Monneret Denis, Godmer Alexandre, Le Guen Ronan, Bravetti Clotilde, Emeraud Cecile, Marteau Anthony, Alkouri Rana, Mestari Fouzi, Dever Sylvie, Imbert-Bismut Françoise, Bonnefont-Rousselot Dominique
Department of Metabolic Biochemistry, La Pitié Salpêtrière-Charles Foix University Hospital (AP-HP), Paris, France.
Department of Biochemistry, Faculty of Pharmacy, Paris Descartes University, Paris, France.
J Clin Lab Anal. 2016 Sep;30(5):602-9. doi: 10.1002/jcla.21909. Epub 2016 Feb 18.
The stability of biochemical analytes has already been investigated, but results strongly differ depending on parameters, methodologies, and sample storage times. We investigated the stability for many biochemical parameters after different storage times of both whole blood and plasma, in order to define acceptable pre- and postcentrifugation delays in hospital laboratories.
Twenty-four analytes were measured (Modular® Roche analyzer) in plasma obtained from blood collected into lithium heparin gel tubes, after 2-6 hr of storage at room temperature either before (n = 28: stability in whole blood) or after (n = 21: stability in plasma) centrifugation. Variations in concentrations were expressed as mean bias from baseline, using the analytical change limit (ACL%) or the reference change value (RCV%) as acceptance limit.
In tubes stored before centrifugation, mean plasma concentrations significantly decreased after 3 hr for phosphorus (-6.1% [95% CI: -7.4 to -4.7%]; ACL 4.62%) and lactate dehydrogenase (LDH; -5.7% [95% CI: -7.4 to -4.1%]; ACL 5.17%), and slightly decreased after 6 hr for potassium (-2.9% [95% CI: -5.3 to -0.5%]; ACL 4.13%). In plasma stored after centrifugation, mean concentrations decreased after 6 hr for bicarbonates (-19.7% [95% CI: -22.9 to -16.5%]; ACL 15.4%), and moderately increased after 4 hr for LDH (+6.0% [95% CI: +4.3 to +7.6%]; ACL 5.17%). Based on RCV, all the analytes can be considered stable up to 6 hr, whether before or after centrifugation.
This study proposes acceptable delays for most biochemical tests on lithium heparin gel tubes arriving at the laboratory or needing to be reanalyzed.
生化分析物的稳定性已得到研究,但结果因参数、方法和样本储存时间的不同而有很大差异。我们研究了全血和血浆在不同储存时间后多种生化参数的稳定性,以确定医院实验室可接受的离心前和离心后延迟时间。
从采集到含锂肝素凝胶管中的血液获得的血浆中,在离心前(n = 28:全血中的稳定性)或离心后(n = 21:血浆中的稳定性)于室温储存2 - 6小时后,测量24种分析物(使用Modular®罗氏分析仪)。浓度变化以相对于基线的平均偏差表示,使用分析变化限度(ACL%)或参考变化值(RCV%)作为可接受限度。
在离心前储存的试管中,磷在3小时后平均血浆浓度显著下降(-6.1% [95% CI:-7.4至-4.7%];ACL 4.62%),乳酸脱氢酶(LDH)也下降(-5.7% [95% CI:-7.4至-4.1%];ACL 5.17%),钾在6小时后略有下降(-2.9% [95% CI:-5.3至-0.5%];ACL 4.13%)。在离心后储存的血浆中,碳酸氢盐在6小时后平均浓度下降(-19.7% [95% CI:-22.9至-16.5%];ACL 15.4%),LDH在4小时后适度升高(+6.0% [95% CI:+4.3至+7.6%];ACL 5.17%)。基于RCV,无论离心前还是离心后,所有分析物在长达6小时内均可视为稳定。
本研究提出了对于到达实验室或需要重新分析的含锂肝素凝胶管上大多数生化检测可接受的延迟时间。