Clinical Study On The Serum Dilution Method To Eliminate The Interference Of Chylous Blood Samples On Six Biochemical Indicators

Objective:To study the effect of serum dilution method on the elimination of six biochemical indicators?alanine aminotransferase?aspartate aminotransferase?creatine kinase?uric acid?serum creatinine and urea nitrogen?in chylous blood samples.Methods:Collected serum samples from peripheral venous blood of healthy crowd that routinely tested biochemical indicators in biochemical laboratory with clarified appearance,no hemolysis,no jaundice,no chyluene.30 samples of light,medium and severe simulated chylous blood samples were prepared,and tested for triglyceride?TG?,alanine aminotransferase?ALT?,aspartate aminotransferase?AST?,creatine kinase?CK?,uric acid?uric acid,UA?),serum creatinine?SCr?,and urea nitrogen?BUN?,compared the effects of varying degrees of chylomicron to the results of six biochemical indicators.Medium chylous blood samples were diluted with normal serum samples according to 2 times,3times,...10 times dilution multiples,severe chylous blood samples were diluted with normal serum samples according to 6 times,7 times,...15times dilution multiples,and tested for TG,AST,ALT,CK,UA,SCr and BUN separately,compared with the changes of various biochemical indicators before and after dilution,and to establish the optimal dilution multiples of each biochemical indicators in chylous blood at different concentrations.Refered to the EP series documents of Clinical and Laboratory Standards Institude?CLSI?,verified the Intra-and inter-assay precision of testing AST,ALT,CK,UA,SCr,and BUN on Abbott C8000after the chylous blood samples be pretreated with serum dilution method,and conducted methodological comparison with low-temperature high-speed centrifugation.Collected 120 clinical serum samples with chyle-like turbidity and the biochemical indicators of AST,ALT,CK,UA,SCr and BUN were abnormal,including 60 cases of medium chylous blood and 60 cases of severe chylous blood,compared the changes of test results after pretreatment with serum dilution method,and then evaluated the serum dilution method.Data were statistically analyzed by paired sample t test.Results:1.Light chylous blood has no significant effect on AST,ALT,CK,UA,SCr and BUN test results?P>0.05?;ALT and AST of medium chylous blood could not be measured,medium chylous blood has significant effects on UA,SCr and BUN test results?P<0.05?,medium chylous blood has no significant effect on CK test results?P>0.05?;ALT and AST of severe chylous blood can not be measured,severe chylous blood has significant effects on CK,UA,SCr and BUN test results?P<0.05?.2.Different concentrations of chylous blood were pretreated by serum dilution method according to different dilution multiples for different indicators.In medium chylous blood samples,the optimal pretreatment effect of ALT and AST was 5 times dilution multiples?P>0.05?,the optimal pretreatment effect of UA,SCr and BUN was 7 times dilution multiples?P>0.05?.In severe chylous blood samples,the optimal pretreatment effect of ALT,AST and CK was 10times dilution multiples?P>0.05?,the optimal pretreatment effect of UA,SCr and BUN was 12 times dilution multiples?P>0.05?.3.The Intra-and inter-assa samples precision for pretreatment by serum dilution method in medium and severe chylous blood were within acceptable limits?Sr??Intra;Sl??inter?;4.The results of serum dilution method and low temperature high-speed centrifugation pretreatment of chylous blood samples were no significant difference(Medium:P_ALT=0.281,P_AST=0.698?P_UA=0.178?P_SCr=0.279?P_BUN=0.157>0.05;Severe:P_ALT=0.550?P_AST=0.198?P_CK=0.534?P_UA=0.817?P_SCr=0.120?P_BUN=0.514>0.05);5.Pretreated 120 clinically collected chyloous blood samples with serum dilution method,and found that there were significant differences among the six biochemical indicators?P<0.05?,the testing results of AST,ALT,CK,UA,SCr,and BUN were consistent with the clinical situation after pretreated with serum dilution method.Conclusion:1.The serum dilution method can effectively eliminate the interference of AST,ALT,CK,UA,SCr and BUN test results in medium and severe chylous blood samples.2.In medium chylous blood,the optimal dilution multiple for ALT and AST was 5 times,and the optimal dilution multiple for UA,SCr and BUN was 7 times.3.In severe chylous blood,the optimal dilution multiple for ALT,AST and CK was 10 times,the optimal dilution multiple for UA,SCr and BUN was 12 times.