Hall James L, Carlton Henry C, Shipman Kate E
Department of Clinical Chemistry, University Hospitals Sussex NHS Trust, Chichester, UK.
Department of Medical Education, Brighton and Sussex Medical School, University of Sussex, Brighton, UK.
Ann Clin Biochem. 2025 Jul;62(4):287-292. doi: 10.1177/00045632241312622. Epub 2025 Jan 4.
BackgroundGrossly lipaemic samples are a significant cause of analytical errors, potentially impacting patient care. The causes of lipaemia are varied and often unavoidable, while methods to reduce lipaemia through gold-standard ultracentrifugation are limited by availability, transportation and cost. Benchtop centrifugation has been proposed as an alternative method to reduce lipaemia.MethodsFifty-three grossly lipaemic serum samples (lipaemia >201.8 mg/dL) that were unsuitable for analysis were selected and centrifugated at 18840 g for different time-periods with lipaemia measured prior to and after centrifugation. Core analytes were measured on serum samples free of lipaemia before and after 30 min of centrifugation at 18840 g to assess the effect of the centrifugation process.ResultsAfter centrifugation for 5 min, 90% of grossly lipaemic samples were either ideal (lipaemia <50 mg/dL) or adequate (lipaemia 50.1-201.7 mg/dL) for analyte testing. All samples were either adequate or ideal for testing following centrifugation for 30 min. Although some analytes showed a statistically significant change in the measured concentration post high-speed centrifugation, none had clinically significant changes according to analyte specific reference change value (RCV) analysis. Aspartate aminotransferase (AST) and creatine kinase (CK) demonstrated the most notable reductions in activity, but these did not exceed their RCV.ConclusionsBenchtop centrifugation shows potential laboratory utility in reducing lipaemia whilst maintaining clinically reliable results, however small sample sizes preclude firm conclusions. Further research is warranted to increase the sample size with finer time-point tuning, sub-group analysis and temperature analysis, due to the potential for sample heat injury, to balance practicality and accuracy.
背景
严重脂血样本是分析误差的一个重要原因，可能影响患者护理。脂血的原因多种多样，且往往不可避免，而通过金标准超速离心法降低脂血的方法受到可用性、运输和成本的限制。台式离心法已被提议作为一种降低脂血的替代方法。
方法
选取53份严重脂血（脂血>201.8mg/dL）且不适于分析的血清样本，在18840g下离心不同时间，离心前后均测定脂血情况。在18840g下离心30分钟前后，对无脂血的血清样本测量核心分析物，以评估离心过程的影响。
结果
离心5分钟后，90%的严重脂血样本对于分析物检测而言要么理想（脂血<50mg/dL）要么合格（脂血50.1 - 201.7mg/dL）。离心30分钟后，所有样本对于检测而言均合格或理想。尽管一些分析物在高速离心后测量浓度显示出统计学上的显著变化，但根据分析物特定参考变化值（RCV）分析，无一有临床显著变化。天冬氨酸转氨酶（AST）和肌酸激酶（CK）的活性降低最为显著，但未超过其RCV。
结论
台式离心法在降低脂血同时保持临床可靠结果方面显示出潜在的实验室效用，然而样本量小妨碍得出确凿结论。鉴于存在样本热损伤的可能性，为平衡实用性和准确性，有必要进行进一步研究，增加样本量并进行更精细的时间点调整、亚组分析和温度分析。
