溶血和脂血标本对凝血指标检测的影响因素探讨

摘要

Objective To investigate the influence of hemolysis and lipemia on coagulation tests, and provide experimental evidence for the pre-test process standardization. Methods The samples of 40 hemolysis cases and 32 lipemia cases in our hospital were collected randomly, to determine the contents of plasma coagulation factors. They were divided into three grades (mild, moderate and severe hemolysis) based on the level of hemoglobin (10 g/L), the concentrations of PT, APTT,TT,Fbg were detected three times. They were divided into three levels (mild, moderate and severe) at an interval of 3 mmol/L, and determined the levels of PT,APTT,TT,Fbg after adding the fat emulsion. The results were statistically analyzed. Results There were statistically significances (P＜0. 05) for PT, Fbg between control group and mild hemolyt-ic group. There were statistically significance (P＜0. 05) for PT,Fbg,TT among mild, moderate and severe hemolytic groups. There were statistically significances (P＜0. 05) for PT, APTT, Fbg, TT testing results among mild, moderate, and severe lipemia groups. Conclusion There were statistically influences of hemolysis for PT, Fbg testing results. There were statistically significances (P＜0. 05) between moderate and severe hemolytic groups for PT, Fbg, TT testing results. There were statistically significance between (P＜0. 05) for PT, APTT, Fbg, TT testing results among mild, moderate and severe lipemia groups.%目的 探讨溶血和脂血标本对凝血指标检测结果的影响,为规范分析前过程提供实验依据.方法 随机收集本院临床溶血标本40例、脂血标本32例,进行血浆血凝测定.以血红蛋白每下降10 g/L为标准,分为轻度、中度、重度溶血3个等级,同时测定3次凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)和纤维蛋白原(Fbg);以检测血浆甘油三脂每升高3 mmol/L为标准,分为轻度、中度、重度3个等级,同时测定3次PT、APTT、TT、Fbg.对溶血和脂血的干扰因素进行统计学分析.结果 轻度溶血组PT、Fbg检测结果的差异具有统计学意义(P＜0.05);中度和重度溶血组PT、Fbg、TT检测结果的差异具有统计学意义(P＜0.05).轻度、中度和重度脂血组PT、APTT、Fbg、TT检测结果的差异均具有统计学意义(P＜0.05).结论 (1)临床检测中溶血标本对APTT检测结果影响较小;而对于PT、TT、Fbg干扰较大,建议临床重抽复测.(2)临床检测中脂血标本对PT、APTT、TT、Fbg测定结果有影响,均建议患者禁食12h后重抽复测.