/12 份（等分#B）和 3/12 份（等分#C）中，下降幅度超过 20%。在 9 份 Accu-TnI<0.04μg/L 的样本中，值保持不变。