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CCLM:含水量在临床实验室中的假低钠血症患病率检测中的作用

2017-05-17 MedSci MedSci原创

钠浓度是鉴别诊断或临床随访的常用标记物。由于在自动化学分析仪中进行间接离子选择性电极(ISE)测量中,假低钠血症可导致不正确的诊断和治疗。本研究基于总蛋白和脂质浓度的估计含水量是否可以用于减少假低钠血症的诊断进行研究。

近日,国际杂志Clinical Chemistry and Laboratory Medicine在线发表一项关于含水量在临床实验室中的假低钠血症患病率的作用的研究。

钠浓度是鉴别诊断或临床随访的常用标记物。由于在自动化学分析仪中进行间接离子选择性电极(ISE)测量中,假低钠血症可导致不正确的诊断和治疗。本研究基于总蛋白和脂质浓度的估计含水量是否可以用于减少假低钠血症的诊断进行研究。

研究人员在重症监护室(ICU)(n = 98)和随机非ICU患者(n = 100)的血液样品中比较了间接和直接的ISE测量。还检测了使用全血和锂-肝素血浆的直接测量值之间的差异。通过总蛋白和脂质浓度的线性组合估计的水含量用于校正间接测量的钠浓度。在ICU患者组中评估了假性低钠血症的患病率。

在使用锂-肝素血浆和全血的直接测量之间观察到3 mmol / L的绝对差异,血浆中钠浓度较高。此外,研究人员还观察到间接和直接测量之间的差异与估计的含水量呈线性关系。在采用水含量进行校正时候(19%)时,间接测量后假低钠血症患病率(32%)出现降低。

在危重病人中,钠浓度应优选通过直接测量来检测。全血是这些检测的首选材料。对于其他患者的常规钠分析,使用估计的含水量进行校正似乎能够降低通过间接测量导致的假低钠血症患病率。     

原始出处:

Marloes L.P. Langelaan, Linda Kamp, Eric Zandijk. et.al. Prevalence of pseudonatremia in a clinical laboratory – role of the water content.

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    2017-05-18 xinmeili
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