摘要
目的报告1例多发性骨髓瘤(MM)患者血液样本在检测叶酸(FOL)过程中出现的结果异常现象,并分析导致FOL结果异常的干扰因素。方法2020年9月15日接收该患者血液样本,使用电化学发光分析仪和全自动生化分析仪检测贫血8项〔包括维生素B_(12)(VB_(12))、FOL、铁蛋白(Fer)、转铁蛋白(TRF)、铁离子(Fe)、不饱和铁结合力(UIBC)、血清转铁蛋白饱和度(TS)、总铁结合力(TIBC)〕。结果患者女性,72岁。检测结果FOL>20.00μg/L,高于FOL的仪器检测范围,因此依照标准操作程序(SOP)对样本进行1︰1稀释,再次上机检测,经换算后FOL结果为9.16μg/L,与原倍样本明显不一致。经与临床沟通,该患者已被诊断为MM,重新上机检测,结果总蛋白(TP)>121.9 g/L,白蛋白(ALB)为25.2 g/L。分析出现异常结果的原因,MM患者血液样本含大量单克隆免疫球蛋白(Ig),也称M蛋白,在实验室检测过程中会增加血液黏滞性,形成蛋白胶,干扰检验过程,从而导致FOL结果假性增高。针对此项干扰因素使用样本稀释法处理,样本稀释时其中的蛋白成分也被稀释,使得样本黏滞性降低,反应得以正常进行。结论临床实验室在样本检测过程中有时会存在结果受到干扰的情况,只有排除干扰因素,才能得到可信的结果,从而为临床诊断及治疗提供可靠的依据。
Objective To report the blood sample testing process of one case of multiple myeloma(MM)with abnormal folic acid(FOL)test results,and analyze the interference factors.Methods On September 15,2020,the blood sample of the patient was received,and eight items of anemia[including vitamin B_(12)(VB_(12)),FOL,ferritin(Fer),transferrin(TRF),iron ion(Fe),unsaturated iron binding capacity(UIBC),serum transferrin saturation(TS)and total iron binding capacity(TIBC)]were detected by electrochemiluminescence analyzer and automatic biochemical analyzer.Results The patient was 72-year-old female.The detection results showed that FOL>20.00μg/L,which was higher than the instrument detection range of FOL.According to standard operating procedure(SOP),the sample was diluted by 1︰1 and tested again.After conversion,the result of FOL was 9.16μg/L,which was obviously inconsistent with the original sample.After communicating with the clinic,the patient was diagnosed as MM,the total protein(TP)was detected as 121.9 g/L,and the albumin(ALB)was 25.2 g/L.The reason of abnormal results was analyzed.The blood samples of MM patients contained a large number of monoclonal immunoglobulin(Ig),also known as M protein.In the process of laboratory testing,it would increase blood viscosity,form protein glue,and interfere with the testing process,resulting in false increase of FOL results.For this interference factor,the sample dilution method was used,and when the sample was diluted,the protein component was also diluted,the viscosity was reduced,and the reaction proceeded normally.Conclusions The detection results may be disturbed when the samples are detected in the clinical laboratory.A credible result can be obtained only after the interference factors were eliminated.The clinical laboratory can provide a reliable basis for clinical diagnosis and treatment.
作者
王依凡
张明芳
赵楠楠
孙国威
Wang Yifan;Zhang Mingfang;Zhao Nannan;Sun Guowei(Heilongjiang Dean Medical Laboratory Co.,Ltd.,Harbin 150000,Heilongjiang,China;Roche Diagnostics(Shanghai)Co.,Ltd.,Harbin 150000,Heilongjiang,China)
出处
《实用检验医师杂志》
2021年第1期56-58,共3页
Chinese Journal of Clinical Pathologist
关键词
结果异常
干扰因素
叶酸
免疫球蛋白
多发性骨髓瘤
Abnormal results
Interference factors
Folic acid
Immunoglobulin
Multiple myeloma
