Henriksen Linda O, Faber Nina R, Moller Mette F, Nexo Ebba, Hansen Annebirthe B
Department of Clinical Biochemistry, Regional Hospital West Jutland , Herning and Holstebro , Denmark.
Scand J Clin Lab Invest. 2014 Oct;74(7):603-10. doi: 10.3109/00365513.2014.928940. Epub 2014 Jul 2.
Suitable procedures for transport of blood samples from general practitioners to hospital laboratories are requested. Here we explore routine testing on samples stored and transported as whole blood in lithium-heparin or serum tubes.
Blood samples were collected from 106 hospitalized patients, and analyzed on Architect c8000 or Advia Centaur XP for 35 analytes at base line, and after storage and transport of whole blood in lithium-heparin or serum tubes at 21 ± 1°C for 10 h. Bias and imprecision (representing variation from analysis and storage) were calculated from values at baseline and after storage, and differences tested by paired t-tests. Results were compared to goals set by the laboratory.
We observed no statistically significant bias and results within the goal for imprecision between baseline samples and 10-h samples for albumin, alkaline phosphatase, antitrypsin, bilirubin, creatinine, free triiodothyronine, γ-glutamyl transferase, haptoglobin, immunoglobulin G, lactate dehydrogenase, prostate specific antigen, total carbon dioxide, and urea. Alanine aminotransferase, amylase, C-reactive protein, calcium, cholesterol, creatine kinase, ferritin, free thyroxine, immunoglobulin A, immunoglobulin M, orosomucoid, sodium, transferrin, and triglycerides met goals for imprecision, though they showed a minor, but statistically significant bias in results after storage. Cobalamin, folate, HDL-cholesterol, iron, phosphate, potassium, thyroid stimulating hormone and urate warranted concern, but only folate and phosphate showed deviations of clinical importance.
We conclude that whole blood in lithium-heparin or serum tubes stored for 10 h at 21 ± 1°C, may be used for routine analysis without restrictions for all investigated analytes but folate and phosphate.
需要合适的程序将全科医生采集的血样运输至医院实验室。在此，我们探讨了在锂肝素管或血清管中以全血形式储存和运输的样本的常规检测。
从106名住院患者采集血样，在基线时以及在21±1°C下将全血储存在锂肝素管或血清管中10小时后，使用Architect c8000或Advia Centaur XP对35种分析物进行分析。根据基线值和储存后的数值计算偏差和不精密度（代表分析和储存过程中的变化），并通过配对t检验对差异进行检验。将结果与实验室设定的目标进行比较。
我们观察到，对于白蛋白、碱性磷酸酶、抗胰蛋白酶、胆红素、肌酐、游离三碘甲状腺原氨酸、γ-谷氨酰转移酶、触珠蛋白、免疫球蛋白G、乳酸脱氢酶、前列腺特异性抗原、总二氧化碳和尿素，基线样本与10小时样本之间在不精密度方面无统计学显著偏差且结果在目标范围内。丙氨酸氨基转移酶、淀粉酶、C反应蛋白、钙、胆固醇、肌酸激酶、铁蛋白、游离甲状腺素、免疫球蛋白A、免疫球蛋白M、类粘蛋白、钠、转铁蛋白和甘油三酯达到了不精密度目标，尽管它们在储存后的结果显示出轻微但具有统计学显著性的偏差。钴胺素、叶酸、高密度脂蛋白胆固醇、铁、磷酸盐、钾、促甲状腺激素和尿酸值得关注，但只有叶酸和磷酸盐显示出具有临床意义的偏差。
我们得出结论，在21±1°C下将锂肝素管或血清管中的全血储存长达10小时，可用于所有研究分析物（叶酸和磷酸盐除外）的常规分析，且无限制。
