Center of Forensic Investigation, China Medical University, Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Department of Forensic Pathology, School of Forensic Medicine, China Medical University, Shenyang 110122, China.
Liaoning University Expert Evidence Center, Shenyang 110031, China.
Fa Yi Xue Za Zhi. 2022 Dec 25;38(6):697-701. doi: 10.12116/j.issn.1004-5619.2021.410904.
To investigate the interference of postmortem hemolysis on the detection of creatinine and whether ultrafiltration can reduce the interference.
A total of 33 non-hemolyzed whole blood samples from the left heart were collected. Hemolyzed samples with 4 hemoglobin mass concentration gradients H1-H4 were artificially prepared. Ultrafiltration was performed on each hemolyzed sample. Creatinine concentrations in non-hemolyzed serum (baseline serum), hemolyzed samples and ultrafiltrate were detected. Bias (), Pearson correlation and receiver operator characteristic (ROC) of baseline creatinine concentration between before and after ultrafiltration were analyzed.
As the hemoglobin mass concentration increased, of the hemolyzed samples in the H1-H4 groups gradually increased, the || was 2.41(0.82, 8.25)-51.31(41.79, 188.25), reaching a maximum of 589.06%, and there was no statistically significant between the creatinine concentration and the baseline creatinine concentration (=0.472 7, =0.129 5). After ultrafiltration of hemolyzed samples, the interference of creatinine concentration in ultrafiltrate was significantly reduced, the || was 5.32(2.26, 9.22)-21.74(20.06, 25.58), reaching a maximum of 32.14%, and there was a positive correlation with baseline creatinine concentration (<0.05, =0.918 2). In the hemolyzed samples of H3 and H4 groups, there were 7 false-positive samples and 1 false-negative sample; in the ultrafiltrate samples, there were no false-positive sample and 1 false-negative sample. ROC analysis results showed the hemolyzed samples were lack of diagnostic value (=0.117 5).
The postmortem hemolysis significantly interferes creatinine detection results of blood samples, ultrafiltration can reduce hemolysis-induced interference in postmortem creatinine detection.
探讨死后溶血对肌酐检测的干扰作用，以及超滤是否可以降低这种干扰。
共采集 33 例来自左心的非溶血全血样本。人为制备血红蛋白质量浓度梯度 H1-H4 的 4 个溶血样本。对每个溶血样本进行超滤。检测非溶血血清（基础血清）、溶血样本和超滤物中的肌酐浓度。分析超滤前后基础肌酐浓度的偏倚（）、Pearson 相关系数和受试者工作特征（ROC）曲线。
随着血红蛋白质量浓度的增加，H1-H4 组的溶血样本的逐渐增加，||为 2.41(0.82, 8.25)-51.31(41.79, 188.25)，最大达 589.06%，且与基础肌酐浓度无统计学差异（=0.472 7，=0.129 5）。超滤溶血样本后，超滤物中肌酐浓度的干扰显著降低，||为 5.32(2.26, 9.22)-21.74(20.06, 25.58)，最大达 32.14%，与基础肌酐浓度呈正相关（<0.05，=0.918 2）。在 H3 和 H4 组的溶血样本中，有 7 个假阳性样本和 1 个假阴性样本；在超滤样本中，没有假阳性样本，有 1 个假阴性样本。ROC 分析结果表明，溶血样本缺乏诊断价值（=0.117 5）。
死后溶血显著干扰血液样本中肌酐的检测结果，超滤可以降低死后肌酐检测中溶血引起的干扰。
