Lippi Giuseppe, Simundic Ana-Maria, Musile Giacomo, Danese Elisa, Salvagno Gianluca, Tagliaro Franco
Working Group for Preanalytical Phase (WG-PRE), European Federation for Clinical Chemistry and Laboratory Medicine (EFLM).
Section of Clinical Biochemistry, University of Verona, Verona, Italy.
Biochem Med (Zagreb). 2017 Jun 15;27(2):398-403. doi: 10.11613/BM.2017.041.
This study aimed to establish whether an alcoholic antiseptic, wiped or not before venipuncture, may jeopardize alcohol testing with a commercial enzymatic assay and a reference head-space gas chromatography (GC) technique.
Venous blood was collected from 23 healthy volunteers, with two sequential procedures. In the first blood collection, 2 mL of alcoholic antiseptic (0.5% chlorhexidine, 70% ethanol) were place on a gauge pad, the venipuncture site of right arm was cleaned but the antiseptic was not let to dry before phlebotomy. In the second blood collection, 2 mL of the same alcoholic antiseptic were placed on another gauge pad, the venipuncture site of left harm was cleaned and the antiseptic was accurately cleansed before phlebotomy. Ethanol was measured with a reference GC technique in whole blood and EDTA plasma, and a commercial enzymatic assay in EDTA plasma.
No subject complained about feeling a particular itchy sensation when the alcohol was not wiped before puncturing the vein. The concentration of alcohol in all EDTA plasma samples was always lower than the limit of detection of the enzymatic assay (, 2.2 mmol/L; 0.1 g/L). Similarly, alcohol concentration was also undetectable using a reference GC technique (, < 0.22 mmol/L; 0.01 g/L) in EDTA plasma and whole blood.
It seems reasonable to conclude that using ethanol-containing antiseptics before venipuncture may not be causes of spurious or false positive results of alcohol measurement at least when ideal venipunctures can be performed.
本研究旨在确定在静脉穿刺前擦拭或不擦拭酒精消毒剂是否会影响使用商业酶法检测和参考顶空气相色谱(GC)技术进行的酒精检测。
从23名健康志愿者身上采集静脉血,分两个连续步骤进行。在第一次采血时,将2 mL酒精消毒剂(0.5%氯己定,70%乙醇)置于纱布垫上,清洁右臂静脉穿刺部位,但在静脉穿刺前不让消毒剂干燥。在第二次采血时,将2 mL相同的酒精消毒剂置于另一个纱布垫上,清洁左臂静脉穿刺部位,并在静脉穿刺前准确擦拭消毒剂。采用参考GC技术测定全血和乙二胺四乙酸(EDTA)血浆中的乙醇含量,并采用商业酶法测定EDTA血浆中的乙醇含量。
在静脉穿刺前未擦拭酒精时,没有受试者抱怨有特别的瘙痒感。所有EDTA血浆样本中的酒精浓度始终低于酶法检测的检测限(<2.2 mmol/L;0.1 g/L)。同样,在EDTA血浆和全血中,使用参考GC技术也未检测到酒精浓度(<0.22 mmol/L;0.01 g/L)。
至少在能够进行理想的静脉穿刺时,静脉穿刺前使用含乙醇的消毒剂似乎不会导致酒精测量出现假阳性或假结果,这一结论似乎是合理的。