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CN111521474A - Method for detecting urea and creatinine in forensic hemolytic blood sample - Google Patents

Method for detecting urea and creatinine in forensic hemolytic blood sample Download PDF

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Publication number
CN111521474A
CN111521474A CN202010387317.0A CN202010387317A CN111521474A CN 111521474 A CN111521474 A CN 111521474A CN 202010387317 A CN202010387317 A CN 202010387317A CN 111521474 A CN111521474 A CN 111521474A
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creatinine
urea
ultrafiltrate
ultrafiltration
syringe
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曹志鹏
贾宇晴
王天琦
田美慧
朱宝利
官大威
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China Medical University
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China Medical University
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    • GPHYSICS
    • G01MEASURING; TESTING
    • G01NINVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N1/00Sampling; Preparing specimens for investigation
    • G01N1/28Preparing specimens for investigation including physical details of (bio-)chemical methods covered elsewhere, e.g. G01N33/50, C12Q
    • G01N1/34Purifying; Cleaning
    • GPHYSICS
    • G01MEASURING; TESTING
    • G01NINVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N33/00Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
    • G01N33/48Biological material, e.g. blood, urine; Haemocytometers
    • G01N33/50Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
    • G01N33/62Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving urea
    • GPHYSICS
    • G01MEASURING; TESTING
    • G01NINVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
    • G01N33/00Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
    • G01N33/48Biological material, e.g. blood, urine; Haemocytometers
    • G01N33/50Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
    • G01N33/70Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving creatine or creatinine

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Abstract

The invention belongs to a blood sample detection method, and particularly relates to a method for detecting urea and creatinine in a forensic hemolytic blood sample. It solves the color interference generated by hemoglobin in the hemolytic sample, and makes the conventional biochemical method more stable. The method comprises the following steps: step 1, carrying out ultrafiltration treatment on a fully dissolved blood sample by using an ultrafiltration device to obtain ultrafiltrate; step 2, detecting urea and creatinine of the ultrafiltrate; step 3, correcting the content values of urea and creatinine in the ultrafiltrate; and 4, obtaining the content values of urea and creatinine in the forensic hemolysis sample.

