Devgun M S
Department of Biochemistry, Law Hospital, Carluke, UK.
Clin Physiol Biochem. 1989;7(3-4):189-97.
It is a fairly common practice to issue biochemical results of multichannel analysers containing many analytes, irrespective of the number of tests requested by the physician. Abnormal results in such profiles may occur from presentation of artefacted blood samples; it is sometimes not possible to differentiate the abnormality arising as a result of pathological process from that due to a poor sample quality. In this study normal volunteers were studied to examine changes occurring when centrifugation was delayed for a few hours to a few days. Analyses on stored serum samples over the same period were also studied. If haemolysis is present, lactate dehydrogenase (hydroxybutyrate dehydrogenase), aspartate transaminase, potassium, chloride, bicarbonate, phosphate and creatinine estimations are not valid. Accurate data, however, can be obtained on sodium, urea, proteins, albumin, alkaline phosphatase and gammaglutamyl transferase. The very concept of efficient and cost-effective testing by multichannel profiles may generate further unnecessary investigations with a consequent waste of health service resources if pre-analytical factors are not taken into consideration.
不管医生要求检测的项目数量多少，发布包含多种分析物的多通道分析仪的生化检测结果是一种相当常见的做法。此类检测结果中的异常可能源于采集到的血液样本存在人为干扰；有时无法区分由病理过程导致的异常与样本质量不佳导致的异常。在本研究中，对正常志愿者进行了研究，以检查离心延迟数小时至数天会出现何种变化。同时还研究了同期对储存血清样本的分析情况。如果存在溶血现象，乳酸脱氢酶（羟丁酸脱氢酶）、天冬氨酸转氨酶、钾、氯、碳酸氢盐、磷酸盐和肌酐的测定结果无效。然而，对于钠、尿素、蛋白质、白蛋白、碱性磷酸酶和γ-谷氨酰转移酶，可以获得准确的数据。如果不考虑分析前因素，多通道检测的高效且具成本效益这一理念可能会引发更多不必要的检查，从而浪费医疗服务资源。
