目的 通过研究血常规及凝血检验分析前的影响因素,探讨控制分析前变异的意义。 方法 选择健康成年志愿者 21 人,按照课题设计的方案采血,进行血常规和凝血常规项目的检测,对检测结果做统计学分析。结果①压脉带时间对血常规测定结果的影响:红细胞数(RBC)、血红蛋白浓度(HGB)和白细胞数(WBC)测定结果 1min 和 2min 无变化、3min 变化有统计学意义;血小板数(PLT)结果 1、2、3min 变化均有统计学意义。②离心前后标本放置 2h 对凝血四项测定结果的影响:凝血酶原时间(PT)、纤维蛋白原(FIB)、凝血酶时间(TT)结果无变化,部分凝血活酶时间(APTT)变化有统计学意义。③离心前后标本放置 4h 对凝血四项测定结果的影响:FIB 无变化,PT、APTT、TT 变化有统计学意义。结论 分析前标本采集和标本放置时间及方式都会对检测结果造成影响,重视分析前影响因素和控制分析前变异,能极大地提高临床实验室的服务质量,为临床医师诊断和治疗提供更可靠的数据支持。
Objective To study the influencing factors on routine blood test and routine coagulation before test analysis, to explore the significance of control preanalytical variation. Methods The 21 healthy adult volunteers were selected and took blood in accordance with the program of study design. Samples for testing blood and clotting regular projects were taken and the test results were analyzed. Results The influence of tourniquet time on routine blood test results: the results of red blood cell count (RBC), hemoglobin concentration (HGB) and white blood cell count (WBC) had no change within one to two minutes, but the result in 3 minutes were statistically significant. The result of platelet count in one to two minutes and 3 minutes were statistically significant (P 〈0. 05). The influence of specimens before and after centrif- ugation for 2 hours on clotting tetrachoric test results: there was no difference with the result of prethrombin time, fibrinogen levels and throm-bin time, compared with the specimens centrifuged two hours. However, the changes of thromboplastin time were significant statistically (P 〈 0.05). The influence of specimens before and after centrifugation for 4 hours on clotting tetrachoric test results : the results of fibrinogen levels had no change, but the changes of prothrombin time, thrombin time and thromboplastin time were significant statistically (P 〈 0. 05). Conclusion Preanalytical specimen collection and specimen placed time and in such manner will impact the test results. Emphasis on analy-sis of the former influencing factors and control pre - analysis variation can greatly improve the quality of clinical laboratory services and pro- vide more reliable data to support the diagnosis and treatment of clinicians.