Effect of hemolysis, jaundice and lipemia on biochemical analysis

release time:2021-11-22 16:41:05

1. Hemolysis

Hemolysis is one of the most common interfering factors in clinical biochemical tests. Hemolysis is the rupture of red blood cells in the blood. The contents of the red blood cells enter the serum. As a result, the concentration or activity of the biochemical test substance is affected.

Common principles of hemolysis affecting biochemical assays

(1) Red blood cells contain high levels of potassium ions, lactate dehydrogenase, and aspartate aminotransferase. When hemolysis occurs in the specimen, it leads to an increase in the concentration in the serum, which has a significant effect on the results.

(2) Hemoglobin in red blood cells has a strong absorption peak at 540nm. For items detected using the endpoint method (e.g. total protein, absorbance value at 540nm) there is a more obvious interference.

(3) The chemical substances in the red blood cells are released and react chemically with the chemical components in the serum. This can affect the concentration or activity of biochemical assays.

Commonly interfered with items.

Increased: serum potassium, serum phosphorus, alanine aminotransferase, aspartate aminotransferase, total bilirubin, creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase, alpha-hydroxybutyrate dehydrogenase, total protein, etc.

Decrease: alkaline phosphatase, gamma-glutamyl transpeptidase, etc.

2. Jaundice

Jaundice is an abnormal color of the specimen due to high bilirubin in the serum. Bilirubin itself is a reducing agent. It neutralizes the oxidizing components of reagents or intermediate reaction products. This can lead to a shortage of reagents or depletion of intermediate products, which can affect the reaction and ultimately the test result.

Common interfered items in biochemical tests.

Decreased: serum creatinine, HDL, LDL, glucose (glucose oxidase method), prealbumin.

3. Lipemia

Biochemical tests rely mainly on the different colors of the products after the reaction. There is a strong absorbance value at a specific wavelength as a way to determine the concentration or activity of the substance being tested. When there is a high level of celiac particles in the blood (lipid blood), it can cloud the specimen. Interference with light scattering, resulting in changes in the final absorbance value, affecting the test results.

Commonly interfered items

Decreased: alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, albumin, phosphorus

Elevated: total bilirubin, total protein, serum potassium, serum sodium, serum chloride, blood glucose, etc.

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