재채혈된 검체를 이용한 허용 Hemolysis Index에 대한 연구
Investigation of an Acceptable Hemolysis Index Using Re-collected Samples
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초록
본 연구는 용혈의 영향과 허용 hemolysis index (HI)를 조사하기 위해 용혈된 검체와 재채혈된 검체의 결과를 비교하였다. 용혈 전ㆍ후, alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), amylase (Amy), direct bilirubin (D-bil), total bilirubin (T-bil), creatine phosphokinase (CK), gamma glutamyl transferase (GGT), iron, potassium (K), lactate dehydrogenase (LDH), magnesium (Mg), phosphorus (Phos), total protein (TP), uric acid (UA) 항목에서 유의미한 결과를 보였다. LDH, K, iron, AST, CK, GGT, TP, Amy, Phos는 용혈 정도와 결과 사이에 높은 상관관계가 있었다. Quality control (QC) high standard deviation (SD)을 이용하여 구한 허용 HI, HIQChigh를 비교했을 때 AST, D-bil, CK, LDH는비슷했지만 Amy, GGT, K, iron, Phos, TP는 장비의 cut-off HI보다 낮은 HI에서부터 영향 받았으며 ALP, ALT는 높게 나왔다. 그리고 paired t-test를 통해 유의미한 결과가 없었던albumin, cholesterol, triglyceride 항목에서도 HI＞200에서는 유의미한 결과가 나왔기 때문에 재채혈하는 것이 바람직하다고 생각되며 HI＜100일 때 영향을 받는 항목들이 있었던 연구 결과를 기반하여 약한 용혈이 나타나는 HI＞50부터 용혈 기준을 설정하는 것을 권장한다.
Abstract
This study compared the results of hemolyzed samples and re-collected samples to investigate a hemolysis influence and an acceptable hemolysis index (HI). Before and after hemolysis, alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), amylase (Amy), direct bilirubin (D-bil), total bilirubin (T-bil), creatine phosphokinase (CK), gamma glutamyl transferase (GGT), iron, potassium (K), lactate dehydrogenase (LDH), magnesium (Mg), phosphorus (Phos), total protein (TP), and uric acid (UA) showed significant results in the paired t-test. LDH, K, iron, AST, CK, GGT, TP, Amy and Phos had a high correlation between the degree of hemolysis and the results of samples. When comparing Roche’s cut-off HI with HIQChigh obtained using quality control (QC) high standard deviation (SD), AST, D-bil, CK, and LDH were similar, but Amy, GGT, K, iron, Phos, and TP were lower than the cut-off HI of Roche, while ALP and ALT were higher. Some analytes which showed no significant results in the paired t-test, were found to have significant results in HI＞200. Hence, it is suggested that the hemolyzed sample should be rejected if HI＞200. Based on this study that some analytes were affected when HI＜100, we recommend to set the standard of hemolysis starting from HI＞50.
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