Description

Method for detecting urea and creatinine in forensic hemolytic blood sample
Technical Field
The invention belongs to a blood sample detection method, and particularly relates to a method for detecting urea and creatinine in a forensic hemolytic blood sample.
Background
The concentration of urea and creatinine in blood after death has important auxiliary diagnostic significance in the inference of legal medical death causes such as renal failure, fatal high and low temperature injury, hypertonic dehydration and the like, and particularly, the concentration of urea and creatinine plays an important role in diagnosing the renal failure after death. At present, the detection of urea and creatinine in the forensic postmortem examination is mainly based on biochemical methods such as manual detection of a separated serum sample by using a kit and a microplate reader, and the like to detect the concentration of the separated serum sample in body fluid. However, in forensic practice, cadaver blood often fails to separate serum that meets the needs of the test due to hemolysis. Studies have shown that hemolysis will severely interfere with biochemical assays and that stable and useful diagnostic assays cannot be obtained. Therefore, the establishment of the pretreatment of the post-mortem hemolytic blood sample and the effective detection method of creatinine and urea in the treated sample have important forensic practical significance.
For the pretreatment of the hemolyzed blood sample, the hemolyzed blood sample is treated by a high-speed centrifugation and multiple dilution method in the prior art, but the liquid obtained after the hemolyzed blood sample is subjected to high-speed centrifugation still presents a serious red appearance, and the blood sample for biochemical detection cannot be obtained; after the hemolyzed blood sample is diluted by multiple times, although the influence of blood color caused by hemolysis can be reduced, the urea and creatinine are not in direct proportion to the dilution times in the detection, and if the concentration of the diluted sample is lower than the lower limit value of the instrument detection method, the detection cannot be carried out, so that the blood sample diluted by multiple times cannot truly reflect the real concentration of the urea and the creatinine in the original blood.
Disclosure of Invention
The invention provides a method for detecting urea and creatinine in a forensic hemolytic blood sample aiming at the defects in the prior art.
In order to achieve the purpose, the invention adopts the following technical scheme that the method for detecting urea and creatinine in the forensic hemolytic blood sample comprises the following steps.
Step 1, carrying out ultrafiltration treatment on the fully dissolved blood sample by using an ultrafiltration device to obtain ultrafiltrate.
And 2, detecting urea and creatinine in the ultrafiltrate.
And 3, correcting the content values of urea and creatinine in the ultrafiltrate.
And 4, obtaining the content values of urea and creatinine in the forensic hemolysis sample.
Further, an ultrafiltration device; the device is characterized by comprising a hollow fiber ultrafiltration component, a first syringe, a second syringe, a third syringe, a vertical ultrafiltration component and a centrifuge; the first syringe and the second syringe are used for accommodating a sample to be treated for hemolysis, and the third syringe is used for collecting primary ultrafiltrate A; one end of the hollow fiber ultrafiltration component is respectively connected with the first syringe and the third syringe, and the other end of the hollow fiber ultrafiltration component is connected with the second syringe; the vertical ultrafiltration module is used for containing ultrafiltrate A, and the centrifuge is used for centrifuging the ultrafiltrate A in the vertical ultrafiltration module.
Furthermore, the hollow fiber ultrafiltration module adopts MicroKros and mPES type ultrafiltration modules which are produced by American Spectrum Laboratories, and have the aperture of 50 KD and the contact area of 20 cm2
Further, the vertical ultrafiltration module was made of Amicon type Ultra-0.530KD vertical ultrafiltration module manufactured by Merck Millipore USA.
Furthermore, two ends of the hollow fiber ultrafiltration module are respectively provided with a connecting joint; the inner core of the first connecting joint is connected with the first syringe, and the outer tube of the first connecting joint is connected with the third syringe; the inner core of the second connecting joint is connected with the second syringe.
