Budak Yasemin U, Huysal Kagan, Bulut Mehtap, Polat Murat
Department of Clinical Laboratory, Sevket Yilmaz Education and Research Hospital, Sevket Yilmaz Devlet Hastanesi. Biyokimya Laboratuari. Yildirim, Bursa, Turkey.
Department of Clinical Laboratory, Yüksek İhtisas Education and Research Hospital, Bursa, Turkey.
BMC Clin Pathol. 2013 Jun 13;13:20. doi: 10.1186/1472-6890-13-20. eCollection 2013.
In our emergency department, we collect blood in Rapid Serum Tubes (RSTs; Becton Dickinson, Franklin Lakes, NJ), in which clotting times are reduced. We investigated the influence of RST use on cardiac troponin T (hs-cTnT) and creatine kinase-MB (CK-MB) test results, in comparison with the use of tubes featuring a separator gel containing a clotting activator (SSTs; Green-vac, Yongin, Korea).
Samples from 60 patients were divided into equal aliquots and placed into RSTs and SSTs; hs-cTnT and CK-MB concentrations were determined using an autoanalyzer (Elecsys 2010) running commercial assays (Roche Diagnostics, Penzberg, Germany). Between-tube differences in CK-MB and hs-cTnT values were compared using the paired t-test, and correlations among variables were evaluated by calculation of Spearman correlation coefficients (r values). Deming regression analysis was performed and Bland-Altman plots were constructed.
The hs-cTnT and CK-MB test results obtained from samples placed into RSTs and SSTs did not differ (p > 0.1). The correlations between the concentrations of hs-cTnT and CK-MB in samples placed into RSTs and SSTs were good; both r values were unity (p < 0.001). Deming regression analysis yielded the equation: RST [hs-cTnT] = 0.98 SST [hs-cTnT] + 0.69 pg/ml; and RST [CK-MB] = 0.95 SST [CK-MB]-0.09 ng/ml. The biases of 1.4 pg/ml (95% CI: minus 8.1-10.7 pg/ml) for hs-cTnT levels and 0.249 ng/ml (95% CI: minus 0.682-1.681 ng/ml) for CK-MB levels assayed using either tube was acceptable.
The hs-cTnT and CK-MB test results did not significantly differ when either tube was used. RST tube use was associated with a short clotting time; this was an advantage in an emergency laboratory setting.
在我们的急诊科，我们使用快速血清管（RST；贝克顿·迪金森公司，新泽西州富兰克林湖）采集血液，这种管子的凝血时间缩短。我们研究了使用RST与使用含有凝血激活剂的分离胶管（SST；韩国龙仁Green-vac公司）对心肌肌钙蛋白T（hs-cTnT）和肌酸激酶同工酶（CK-MB）检测结果的影响。
将60例患者的样本分成等量的几份，分别置于RST和SST中；使用运行商业检测试剂盒（德国彭茨贝格罗氏诊断公司）的自动分析仪（Elecsys 2010）测定hs-cTnT和CK-MB浓度。使用配对t检验比较CK-MB和hs-cTnT值在两种管子之间的差异，并通过计算Spearman相关系数（r值）评估变量之间的相关性。进行Deming回归分析并构建Bland-Altman图。
置于RST和SST中的样本所获得的hs-cTnT和CK-MB检测结果无差异（p>0.1）。置于RST和SST中的样本中hs-cTnT和CK-MB浓度之间的相关性良好；两个r值均为1（p<0.001）。Deming回归分析得出方程：RST[hs-cTnT]=0.98 SST[hs-cTnT]+0.69 pg/ml；RST[CK-MB]=0.95 SST[CK-MB]-0.09 ng/ml。使用任何一种管子检测时，hs-cTnT水平的偏差为1.4 pg/ml（95%CI：-8.1至10.7 pg/ml），CK-MB水平的偏差为0.249 ng/ml（95%CI：-0.682至1.681 ng/ml），这是可以接受的。
使用任何一种管子时，hs-cTnT和CK-MB检测结果均无显著差异。使用RST管的凝血时间较短；这在急诊实验室环境中是一个优势。
