应用沉淀法消除HLAP患者生化标本乳糜状态的探讨

doi:10.3969/j.issn.1673-8640.2014.09.019

检验医学 ›› 2014, Vol. 29 ›› Issue (9): 955-960.DOI: 10.3969/j.issn.1673-8640.2014.09.019

• 技术研究与评价·论著 • 上一篇下一篇

应用沉淀法消除HLAP患者生化标本乳糜状态的探讨

张辉亮,黄树华,刘健玲,夏厚才

广州市南沙区第六人民医院检验科,广东广州 511470

收稿日期:2013-12-10 出版日期:2014-09-30 发布日期:2014-09-25
作者简介:张辉亮,男,1980年生,硕士,主管技师,主要从事临床生化检验工作
基金资助:
广州市番禺区科技局资助项目(2012-Z-03-14)

The discussion of applying precipitation to eliminate the state of chyle for HLAP patients' specimens

ZHANG Huiliang, HUANG Shuhua, LIU Jianling, XIA Houcai

Department of Clinical Laboratory, the Sixth People's Hospital of Nansha District, Guangdong Guangzhou 511470, China

Received:2013-12-10 Online:2014-09-30 Published:2014-09-25

摘要/Abstract

摘要： 目的探索磷钨酸镁沉淀法在高脂血症性急性胰腺炎(HLAP)患者标本进行生化检验前对重度乳糜状态的消除作用。方法取外观正常标本经磷钨酸镁处理后做各项生化检验,与处理前数据进行相关性分析;以脂肪乳液配制轻、中、重3组模拟乳糜血清做回收试验,计算各生化项目的回收率;收集HLAP患者标本做实证试验,观察乳糜消除效果和生化检验效果。结果除了二氧化碳结合力(CO₂CP)、总胆红素(TBil)、直接胆红素(DBil)、肌酸激酶同工酶MB(CK-MB)、乳酸脱氢酶同工酶1(LD-1)、半胱氨酸蛋白酶抑制剂C(Cys C)、高敏C反应蛋白(hs-CRP)外,钾离子(K^＋)、钠离子(Na^＋)、氯离子(Cl^－)、钙离子(Ca^2＋)、血糖(Glu)、尿素(Urea)、尿酸(UA)、肌酐(Cr)、淀粉酶(AMY)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰基转移酶(GGT)、碱性磷酸酶(ALP)、胆碱酯酶(CHE)、总蛋白(TP)、白蛋白(Alb)、总胆汁酸(TBA)、肌酸激酶(CK)、乳酸脱氢酶(LD)、α-羟丁酸脱氢酶(α-HBDH)经磷钨酸镁处理后均可正确检测,且与处理前呈高度的直线相关,拟合曲线显著性检验显示P均＜0.01。回收试验中3组模拟乳糜血清各生化项目的回收率最低为98.03%,最高为103.44%,回收效果良好。HLAP患者标本经磷钨酸镁处理后可正确检测的生化项目与相关性分析实验中外观正常的标本一致,甘油三酯(TG)＜10 mmol/L或TG＞40 mmol/L的标本乳糜消除效果明显,TG为10～40 mmol/L的标本需先做稀释使TG＜10 mmol/L再做处理。结论磷钨酸镁沉淀法清除血脂效果显著,对绝大多数的生化检验不会产生干扰,适用于重度乳糜状态的HLAP患者标本生化检验前的处理。

关键词: 沉淀法, 磷钨酸镁, 高脂血症性急性胰腺炎, 生化检验

Abstract: Objective To investigate phosphotungstic acid magnesium precipitation eliminating effects on hyperlipidemic acute pancreatitis(HLAP) patient's specimens in severe state of chyle before biochemical tests. Methods The normal appearance specimens undergoing phosphotungstic acid magnesium treatment were collected to do biochemical tests, and the correlation data before and after tests were analyzed. The 3 different, mild, moderate and severe, groups of chylous sera with intralipid were performed to do recovery test, and the recovery rates of all biochemical projects were calculated. HLAP patients' specimens were collected to do empirical test, and the chyle eliminating effect and biochemical test effect were observed. Results Except for CO₂ combining ability(CO₂CP), total bilirubin(TBil), direct bilirubin(DBil), creatine kinase-MB(CK-MB), lactate dehydrogenase 1(LD-1), cystatin C(Cys C), high-sensitivity C-reactive protein(hs-CRP), K^＋, Na^＋, Cl^－, Ca^2＋, glucose(Glu), urea, uric acid(UA), creatinine(Cr), amylase(AMY), alanine aminotransferase(ALT), aspartate aminotransferase(AST), gamma-glutamyl transpeptidase(GGT), alkaline phosphatase(ALP), cholinesterase(CHE), total protein(TP), albumin(Alb), total bile acid(TBA), creatine kinase(CK), lactate dehydrogenase(LD) and alpha-hydroxybutyrate dehydrogenase(α-HBDH) can be correctly detected after phosphotungstic acid magnesium treatment, and it showed obvious linear correlation before the treatment.Fitted curve showed that the P was <0.01. In the 3 groups of chylous sera, the lowest recovery rate was 98.03%, the highest recovery rate was 103.44%, and it showed a good recovery effect. The correctly detected biochemical projects of HLAP patients' specimens by phosphotungstic acid magnesium were consistent with the correlation tests of the normal appearance specimens. The specimens of triglyceride (TG)＜10 mmol/L or TG＞40 mmol/L had obvious chyle eliminating effects, and the specimens with TG 10-40 mmol/L needed to be diluted to TG<10 mmol/L before processing. Conclusions Phosphotungstic acid magnesium precipitation has an obvious effect on eliminating blood lipid. It won't interfere most of the biochemical tests. The treatment can be applied before the biochemical tests for HLAP patients' specimens in severe state of chyle.

Key words: Precipitation, Phosphotungstic acid magnesium, Hyperlipidemic acute pancreatitis, Biochemical test

中图分类号:

R446.1

张辉亮,黄树华,刘健玲,夏厚才. 应用沉淀法消除HLAP患者生化标本乳糜状态的探讨[J]. 检验医学, 2014, 29(9): 955-960.

ZHANG Huiliang, HUANG Shuhua, LIU Jianling, XIA Houcai. The discussion of applying precipitation to eliminate the state of chyle for HLAP patients' specimens[J]. , 2014, 29(9): 955-960.

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应用沉淀法消除HLAP患者生化标本乳糜状态的探讨

The discussion of applying precipitation to eliminate the state of chyle for HLAP patients' specimens

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