Further, the step 1 includes the following steps.
Step 1.1, a quantitative (3 mL) total hemolysis sample is extracted by using a first syringe, the first syringe and a second syringe are repeatedly pushed to carry out primary ultrafiltration on liquid in the hollow fiber ultrafiltration component, and at least 500 mu L of light red ultrafiltrate is collected by using a third syringe to obtain ultrafiltrate A.
Step 1.2, transferring 500 mu L of ultrafiltrate A into an inner core of a vertical ultrafiltration component (Amicon Ultra-0.530KD ultrafiltration tube), carrying out secondary ultrafiltration by using a fixed angle rotor centrifuge (14000 g for 10 min), discarding residues of the inner core, and collecting colorless and transparent ultrafiltrate of an outer tube to obtain ultrafiltrate B.
Further, the step 2 comprises the following steps: and (3) detecting the UREA and the creatinine in the ultrafiltrate B by using a biochemical analyzer, a UREA (UREA) determination kit and a Creatinine (CREA) determination kit.
Furthermore, the biochemical analyzer adopts a Heal Force MOL-300 full-automatic biochemical analyzer, the UREA (UREA) determination kit adopts a Shenzhen Meyer biomedical electronics Limited UREA (UREA) determination kit (ultraviolet-glutamic acid dehydrogenase method), and the Creatinine (CREA) determination kit adopts a Shenzhen Meyer biomedical electronics Limited Creatinine (CREA) determination kit (enzyme method).
Further, the step 3 includes the following steps.
Step 3.1, detecting the concentration (N) of urea (Y) and creatinine in the serum when the corpse is not hemolyzed, and respectively marking the concentration (N) of urea (Y) and creatinine as Y1, Y2 and Y3 … …, N1, N2 and N3 … ….
And 3.2, performing freeze-thawing treatment on the whole blood sample corresponding to the serum in the step 3.1, and preparing a full hemolysis sample.
And 3.3, carrying out ultrafiltration treatment on the fully dissolved blood sample by using an ultrafiltration device to obtain ultrafiltrate.
3.4, detecting the urea and the creatinine of the ultrafiltrate by using a biochemical analyzer, a urea determination kit and a Creatinine (CREA) determination kit; the concentrations (M) of urea (X) and creatinine in the ultrafiltrate were obtained and designated X1, X2, X3 … … and … … M1, M2 and M3 … …, respectively.
And 3.5, performing regression analysis (by using SPSS software) on the X and Y values obtained by detecting each group of urea and the M and N values obtained by detecting creatinine, and respectively establishing a urea linear regression equation Y = alpha X + beta and a creatinine linear regression equation N = gamma M +, so as to respectively obtain a value of the urea linear regression equation coefficient alpha and a value of the coefficient beta and a value of the creatinine linear regression equation coefficient gamma and a value of the coefficient gamma.
And 3.6, correcting the content values of the urea and the creatinine in the ultrafiltrate according to the value of the coefficient alpha and the value of the coefficient beta of the urea linear regression equation, the value of the coefficient gamma of the creatinine linear regression equation and the linear regression equation.
Compared with the prior art, the invention has the beneficial effects.
In the aspect of sample pretreatment, the invention firstly adopts hollow fiber ultrafiltration and vertical ultrafiltration components to carry out two-step ultrafiltration treatment on a hemolytic sample, intercepts high molecular weight interference components of the hemolytic sample through an ultrafiltration membrane, and filters target indexes, so that the treated ultrafiltrate is colorless and transparent, the color interference generated by hemoglobin in the hemolytic sample is solved, and the concentration of urea and creatinine in the ultrafiltrate can be more stably and accurately detected by a conventional biochemical method.
In the aspect of detection technology, the full-automatic biochemical analyzer adopted in the invention is used for detecting urea and creatinine in ultrafiltrate, so that detection errors caused by various reasons in the conventional forensic detection can be reduced to the maximum extent, and the urea and creatinine levels in a sample can be accurately detected. Meanwhile, according to the ultrafiltration and detection method in the technology, a correction equation is established, and the influence of hemolysis factors on biochemical detection of urea and creatinine after death in forensic actual work is completely solved.
