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目的探讨采用气动物流传输系统运输白细胞显著升高白血病患者的血液标本对血钾检测结果的影响。方法分析2013年7月至2015年7月北京协和医院检验科急诊生化实验室发现的4例白血病患者假性高钾血症相关临床指标,包括临床诊断、标本运输方式、白细胞数量、血浆钾离子浓度、血气钾离子浓度、部分血清钾离子浓度、化疗情况、心电图等临床信息。以同期10例感染性疾病合并类白血病反应患者和50例白细胞数量正常非血液系统疾病患者的以上临床指标作为对照组,比较气动运输和人工运输对白细胞不同功能状态、不同标本类型、不同容器标本血钾结果的影响。结果 4例白细胞数量显著升高(206.8×10~9/L~652.1×10~9/L)白血病患者肝素锂抗凝静脉血标本通过气动传输导致血钾明显升高(5.9~14.8 mmol/L);气动传输对血气标本、血清管标本的血钾无明显影响;而气泵运输方式对于对照组的肝素锂抗凝静脉血标本和血气标本的血钾水平无显著影响(P>0.05)。结论对于白细胞显著升高的白血病患者,采用气动物流传输系统运输肝素锂抗凝的静脉血标本可导致血钾假性升高。
Objective To investigate the effect of blood samples of leukemia patients with leukocyte transport by pneumatic transport system on serum potassium test results. Methods Clinical data of 4 cases of leukemia patients with pseudo-hyperkalemia, including clinical diagnosis, mode of specimen transport, number of white blood cells, plasma potassium level Concentration, blood potassium concentration, partial serum potassium concentration, chemotherapy, electrocardiogram and other clinical information. The above clinical indexes of 10 leukemia patients with infectious diseases and 50 normal white blood cells patients with non-hematological diseases were used as control group to compare the different functional states of leukocytes, different specimen types, different container specimens The effect of serum potassium. Results The number of leukocytes in 4 leukocytes was significantly increased (206.8 × 10 ~ 9 / L ~ 652.1 × 10 ~ 9 / L) in patients with leukemia by heparin lithium anticoagulation venous blood lead significantly increased serum potassium (5.9 ~ 14.8 mmol / L ); Pneumatic transport had no significant effect on serum potassium and blood serum samples; however, pump transport mode had no significant effect on blood potassium level of heparin anticoagulation venous blood samples and blood gas samples of control group (P> 0.05). CONCLUSIONS: In patients with leukemia with markedly elevated white blood cells, intravenous heparin anticoagulant blood transfusion using a pneumatic transport system can lead to a false rise in blood potassium.