摘要
目的利用血清指数(SI)作为量化指标,探讨内源性干扰物血红蛋白(Hb)、结合胆红素(Bil-C)、游离胆红素(Bil-F)和乳糜微粒(CM)对溴甲酚绿(BCG)法和免疫比浊法检测血清清蛋白(ALB)的影响。方法统计临床生化标本SI波动范围。配制含不同水平干扰物的干扰标本和对照标本。分别采用BCG法和免疫比浊法检测血清ALB,计算干扰标本与对照标本血清ALB检测结果的相对偏倚。以1/2国家卫生健康委临床检验中心室间质评允许总误差(3%)作为临床可接受标准。结果SI波动范围:溶血指数、黄疸指数、脂浊指数的P2.5和P97.5分别为0和24、0和2、1和27。不同水平Hb、Bil-C、CM对两种方法检测血清ALB均无干扰,所有偏倚均在允许范围内。Bil-F对BCG法检测血清ALB正常值、低值标本均产生正干扰。低值标本的检测中,当黄疸指数≥6(Bil-F≥72.04μmol/L)时,偏倚超出允许范围,正常值标本的检测中,则黄疸指数≥17(Bil-F≥324.18μmol/L)时,偏倚超出允许偏倚范围,而且随着Bil-F水平升高,干扰逐步增加。Bil-F对免疫比浊法检测血清ALB正常值、低值标本产生正干扰,两个水平标本,均在黄疸指数≥19(Bil-F≥360.2μmol/L)时,检测偏倚超出允许范围。临床常见水平的Bil-F对结果的影响均在可接受范围内。结论SI可以对干扰程度进行量化,便于临床实验室决定是否需要采取针对性措施降低干扰物的影响或据此建立标本退检界值。BCG法和免疫比浊法检测血清ALB具有相似的抗干扰能力,临床常见的溶血、黄疸、脂浊不会影响检测结果。
Objective Using serum index(SI)as a quantitative index to investigate the effects of endogenous interfering substances such as hemoglobin(Hb),conjugated bilirubin(Bil-C),free bilirubin(Bil-F)and chylomicrons(CM)in the detection of serum albumin(ALB)by bromocresol green(BCG)method and immunoturbidimetric method.Methods The SI fluctuation range of clinical biochemical samples was counted.Interference specimens and control specimens containing different levels of distractors were prepared.Serum ALB was detected by BCG method and immunoturbidimetric method,respectively.The relative bias of serum ALB detection results between interference samples and control samples was calculated.Half the total error allowed by the National Center for Clinical Laboratories′external quality assessment(3%)was used as the clinical acceptable standard.Results The P2.5 and P97.5 of hemolysis index,icteric index and lipemic index were 0 and 24,0 and 2,1 and 27,respectively.Different levels of Hb,Bil-C and CM had no interference in the detection of serum ALB by both methods,and all biases were within the allowable range.Bil-F had positive interference on the normal and low value of serum ALB detected by BCG method.In the detection of low-level samples,when the cteric index was≥6(Bil-F≥72.04μmol/L),the bias was beyond the allowable range,in the detection of high-level samples,when the cteric index was≥17(Bil-F≥324.18μmol/L),the bias was beyond the allowable bias range,and the interference gradually increased with the increase of Bil-F level.Bil-F had positive interference on the normal and low serum ALB levels detected by using immunoturbidimetry.When the cteric index was≥19(Bil-F≥360.2μmol/L),the detection bias was beyond the allowable range.The effect of common levels of Bil-F on the test results was within the acceptable range.Conclusion SI can quantify the degree of interference,which is convenient for clinical laboratories to decide whether to take targeted measures to reduce the influence of distractors or establish the specimen rejection threshold.BCG method and immunoturbidimetric method have the same anti-interference ability in the detection of serum ALB,and for most of the clinical samples,the interference generated by hemolysis,jaundice,lipemia is acceptable..
作者
李慧
蔡栋昊
刘启波
谭俊青
LI Hui;CAI Donghao;LIU Qibo;TIAN Junqing(Department of Clinical Laboratory,Guangdong Second Traditional Chinese Medicine Hospital,Guangzhou,Guangdong 510095,China)
出处
《国际检验医学杂志》
CAS
2023年第13期1604-1608,共5页
International Journal of Laboratory Medicine
基金
广东省中医药局科研项目(20222008)。
关键词
血清指数
干扰
血清清蛋白
溴甲酚绿法
免疫比浊法
serum index
interference
serum albumin
bromocresol green method
immune turbidimetry
