Fueyo Laura, Robles Juan, Aguilar Irene, Yáñez Aina M, Socias Magdalena, Parera Magdalena
Servicio de Análisis Clínicos, Hospital Universitario Son Espases, Palma, Balearic Islands, Spain.
Instituto de investigación sanitaria de Palma (IdISPa), Palma, Balearic Islands, Spain.
J Clin Lab Anal. 2017 Sep;31(5). doi: 10.1002/jcla.22089. Epub 2016 Nov 10.
Cyanokit (hydroxocobalamin OHCo) is the recommended treatment for cyanide poisoning. OHCo is a red chromophore and may cause interference with some biochemical measurements. In this study, we assessed the possible interference of Cyanokit on several cooximetric and plasma biochemistry tests and then determined the possible mathematical correction for some analytes. We studied the possibility of detecting and evaluating the degree of interference with the hemolysis index (HI) provided by our autoanalyzer because it is not possible to measure the OHCo concentration in conventional laboratories.
Several pools of plasma samples spiked with increasing concentrations of OHCo were prepared. Each one was compared to the pool without interferent. Interference was considered when the bias was more than 10%. An interferograph was developed for those analytes with significant interference. The correlation between interference agent concentration and HI was calculated by Spearman correlation coefficient. We used multiple regression analysis to determine the mathematical correction for amylase, creatinine, and lactate.
We detected significant interference in the amylase, carboxyhemoglobin, creatinine, creatine kinase, bilirubin, lactate, and total protein measurement. The HI was positively correlated with OHCo concentration. Corresponding equations for estimating lactate and creatinine concentrations were obtained.
OHCo interferes with many laboratory assays in an unpredictable way making some results invalid and confounding clinical decision making. We can detect and evaluate the degree of interference with the HI. We can still estimate real creatinine and lactate levels using the regression equation obtained in this study.
Cyanokit（羟钴胺素OHCo）是氰化物中毒的推荐治疗药物。OHCo是一种红色发色团，可能会干扰一些生化检测。在本研究中，我们评估了Cyanokit对几种共血氧测定法和血浆生化检测的可能干扰，然后确定了对某些分析物的可能数学校正方法。我们研究了利用自动分析仪提供的溶血指数（HI）检测和评估干扰程度的可能性，因为在常规实验室无法测量OHCo浓度。
制备了几个添加了不同浓度OHCo的血浆样本池。将每个样本池与无干扰物的样本池进行比较。当偏差超过10%时，认为存在干扰。针对那些有显著干扰的分析物绘制了干扰图。通过Spearman相关系数计算干扰剂浓度与HI之间的相关性。我们使用多元回归分析来确定淀粉酶、肌酐和乳酸的数学校正方法。
我们检测到淀粉酶、碳氧血红蛋白、肌酐、肌酸激酶、胆红素、乳酸和总蛋白测量存在显著干扰。HI与OHCo浓度呈正相关。获得了估算乳酸和肌酐浓度的相应方程。
OHCo以不可预测的方式干扰许多实验室检测，使一些结果无效并混淆临床决策。我们可以检测和评估HI的干扰程度。利用本研究获得的回归方程，我们仍然可以估算真实的肌酐和乳酸水平。
