Ma Z, Monk T G, Goodnough L T, McClellan A, Gawryl M, Clark T, Moreira P, Keipert P E, Scott M G
Department of Pathology, Washington University School of Medicine, St. Louis, MO, USA.
Clin Chem. 1997 Sep;43(9):1732-7.
Polymerized hemoglobin solutions (Hb-based oxygen carriers; HBOCs) and a second-generation perfluorocarbon (PFC) emulsion (Perflubron) are in clinical trials as temporary oxygen carriers ("blood substitutes"). Plasma and serum samples from patients receiving HBOCs look markedly red, whereas those from patients receiving PFC appear to be lipemic. Because hemolysis and lipemia are well-known interferents in many assays, we examined the effects of these substances on clinical chemistry, immunoassay, therapeutic drug, and coagulation tests. HBOC concentrations up to 50 g/L caused essentially no interference for Na, K, Cl, urea, total CO2, P, uric acid, Mg, creatinine, and glucose values determined by the Hitachi 747 or Vitros 750 analyzers (or both) or for immunoassays of lidocaine, N-acetylprocainamide, procainamide, digoxin, phenytoin, quinidine, or theophylline performed on the Abbott AxSym or TDx. Gentamycin and vancomycin assays on the AxSym exhibited a significant positive and negative interference, respectively. Immunoassays for TSH on the Abbott IMx and for troponin I on the Dade Stratus were unaffected by HBOC at this concentration. Tests for total protein, albumin, LDH, AST, ALT, GGT, amylase, lipase, and cholesterol were significantly affected to various extents at different HBOC concentrations on the Hitachi 747 and Vitros 750. The CK-MB assay on the Stratus exhibited a negative interference at 5 g/L HBOC. HBOC interference in coagulation tests was method-dependent-fibrometer-based methods on the BBL Fibro System were free from interference, but optical-based methods on the MLA 1000C exhibited interferences at 20 g/L HBOC. A 1:20 dilution of the PFC-based oxygen carrier (600 g/L) caused no interference on any of these chemistry or immunoassay tests except for amylase and ammonia on the Vitros 750 and plasma iron on the Hitachi 747.
聚合血红蛋白溶液（基于血红蛋白的氧载体；HBOCs）和第二代全氟碳（PFC）乳剂（全氟溴烷）作为临时氧载体（“血液替代品”）正在进行临床试验。接受HBOCs治疗的患者的血浆和血清样本看起来明显呈红色，而接受PFC治疗的患者的样本则似乎呈脂血状。由于溶血和脂血在许多检测中是众所周知的干扰因素，我们研究了这些物质对临床化学、免疫测定、治疗药物和凝血检测的影响。高达50 g/L的HBOC浓度对日立747或Vitros 750分析仪（或两者）测定的钠、钾、氯、尿素、总二氧化碳、磷、尿酸、镁、肌酐和葡萄糖值，或对在雅培AxSym或TDx上进行的利多卡因、N - 乙酰普鲁卡因胺、普鲁卡因胺、地高辛、苯妥英、奎尼丁或茶碱的免疫测定基本上没有干扰。在AxSym上进行的庆大霉素和万古霉素测定分别表现出显著的正干扰和负干扰。在此浓度下，雅培IMx上的促甲状腺激素（TSH）免疫测定和达德Stratus上的肌钙蛋白I免疫测定不受HBOC影响。在日立747和Vitros 750上，不同HBOC浓度下，总蛋白、白蛋白、乳酸脱氢酶（LDH）、天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）、γ - 谷氨酰转移酶（GGT）、淀粉酶、脂肪酶和胆固醇的检测在不同程度上受到显著影响。Stratus上的肌酸激酶同工酶（CK - MB）测定在5 g/L HBOC时表现出负干扰。HBOC对凝血检测的干扰取决于方法——BBL Fibro系统上基于纤维光度计的方法无干扰，但MLA 1000C上基于光学的方法在20 g/L HBOC时表现出干扰。基于PFC的氧载体（600 g/L）1:20稀释液对除Vitros 750上的淀粉酶和氨以及日立747上的血浆铁之外的任何这些化学或免疫测定检测均无干扰。
