新生儿血液样本溶血对血清NSE检测结果的影响及其校正公式的建立

doi:10.3969/j.issn.1673-8640.2019.01.009

检验医学 ›› 2019, Vol. 34 ›› Issue (1): 42-46.DOI: 10.3969/j.issn.1673-8640.2019.01.009

新生儿血液样本溶血对血清NSE检测结果的影响及其校正公式的建立

王强¹, 卢小岚², 汪光蓉³, 蔡艳娟², 杜琴², 张茂鑫², 张国元², 王东生²

1.川北医学院医学检验系,四川南充 637000
2.川北医学院附属医院检验科,四川南充 637000
3. 川北医学院转化医学研究中心,四川南充 637000

收稿日期:2018-04-19 出版日期:2019-01-30 发布日期:2019-01-29
作者简介:null
作者简介：王强,男,1981年生,硕士,讲师,主要从事临床免疫学检验数学工作。

Influence of neonatal blood sample hemolysis on the determination of serum neuron-specific enolase and establishment of correction equation

WANG Qiang¹, LU Xiaolan², WANG Guangrong³, CAI Yanjuan², DU Qin², ZHANG Maoxin², ZHANG Guoyuan², WANG Dongsheng²

1. Faculty of Laboratory Medicine,North Sichuan Medical College,Nanchong 637000,Sichuan,China
2. Department of Clinical Laboratory,the Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China
3. Center for Translational Medicine,North Sichuan Medical College,Nanchong 637000,Sichuan,China

Received:2018-04-19 Online:2019-01-30 Published:2019-01-29

摘要/Abstract

摘要：

目的探讨新生儿血液样本溶血对血清神经元特异性烯醇化酶（NSE）检测结果的影响,并建立其校正公式。方法在72份出生24 h内的新生儿血清样本中添加对应的冻融红细胞。采用化学发光法检测添加前后血清NSE浓度的变化,氰化高铁血红蛋白（HiCN）法检测添加前后血清血红蛋白（Hb）浓度的变化,从而建立新生儿溶血样本的NSE校正公式。根据自身Hb变化对NSE结果的影响推算出变化常数。将变化常数校正的NSE结果与HiCN法校正公式校正的NSE结果进行比较,评价HiCN法校正公式的可行性。对HiCN法与仪器法的Hb检测结果进行相关性分析,以建立针对仪器法的NSE校正公式。结果 72份新生儿溶血样本NSE浓度结果变化常数为（23.70±3.62）mg/g Hb。以ΔNSE_血清为Y、ΔHb_HiCN为X,血清NSE浓度变化与Hb浓度变化之间的相关方程为Y=23.17X（r²=0.812 2,P<0.001）。采用自身变化常数获得的NSE校正值和采用相关方程获得的NSE校正值之间差异无统计学意义（P=0.541）。HiCN法与仪器法的Hb结果高度相关（r²=0.992 4,P<0.001）。HiCN法和仪器法新生儿血清NSE检测结果的校正公式分别为NSE_校正=NSE_测定-23.17Hb_HiCN和NSE_校正=NSE_测定-23.60Hb_仪器+13.22。结论溶血对血清NSE检测影响较大。可以通过校正公式计算新生儿溶血样本NSE浓度,以帮助临床评价新生儿缺氧缺血性脑病（HIE）的严重程度。

关键词: 神经元特异性烯醇化酶, 溶血, 样本, 校正公式, 新生儿

Abstract:

Objective To evaluate the influence of neonatal blood sample hemolysis on the determination of serum neuron-specific enolase（NSE）,and to establish correction equation. Methods Chemiluminescence was used to determine the change of serum NSE level before and after adding self-frozen thawed red blood cells in 72 neonates borned less than 24 h. The changes of hemoglobin（Hb） before and after adding were determined by cyanmethemoglobin（HiCN）. The correction equation was established. The feasibility of correction equation was evaluated by comparing the NSE results with the NSE results corrected by self-constant and the correction equation. The NSE correction equation for instrumental method was established by analyzing the correlation of Hb results determined by HiCN method and instrumental method. Results The change constants of NSE in 72 neonates with serum hemolysis was（23.70 ±3.62） mg/g Hb. The relationship of concentration variation between Hb and NSE in neonatal bloodsample was ΔNSE_serum=23.17×ΔHb_HiCN （Y=23.17X,r²=0.812 2,P<0.001）. There was no statistical significance of NSE corrected results between self-constant group and correction equation group（P=0.541）. The linearity for Hb of instrumental method with HiCN was high（r²=0.992 4,P<0.001）. The correction equations of NSE in neonatal hemolytic serum were NSE_correction=NSE_measurement-23.17Hb_HiCN and NSE_correction=NSE_measurement-23.60Hb_instrument+13.22. Conclusions Hemolysis has a serious influence on the determination of NSE in serum. For neonatal hemolytic sera,it is critical to evaluate the severity of neonatal hypoxic ischemic encephalopathy by correcting NSE level.

Key words: Neuron-specific enolase, Hemolysis, Sample, Correction equation, Neonate

中图分类号:

R446.1

王强, 卢小岚, 汪光蓉, 蔡艳娟, 杜琴, 张茂鑫, 张国元, 王东生. 新生儿血液样本溶血对血清NSE检测结果的影响及其校正公式的建立[J]. 检验医学, 2019, 34(1): 42-46.

WANG Qiang, LU Xiaolan, WANG Guangrong, CAI Yanjuan, DU Qin, ZHANG Maoxin, ZHANG Guoyuan, WANG Dongsheng. Influence of neonatal blood sample hemolysis on the determination of serum neuron-specific enolase and establishment of correction equation[J]. Laboratory Medicine, 2019, 34(1): 42-46.

图/表 4

图1 Hb标准曲线注：（a）全血样本Hb的标准曲线,Hb全血=376.2×A540 nm（r2=0.999 5）;（b）血清样本Hb的标准曲线,Hb血清=35.98×A540 nm（r2=0.999 3）

图2 血清NSE浓度变化与Hb浓度变化的相关性注：Y=23.17X（r2=0.812 2）

图3 常数校正和方程校正结果注：（a）校正前后NSE结果的连线图;（b）2种校正方式之间NSE校正值的比较;（c）2种校正方式NSE校正结果之间的相关性

图4 HiCN法与仪器法测定Hb的相关性

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新生儿血液样本溶血对血清NSE检测结果的影响及其校正公式的建立

Influence of neonatal blood sample hemolysis on the determination of serum neuron-specific enolase and establishment of correction equation

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