血液样品中防腐剂对碳氧血红蛋白稳定性的影响

目的研究临床上常用8种试剂对血液样品中碳氧血红蛋白(HbCO)稳定性的影响。方法将血液样品分为高、低两个HbCO浓度组,选用临床常用的甲醛、氟化钠、乙二胺四乙酸二钠、亚硝酸钠、草酸钾、肝素钠、柠檬酸钾及氟化钠与草酸钾混合物(1:3)8种试剂,按常用浓度分别添加到血样品中,并于添加后0h、2h、8h、24h、3d、7d用紫外可见光分光光度法检测其中HbCO饱和度,用统计学方法进行结果分析。结果本实验选用的8种试剂只有甲醛和亚硝酸钠对HbCO的稳定性影响较为显著,而其余6种对HbCO稳定性的影响无统计学意义。结论在检验疑似CO中毒并经甲醛或亚硝酸钠防腐的检材时应慎重,以免导致错误的鉴定结论。

A study on the effect of preservatives on the stability of carboxyhemoglobin in the blood samples

Objective To investigate the effect of conventional preseratives on the stability of carboxyhemoglobin(HbCO)in the stored blood samples.Methods Blood samples with 30%～40% and 60%～70% of HbCO were established,respectiviely.The samples were stored with the commomly used preseratives including formaldehyde,sodium fluoride,EDTA-Na_2,sodium nitrite,potassium oxalate,heparin sodium,sodium citrate and the mixture of sodium fluoride and sodium citrate(1:3).Saturation of HbCO in the preserved blood samples were determined at 0h,2h,8h,24h,3d,and 7d after treatment with the addictives,respectively.The data were evaluated statistically.Results The stability of HbCO was significantly affected in the formaldehyde and sodium nitrite-treated samples,but no significant effects of the other preseratives on the blood samples were detected.Conclusion The stability of HbCO in the blood samples conserved varies with the type of the preseratives used.The samples taken from cases with suspected death from carbon monoxide poisoning should be kept with proper preseratives.Blood samples preserved with formaldehyde and sodium nitrite are not suitable for HbCO determination.