The invention firstly provides the detection of urea and creatinine by a full-automatic biochemical detection method after two-step ultrafiltration treatment of a forensic hemolytic blood sample. Can truly reflect the concentration of urea and creatinine in a forensic hemolytic blood sample.
Drawings
The invention is further described with reference to the following figures and detailed description. The scope of the invention is not limited to the following expressions.
FIG. 1 is a schematic view of the ultrafiltration device of the present invention.
FIG. 2 is a linear regression plot of ultrafiltrate and serum urea measurements according to the present invention.
FIG. 3 is a linear regression plot of ultrafiltrate and serum creatinine assay values according to the present invention.
Detailed Description
As shown in FIGS. 1-3, the present ultrafiltration method consisted of hollow fiber ultrafiltration modules (MicroKros, mPES, 50000D, 20 cm @)2Spectrum Laboratories, USA) with disposable injector and Amicon Ultra-0.530KD vertical ultrafiltration module (Merck Millipore, USA) to ultrafiltrate the hemolyzed sample, as described in detail below.
Firstly, assembling an ultrafiltration device.
Assembling an ultrafiltration device: the hollow fiber ultrafiltration module and 3 syringes were assembled as shown in fig. 1. Wherein, the first syringe and the second syringe are used as ultrafiltration blood samples, and the third syringe is used for collecting the first step ultrafiltrate.
Secondly, a specific ultrafiltration process.
(1) Using syringe I to extract 3 mL of the whole hemolyzed sample, repeatedly pushing syringes I and II to perform the first ultrafiltration on the liquid in the ultrafiltration module, and using syringe 3 to collect at least 500 μ L of light red ultrafiltrate, i.e. ultrafiltrate A as shown in the figure.
(2) Transferring 500 μ L ultrafiltrate A into Amicon Ultra-0.530KD ultrafiltrate tube inner core, performing second step ultrafiltration at 14000g for 10min by using a fixed angle rotor centrifuge, discarding the inner core residue, and collecting outer tube colorless transparent ultrafiltrate, i.e. ultrafiltrate B as shown in the figure.
And thirdly, detecting urea and creatinine.
And (3) detecting UREA and creatinine in the ultrafiltrate B after the ultrafiltration treatment by using a Heal Force MOL-300 full-automatic biochemical analyzer, a Shenzhen Meyer biomedical electronics Limited UREA (UREA) determination kit (ultraviolet-glutamic acid dehydrogenase method) and a Shenzhen Meyer biomedical electronics Limited Creatinine (CREA) determination kit (enzyme method).
The methods for detecting IgE in a hemolysis sample reported in the past adopt an electrochemiluminescence method for detecting IgE, but the urea and creatinine involved in the technology cannot be detected by the electrochemiluminescence method.
In addition, in the past, the forensic detection of urea and creatinine adopts a 96-well plate detection kit and a microplate reader for detection, but the detection method is mostly operated manually, has large error and is greatly influenced by the technical skill of an operator. The full-automatic biochemical detection instrument adopted in the technology has mature detection technology, stable detection process and little influence of human factors, is a detection method commonly used for laboratory tests in hospitals, and can accurately detect the concentration of urea and creatinine in a sample.
In the domestic field, the method for detecting urea and creatinine by using a full-automatic biochemical detection method after two-step ultrafiltration treatment of a forensic hemolytic blood sample is proposed for the first time. Through years of earlier groping and practice, the method can truly reflect the concentration of urea and creatinine in the forensic hemolytic blood sample.
And fourthly, correcting the contents of urea and creatinine in the ultrafiltrate and the serum.
After the detection is performed by applying the technology, a correction formula needs to be established according to detection samples of respective laboratories, and the method is as follows.
