Examination Of Factors Affecting Term Examination Creatinine Results
Dec 13, 2022
Physical examination is one of the effective means of disease prevention and diagnosis. However, there are always many people who do not pay enough attention to some key links of the physical examination, which leads to deviations in the results and makes it difficult to achieve the purpose of the physical examination. In addition, there are some external factors that will also affect it. A recent study in the Journal of the American Medical Association found that even temperature can affect the accuracy of laboratory tests.
Minor errors in most checks
The UC Berkeley study analyzed data from a sample of more than 4 million patients between 2009 and 2015, across several climate zones, to study how temperature fluctuations affect test results. The results showed that temperature affected 51 of the 75 tests (including kidney function, cholesterol, triglycerides, etc.). While most tests varied by less than 1 percent at normal temperatures, the small difference did affect treatment options, the researchers said. For example, the study found that blood lipid were checked on colder days, and the results seemed to be more biased to indicate a lower risk of cardiovascular disease, resulting in nearly 10% fewer statin prescriptions on the coldest days than on the hottest days.
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In addition, when the weather is hot or cold, the subject may have a transient increase in the total number of white blood cells, and the blood pressure value and pressure difference will also be affected. In addition to environmental factors such as air temperature, operations during the inspection can also affect the results. For example, the sequence of injecting test tubes during blood collection is incorrect, and the transport and storage of specimens are not timely. Instruments, reagents, etc. used for testing may also cause errors in test results.
Yao Haiyan, deputy director of the Physical Examination Center of the Third Affiliated Hospital of Southern Medical University, said that the chances of errors in medical operations and equipment and reagents are relatively low, and the most common ones are personal factors. For example, some people wear gold and silver jewelry for imaging examinations, or there are metal buttons on their underwear, which are just near the chest, resulting in shadows when taking chest X-rays. The medical examiner may suspect tumors or inflammation. There are also women who forget to avoid menstrual periods when they do gynecological examinations and ultrasounds, which may also cause abnormal indicators such as "hematuria" in the test results.
Yao Haiyan said that regular physical examination is the best way to prevent disease progression, early detection, and early treatment. However, if the examination shows inaccurate data or false positives/negatives, it will not only waste money, but also cause excessive medical treatment and repeated examinations. Interfere with clinicians' medication decisions. There are also some social physical examinations, such as child care physical examinations, entry-level physical examinations, entry-exit physical examinations, military conscription physical examinations, etc. Deviations in the results will affect the life or career development of the examinees.
Details of life interfere with inspection results
Yao Haiyan said that the human body is in dynamic operation every minute and every second, and the test results are different at different times of the day. Any of the following subtle changes may interfere with the accuracy of the test results.
In order to ensure accuracy, many blood biochemical tests require fasting, because some components in the diet can directly affect the blood test results.
During the day, the number of eosinophils, white blood cells, and platelets of normal people will fluctuate to a certain extent. If eating and drinking too much water will have a certain dilution effect on the blood, the number of red blood cells and hemoglobin will decrease. If you eat a high-protein, high-fat diet, it can increase blood urea, uric acid, blood ammonia, blood creatinine, and triglycerides. On the contrary, too long fasting time can reduce plasma protein, cholesterol, triglyceride, apolipoprotein, urea, etc. When doing gastrointestinal endoscopy, if the food eaten in the previous two days is not easy to digest, food residues will easily stick to the inner wall of the intestine, affecting the clarity of the endoscope.
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Drugs can not only alter the metabolism of certain substances, but also interfere with the assay process.
For example, it is generally required to stop using vitamin C a few days before the fasting blood sugar test to prevent it from chemically reacting with the reagents for testing blood sugar and diabetes and making the test results low. Some antibiotics can react with alkaline picric acid, causing creatinine to increase. Oral contraceptives and estrogen drugs can increase transferrin and triglycerides.
Tobacco and alcohol. Drinking alcohol may affect the test results of triglycerides, transaminases, uric acid, etc., and may also cause changes in blood pressure, reducing the accuracy of electrocardiograms, transcranial Doppler ultrasound, and cerebrovascular function tests. Long-term smokers, white blood cell count, hemoglobin concentration, carboxyhemoglobin, carcinoembryonic antigen, etc. will increase.
sports. Exercise can cause changes in the composition of blood and body fluids. Even mild exercise can cause a physiological increase in blood sugar and changes in endocrine hormone levels, thereby affecting laboratory results. After strenuous exercise, the blood will be concentrated, and the total number of white blood cells will increase transiently. Vigorous exercise can also lead to changes in alanine aminotransferase and creatine kinase, which can be more than doubled after exercise. After 1 hour of stopping exercise, the alanine aminotransferase can still be 30% to 50% higher.
mood. Mental stress, emotional agitation, and fatigue can increase catecholamines, cortisol, blood sugar, white blood cells, and neutrophils. Some subjects are prone to "white coat hypertension" when measuring blood pressure, that is, they are nervous when they see a doctor, resulting in an increase in blood pressure. Therefore, you must control your emotions before the physical examination. It is best to rest for half an hour before the test to maintain emotional stability. Do not walk around, eat cold drinks or smoke.
sleep. Staying up late will have an impact on basic body indicators, such as blood pressure, heart rate, respiration, etc., and will also interfere with the accuracy of blood indicators. Adrenocorticotropic hormone and cortisol are the highest at 6-7 o'clock in the morning, and the lowest at 0-2 o'clock in the middle of the night. If you don't have a good sleep, it will have a great impact on the test results.
operate. During the urine test, if the urine is not taken from the middle section, it is easy to cause the urine pH to be high or low, and other data may also have slight deviations.
