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临床输血与检验

临床输血与检验 ›› 2019, Vol. 21 ›› Issue (6): 641-645.DOI: 10.3969/j.issn.1671-2587.2019.06.023

• 临床检验 • 上一篇    下一篇

白血病细胞对外周血钾、葡萄糖检测的影响*

黎艳湘, 邸玉玮, 陈倩礼, 谢佳斌   

  1. 510080 广州,广东省人民医院、广东省医学科学院检验科
  • 收稿日期:2018-07-17 出版日期:2019-12-20 发布日期:2019-12-25
  • 通讯作者: 邸玉玮,女,副主任技师,博士,主要从事临床检验研究工作,（E-mail）diyuweinn@163.com。
  • 作者简介:黎艳湘（1982-）,女,广东东莞人,主管技师,学士,主要从事临床生化技术及应用研究,（Tel）13570958748。
  • 基金资助:
    *本课题受广东省医学科研基金（No.A2014025）,广州市科技计划一般项目（No.1563000383）资助

The Effect of Leukemia Cells on K+ and Glucose Detection in Peripheral Blood

LI Yan-Xiang, DI Yu-Wei, CHEN Qian-li, et al   

  1. Department of Clinic Lab,Guangdong General Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080
  • Received:2018-07-17 Online:2019-12-20 Published:2019-12-25

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摘要： 目的 探讨白血病细胞是否引起血清（浆）钾、葡萄糖假性升高/降低,可能的原因以及解决措施。方法 白血病患者按诊断及外周血白细胞数（<20、20~50、50~100、>100）×109/L分组,检测血清（浆）钾、葡萄糖;白血病细胞离体后经PI、Annexin V染色,流式细胞仪检测其坏死及凋亡状态;分离血清后,检测血清（浆）钾、葡萄糖。结果 与对照组（白细胞数<20×109/L）比较,白细胞数较高组（20~50、50~100、>100）×109/L组白血病患者的血钾显著升高（P<0.05,P<0.01）,（50~100、>100）×109/L组血糖显著降低（P<0.05）。白血病治疗过程中,随白细胞数量下降,白血病患者的血钾降低,血糖升高。白血病细胞离体后,随时间延长,坏死细胞比例升高。分离血清后,白血病细胞对血钾、血糖影响差异无显著性。采用分离胶管能够在6 h内延缓白血病细胞引起的对血钾、血糖假性升高/降低。结论 白血病患者外周血内白细胞数量升高,引起血钾假性升高、血葡萄糖假性降低;离体后外周血内白细胞坏死增加;分离血清可降低白细胞对血清（浆）钾、葡萄糖检测的影响;建议使用分离胶管采集并及时检测临床血液样本。

关键词: 白血病细胞, 血钾, 血糖, 外周血

Abstract: Objective To explore if the leukemia cells count affect the K+ （potassium） and Glu （glucose） detection in PB （peripheral blood）. Methods According to the clinical diagnose and the leukemia cells count,group the leukemia PB samples. K+ and Glucose concentration were detected. Leukemia cells were isolated from peripheral blood,labeled by PI and Annexin-V and detected by flow cytometry. Results Individual case indicated that pseudo-hyperkalemia may be present when WBC count is high. In PB samples no matter collected from acute or chronic leukemia patients,compared with control group （WBC<20×109/L）,the K+ concentration increased significantly in WBC （20~50,50~100 and >100）×109/L groups,the Glucose concentration decreased significantly in WBC （50~100 and >100） ×109/L groups. Necrosis rate of leukemia cells increased significantly as in vitro time increased. K+ and glucose concentration change was not significant in 6 hours after separate serum from blood cells. Conclusion leukemia cells count affects K+ and Glucose concentration in PB,cell necrosis is part of the important reasons. Separation serum is one of effective way to avoid pseudo-hyperkalemia and pseudo-hypoglycemia in PB samples from leukemia patients.

Key words: leukemia cell, Blood potassium, Blood glucose, Peripheral blood

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