Clinical Study On Eliminating Interference Of Jaundice Blood Specimens To Some Biochemical Items By Serum Dilution Method

Objective:To study the use of serum dilution method to eliminate the interference of jaundice blood specimen on some biochemical indexes of renal function,namely urea nitrogen（BUN）,creatinine（Crea）and uric acid（UA）.Methods:BUN,Crea and UA were tested on the prepared serum samples of mild,moderate and severe jaundice,and the influence of serum specimen of jaundice with different bilirubin concentrations on the results of three renal function tests was evaluated.The serum specimen of moderate and severe jaundice were diluted with normal people’s serum and then BUN,Crea and UA were detected.The changes of the three indexes before and after dilution were compared and the best dilution multiple of each index of serum specimen with different jaundice was established.Referring to the relevant documents of CLSI of American Association for Clinical and Laboratory Standardization,verified the intra-batch and inter-batch precision of BUN,Crea and UA after serum dilution method was used to treat icteric blood specimen,and compared it with fetal bovine serum dilution method to verify its accuracy.Use the allowable deviation specified by health industry standard"Quality Index for Analysis of Routine Items in Clinical Chemical Examination（WS/T403-2012）"to evaluate the deviation of serum dilution method.Collecting jaundice serum specimen in clinical work,detecting three renal function items after pre-dilution treatment by serum dilution method,comparing the changes of various indexes before and after treatment,and evaluating the reliability of serum dilution method in solving practical clinical problems;Finally,the collected clinical jaundice serum specimen were treated with physiological saline dilution method to detect the three renal functions and explore the feasibility of physiological saline dilution method in treating jaundice serum specimen.Results:Serum with mild jaundice had no significant effect on BUN,Crea and UA（P>0.05）.The serum of moderate and severe jaundice had obvious influence on the detection results of Crea and UA（P<0.05）.Jaundice serum samples with different bilirubin concentrations had different pre-dilution effects on renal function items with different gradients by serum dilution method.the optimal dilution multiple of Crea and UA in moderate jaundice blood was 5 times（P>0.05）,and the optimal dilution multiple of Crea and UA in severe jaundice serum samples was 7 times（P>0.05）.The intra-batch and inter assay precision of serum specimen with moderate and severe jaundice treated by serum dilution method was less than the manufacturer’s claimed value.There was no significant difference between serum dilution method and fetal bovine serum dilution method in the detection results of jaundice serum specimen(P_UAA and P_CREAREA of moderate and severe jaundice blood were both>0.05).The distribution range of relative deviation was within the acceptable range.The results of BUN,Crea and UA were compared after serum dilution treatment of clinically collected serum samples with moderate and severe jaundice.The results before and after Crea and UA treatment were significantly different（P<0.05）.The results of Crea and UA after treatment were consistent with the clinical situation.The results of BUN,Crea and UA before and after dilution were compared after the jaundice serum samples collected clinically were diluted with physiological saline.The results of urea nitrogen and creatinine were increased while the results of uric acid were decreased.The deviation of results after 2-to 8-fold dilution was the same in all parts,showing a progressive increase.Conclusion:1.The blood samples of mild jaundice have no obvious interference with the biochemical test results of BUN,Crea and UA;the blood samples with moderate and severe jaundice will cause negative interference to the detection results of Crea and UA.2.The serum dilution method can effectively eliminate the interference of serum specimen with moderate and severe jaundice on the detection results of Crea and UA.3.A calculation model for treating icteric blood samples by serum dilution method was established,namely the conversion formula of serum dilution method.4.The normal saline dilution method was used to treat jaundice serum samples,the deviation range of renal function test results was different and varied greatly.