The evaluation of hemolytic index monitoring of 39 immune markers and verification of the warning threshold of hemolytic index

Objective: To evaluate the influence of different degrees of hemolysis on 39 immune markers by monitoring hemolysis index (H), and to determine the warning threshold of hemolysis index according to the evaluation results, so as to provide a knowledge base for the treatment of hemolysis samples, procedures of report review and reasonable interpretation of the results. Methods: The blood samples were artificially interfered into hemolytic samples of different degrees, and the hemolytic index and 39 immune markers of each group were detected. The differences between the detection results of hemolytic samples of different degrees and normal samples were compared, and the warning threshold of hemolytic index was evaluated and identified. Results: Hemolysis produced a negative interference on the detection results of ACTH, Pro-GRP, PCT, PTH and INS, while a positive interference to NSE and FOL detection results. The warning thresholds were determined as following: ACTH, INS, NSE, FOL H > 50 mg/dL; Pro-GRP, PCT H > 400 mg/dL; PTH H > 800 mg/dL. FER severe hemolysis showed a tendency of higher results, but had no clinical significance and was not disturbed by hemolysis. Conclusion: The verification and monitoring of the threshold value of hemolysis index can help the laboratory inspectors to obtain more accurate specimen information, reduce the error of artificial subjective judgment of unqualified specimens, make the decision more reasonable to dispose samples with different degrees of hemolysis, and reduce the medical burden brought by unqualified samples and the misleading of clinical diagnosis and treatment. (authors)