Hemolysis of the specimen, that is, the destruction of the red blood cells inside the blood specimen, the contents of the red blood cells are released to the outside. In this case, many tests will be affected to varying degrees, and may even cause serious inaccuracies in the results. Therefore, it is often necessary to retake the specimen at this time.
Hemolysis is a frequent phenomenon in clinical testing of medical blood specimens. In order to understand the interference and influence of hemolysis on test results, this paper compares the biochemical test results of 20 non-hemolyzed and hemolyzed blood, and analyzes the influence of hemolysis on biochemical test results and its countermeasures.
Twenty normal blood specimens of medical examiners were taken, and their serums were free from jaundice, lipodystrophy and hemolysis visible to the naked eye. They were placed in two test tubes of 2.5 ml each, one of which was separated naturally at room temperature, and then centrifuged at 1200 r/min for 10 min after 3 min to separate the serum, and 1 ml of serum was taken as normal serum for spare use; and the other specimen in the other tube was hemolysed artificially, and then centrifuged under the same conditions to separate the hemolysed serum for spare use, and the whole process was completed in 2 h. The results were as follows:
The blood specimens of the patients with no visible jaundice, lipodystrophy or lipemicity in their serums were collected from the test tubes.
The results showed that ALT, AST, LDH, K and CHO of hemolysed serum were significantly higher than those of normal serum (P less than 0.05), and the activity of ALP was reduced with hemolysis (P less than 0.05), the hemolysis had little effect on the measurement of BUN, Cr, TG, GLU and UA, and the difference between normal serum and hemolysed serum was not statistically significant (P more than 0.05). The difference between normal serum and hemolyzed serum was not statistically significant.
This result shows that hemolysis of samples affects the accuracy of almost all biochemical test results. Therefore, both clinical nurses, doctors and laboratory workers should pay enough attention to the problem of sample hemolysis. The results of this experiment show that the change of enzyme concentration after hemolysis of specimen is extremely significant, and the requirement of enzyme on specimen is higher than that of other biochemical tests, so it is not suitable to measure the enzyme after hemolysis of specimen in daily work. In addition, serum K is more affected by hemolysis, followed by CHO, while hemolysis has a very limited effect on proteins, Na, Cl-, Ca2, TG, GLU, BUN, Cr, UA and so on.
Hemolysis of different test results of different mechanisms, mainly in the following aspects: the interference of the concentration difference between the internal and external components of the cell, the high content of intracellular hemoglobin, enzymes, ions, organics, etc., hemolysis of intracellular substances along the concentration difference in the spillover, so that the measured value is significantly higher than the non-hemolysed specimens; on the contrary, the concentration of erythrocytes is very low in the substances, such as lipoproteins, cholesterol esters, sodium, etc., with hemolysis, the cellular substance overflowed, making the value significantly higher than non-hemolysed specimens. On the contrary, with hemolysis, the intracellular fluid dilution of serum, so that the results of the determination of a significant decrease; intracellular and external fluid reaction between the components of the interference; colored substances on the absorption spectrum of the interference, resulting in absorbance and astigmatism to produce a large error, when the color of the solution to be measured and the color of the color of the color of the substance close to the positive interference, and the color of the color of the color of the color of the color of the substance with the color of the color of the difference is far away from the negative interference; hemolyzed specimens of heme in the positive iron ion, can be used as a reference material for the measurement of hemoglobin, but not as the color of the hemoglobin. Positive iron ions in hemoglobin in hemolyzed specimens can be oxidized by the reagent oxidant (such as sodium nitrite) to become yellow methemoglobin, causing interference with the two-point colorimetric method; in the serum total cholesterol CHODPAP endpoint method, Hb is higher than 2 g/L will cause a positive interference; in the determination of phosphorus, hemolyzed specimens, the erythrocyte phosphate hydrolysis, so that the inorganic phosphorus increases.
Prevention of hemolysis, it is necessary to master the correct method of collecting blood samples. Clinical blood collection more choice of the middle elbow vein or vein, infants and young children more choice of the external jugular vein or femoral vein, avoid choosing too thin vein, not to draw blood from the infusion tube. Strictly follow the operating procedures. Proper preservation of samples. After the sample is sent to the laboratory, it should be kept at room temperature to prevent hemolysis. During the transportation of blood samples, prevent hemolysis by excessive oscillation. Strictly control the quality of syringes and test tubes. Strictly control the purchase channels of disposable syringes and test tubes to prevent unqualified products from flowing into the market and medical units to ensure the accuracy of test results and reduce unnecessary economic burden and pain of patients. Understanding hemolysis will cause some biochemical project results in false elevation or lower on the test physicians to reduce errors and errors, improve the accuracy of test results, better serve the clinical has important significance. In the work of the specimen once found obvious hemolysis, immediately take appropriate measures, such as re-collection of specimens or hemolysis to a lesser degree of specimen results for correction, especially with the popularity of the use of fully automated biochemical analyzers to check the appearance of serum specimens whether hemolysis has become an important part of the process of quality control tests.