1. The concentration of urea (Y) and creatinine (N) in serum of the corpses without hemolysis are detected and marked as Y1, Y2, Y3 … …, N1, N2 and N3 … … respectively.
2. And (3) performing freeze-thawing treatment on the whole blood sample corresponding to the serum to prepare a fully hemolyzed sample.
3. The hemolyzed sample is treated according to the two-step ultrafiltration method employed in the present technique to obtain an ultrafiltrate.
4. The concentrations (M) of urea (X) and creatinine in the ultrafiltrate were measured and labeled X1, X2, X3 … …, … … M1, M2, and M3 … …, respectively.
Regression analysis is carried out on the X and Y values obtained by detecting each group of urea and the M and N values obtained by detecting creatinine (SPSS software can be used), and a urea linear regression equation Y = alpha X + beta and a creatinine linear regression equation N = gamma M + are respectively established.
For example, as shown in fig. 2 and 3, the correlation between ultrafiltrate and serum urea and creatinine is analyzed by using 39 non-frozen autopsy case heart blood samples, and good correlation (urea r) is obtained2= 0.9651; creatinine r2=0.9795) (fig. 3) and established calibration method for ultrafiltrate, serum urea and creatinineThe process: urea concentration (X) in ultrafiltrate and urea concentration (Y) in non-hemolyzed serum Y =0.9971X + 0.8922; creatinine concentration (M) in ultrafiltrate and creatinine concentration (N) in non-hemolyzed serum N =0.9717M + 21.52.
The detection value in the ultrafiltrate can reflect the level of the ultrafiltrate in serum before hemolysis more reliably after being corrected. If we use the ultrafiltration technology to process the hemolysis sample, and the concentration of urea (X value) and creatinine (M value) in the ultrafiltrate are respectively 13.2mmol/L and 47.17 μmol/L by biochemical method, and the concentration of urea (Y value) and creatinine (N value) in the serum can be estimated to be about 14.05mmol/L and 67.36 μmol/L after the substitution into the calibration formula.
The ultrafiltration technology can separate substances with different molecular weights in the solution according to the pore size of the ultrafiltration membrane. Because of simple and convenient operation, high efficiency and the like, the method is widely applied to a plurality of fields such as water quality purification, hemodialysis, biological sample preparation and the like. According to the invention, according to the fact that the molecular weights of urea and creatinine are very small (far less than 30 KD), a tangential flow hollow fiber ultrafiltration membrane column with the aperture of 50 KD is selected to be combined with a vertical ultrafiltration component with the aperture of 30KD to carry out two-step ultrafiltration treatment, so that hemoglobin and other high molecular weight impurities which generate color interference can be effectively intercepted, the treated sample presents colorless transparent properties, accurate detection by a conventional biochemical method after treatment is ensured, and the serum level before hemolysis is reduced to a great extent by establishing a correction equation.
In the conventional IgE ultrafiltration treatment, because the molecular weight of the IgE is 196000, a tangential flow hollow fiber ultrafiltration membrane column with the pore diameter of 100 KD is selected for carrying out single ultrafiltration treatment on the IgE, and the IgE is retained in an inner core of a hollow fiber ultrafiltration module. In the invention, a tangential flow hollow fiber ultrafiltration membrane column with the aperture of 50 KD is selected to be combined with a vertical ultrafiltration component with the aperture of 30KD to carry out two-step ultrafiltration treatment, and according to the molecular weight of urea and creatinine being less than 30KD, outer core liquid in the ultrafiltration component is reserved in the two-step ultrafiltration treatment for biochemical detection in the next step.
It should be understood that the detailed description of the present invention is only for illustrating the present invention and is not limited by the technical solutions described in the embodiments of the present invention, and those skilled in the art should understand that the present invention can be modified or substituted equally to achieve the same technical effects; as long as the use requirements are met, the method is within the protection scope of the invention.

