IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.
Sports Med. 2011 Dec 1;41(12):1033-42. doi: 10.2165/11591460-000000000-00000.
The stability of haematological parameters is crucial to guarantee accurate and reliable data for implementing and interpreting the athlete's biological passport (ABP). In this model, the values of haemoglobin, reticulocytes and out-of-doping period (OFF)-score (Hb-60√Ret) are used to monitor the possible variations of those parameters, and also to compare the thresholds developed by the statistical model for the single athlete on the basis of its personal values and the variance of parameters in the modal group. Nevertheless, a critical review of the current scientific literature dealing with the stability of the haematological parameters included in the ABP programme, and which are used for evaluating the probability of anomalies in the athlete's profile, is currently lacking. In addition, we collected information from published studies, in order to supply a useful, practical and updated review to sports physicians and haematologists. There are some parameters that are highly stable, such as haemoglobin and erythrocytes (red blood cells [RBCs]), whereas others, (e.g. reticulocytes, mean RBC volume and haematocrit) appear less stable. Regardless of the methodology, the stability of haematological parameters is improved by sample refrigeration. The stability of all parameters is highly affected from high storage temperatures, whereas the stability of RBCs and haematocrit is affected by initial freezing followed by refrigeration. Transport and rotation of tubes do not substantially influence any haematological parameter except for reticulocytes. In all the studies we reviewed that used Sysmex instrumentation, which is recommended for ABP measurements, stability was shown for 72 hours at 4 ° C for haemoglobin, RBCs and mean curpuscular haemoglobin concentration (MCHC); up to 48 hours for reticulocytes; and up to 24 hours for haematocrit. In one study, Sysmex instrumentation shows stability extended up to 72 hours at 4 ° C for all the parameters. There are significant differences among methods and instruments: Siemens Advia shows lower stability than Sysmex as regards to reticulocytes. However, the limit of 36 hours from blood collection to analysis as recommended by ABP scientists is reasonable to guarantee analytical quality, when samples are transported at 4 ° C and are accompanied by a certified steadiness of this temperature. There are some parameters that are highly stable, such as haemoglobin and RBCs; whereas others, such as reticulocytes, mean cell volume and haematocrit are more unstable. The stability of haematological parameters might be improved independently from the analytical methodology, by refrigeration of the specimens.
血液学参数的稳定性对于保证运动员生物护照（ABP）数据的准确和可靠至关重要。在这个模型中，血红蛋白、网织红细胞和脱兴奋剂期（OFF）分数（Hb-60√Ret）的值用于监测这些参数的可能变化，并比较基于个体值和模态组中参数方差的单个运动员的统计模型开发的阈值。然而，目前缺乏对当前涉及 ABP 计划中血液学参数稳定性的科学文献的批判性审查，这些参数用于评估运动员特征中异常的可能性。此外，我们从已发表的研究中收集信息，为运动医生和血液学家提供有用、实用和最新的综述。有些参数非常稳定，如血红蛋白和红细胞（RBC），而其他参数（如网织红细胞、平均红细胞体积和血细胞比容）则不太稳定。无论采用何种方法，冷藏均可提高血液学参数的稳定性。所有参数的稳定性都受到高储存温度的高度影响，而 RBC 和血细胞比容的稳定性则受到初始冷冻后冷藏的影响。管的运输和旋转不会实质性地影响除网织红细胞以外的任何血液学参数。在我们审查的所有使用推荐用于 ABP 测量的希森美康仪器的研究中，血红蛋白、RBC 和平均红细胞血红蛋白浓度（MCHC）在 4°C 下可稳定 72 小时；网织红细胞可稳定 48 小时；血细胞比容可稳定 24 小时。在一项研究中，希森美康仪器显示所有参数在 4°C 下可稳定长达 72 小时。不同的方法和仪器之间存在显著差异：西门子 Advia 与希森美康相比，网织红细胞的稳定性较低。然而，ABP 科学家建议从采血到分析的时间不超过 36 小时，以保证分析质量，前提是在 4°C 下运输样本并附有证明该温度稳定的证明。有些参数非常稳定，如血红蛋白和 RBC；而其他参数，如网织红细胞、平均细胞体积和血细胞比容则更不稳定。血液学参数的稳定性可以通过标本冷藏来提高，而无需依赖分析方法。