Claims (9)

1. A method for detecting urea and creatinine in a forensic hemolytic blood sample, comprising the steps of:
step 1, carrying out ultrafiltration treatment on a fully dissolved blood sample by using an ultrafiltration device to obtain ultrafiltrate;
step 2, detecting urea and creatinine of the ultrafiltrate;
step 3, correcting the content values of urea and creatinine in the ultrafiltrate;
and 4, obtaining the content values of urea and creatinine in the forensic hemolysis sample.
2. An ultrafiltration device for carrying out the method of claim 1, wherein: comprises a hollow fiber ultrafiltration component, a first syringe, a second syringe, a third syringe, a vertical ultrafiltration component and a centrifuge; the first syringe and the second syringe are used for accommodating a sample to be treated for hemolysis, and the third syringe is used for collecting primary ultrafiltrate A; one end of the hollow fiber ultrafiltration component is respectively connected with the first syringe and the third syringe, and the other end of the hollow fiber ultrafiltration component is connected with the second syringe; the vertical ultrafiltration module is used for containing ultrafiltrate A, and the centrifuge is used for centrifuging the ultrafiltrate A in the vertical ultrafiltration module.
3. Ultrafiltration device according to claim 2, characterized in that: the hollow fiber ultrafiltration component adopts MicroKros and mPES type ultrafiltration components produced by American Spectrum Laboratories, the aperture is 50 KD, the contact area is 20 cm2
4. Ultrafiltration device according to claim 2, characterized in that: the vertical ultrafiltration component adopts Amicon type Ultra-0.530KD vertical ultrafiltration component manufactured by Merck Millipore company in America.
5. Ultrafiltration device according to claim 2, characterized in that: the two ends of the hollow fiber ultrafiltration component are respectively provided with a connecting joint; the inner core of the first connecting joint is connected with the first syringe, and the outer tube of the first connecting joint is connected with the third syringe; the inner core of the second connecting joint is connected with the second syringe.
6. The method of claim 1, wherein the method comprises the steps of: the step 1 comprises the following steps:
step 1.1, extracting a quantitative total hemolysis sample by using a first syringe, repeatedly pushing the first syringe and a second syringe to carry out primary ultrafiltration on liquid in a hollow fiber ultrafiltration assembly, and collecting at least 500 mu L of light red ultrafiltrate by using a third syringe to obtain ultrafiltrate A;
and step 1.2, transferring 500 mu L of ultrafiltrate A into an inner core of a vertical ultrafiltration assembly, performing secondary ultrafiltration by using a fixed-angle rotor centrifuge, removing residues of the inner core, and collecting colorless and transparent ultrafiltrate of an outer tube to obtain ultrafiltrate B.
7. The method of claim 1, wherein the method comprises the steps of: the step 2 comprises the following steps: and (3) detecting the urea and the creatinine of the ultrafiltrate B by using a biochemical analyzer, a urea determination kit and a creatinine determination kit.
8. The method of claim 1, wherein the method comprises the steps of: the biochemical analyzer adopts a Heal Force MOL-300 full-automatic biochemical analyzer, the urea determination kit adopts a Shenzhen Merrill biomedical electronics Limited urea determination kit, and the creatinine determination kit adopts a Shenzhen Merrill biomedical electronics Limited creatinine determination kit.
9. The method of claim 1, wherein the method comprises the steps of: the step 3 comprises the following steps:
step 3.1, detecting the concentrations of urea and creatinine in the serum of the corpse without hemolysis, wherein the concentrations are marked as Y1, Y2, Y3 … …, N1, N2 and N3 … … respectively;
step 3.2, performing freeze thawing treatment on the whole blood sample corresponding to the serum in the step 3.1 to prepare a full hemolysis sample;
3.3, carrying out ultrafiltration treatment on the fully dissolved blood sample by using an ultrafiltration device to obtain ultrafiltrate;
3.4, detecting the urea and the creatinine of the ultrafiltrate by using a biochemical analyzer, a urea determination kit and a creatinine determination kit; obtaining the concentrations of urea and creatinine in the ultrafiltrate, which are respectively marked as X1, X2, X3 … …, … … M1, M2 and M3 … …;
step 3.5, carrying out regression analysis on the X and Y values obtained by detecting each group of urea and the M and N values obtained by detecting creatinine, and respectively establishing a urea linear regression equation Y = alpha X + beta and a linear regression equation N = gamma M + of creatinine to respectively obtain the value of the coefficient alpha and the value of the coefficient beta of the urea linear regression equation and the value of the coefficient gamma of the linear regression equation of creatinine;
and 3.6, correcting the content values of the urea and the creatinine in the ultrafiltrate according to the value of the coefficient alpha and the value of the coefficient beta of the urea linear regression equation, the value of the coefficient gamma of the creatinine linear regression equation and the linear regression equation.
CN202010387317.0A 2020-05-09 2020-05-09 Method for detecting urea and creatinine in forensic hemolytic blood sample Pending CN111521474A (en)

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Citations (2)

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Publication number Priority date Publication date Assignee Title
US20150260747A1 (en) * 2012-12-09 2015-09-17 Chromedx Corp. Automated ultra-filtration system
CN110938139A (en) * 2020-01-20 2020-03-31 中国医科大学 Hollow fiber ultrafiltration method for total IgE detection of forensic hemolytic sample

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20150260747A1 (en) * 2012-12-09 2015-09-17 Chromedx Corp. Automated ultra-filtration system
CN110938139A (en) * 2020-01-20 2020-03-31 中国医科大学 Hollow fiber ultrafiltration method for total IgE detection of forensic hemolytic sample

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* Cited by examiner, † Cited by third party
Title
贾宇晴: "溶血对样本中含氮化合物、N 末端脑利钠肽前体死后生化学检测的影响", 《中国优秀硕士学位论文全文数据库 医药卫生科技辑》 *
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