检验医学 ›› 2018, Vol. 33 ›› Issue (10): 875-878.DOI: 10.3969/j.issn.1673-8640.2018.10.001

• 临床应用研究∙论著 •    下一篇

上海地区儿童快速免疫层析法cTnI参考区间的建立

郑建新, 杨慧, 傅启华   

  1. 上海交通大学医学院附属上海儿童医学中心,上海 200127
  • 收稿日期:2017-03-09 出版日期:2018-10-30 发布日期:2018-10-23
  • 作者简介:null
    作者简介:郑建新,女,1975年生,学士,主管技师,主要从事临床检验工作。

Establishment of pediatric reference interval of cTnI in Shanghai based on rapid immunochromatography

ZHENG Jianxin, YANG Hui, FU Qihua   

  1. Shanghai Children's Medical Center,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China
  • Received:2017-03-09 Online:2018-10-30 Published:2018-10-23

摘要:

目的 采用快速免疫层析法检测上海地区儿童末梢血心肌肌钙蛋白(cTnI)水平,初步建立儿童末梢血cTnI的参考区间,为临床诊断儿童心肌损伤提供实验室依据。方法 选取7个月~12岁儿童240名,采用快速免疫层析法检测其末梢血cTnI。先进行方法学评估(准确性、精密度、最低检测限、线性范围验证、方法比对),然后采用百分位数法确定cTnI的参考区间。结果 快速免疫层析法检测高、低值质控品的结果分别为4.73和0.49 ng/mL,均在质控品标示的预期范围内;低值质控品日间和日内精密度[变异系数(CV)]分别为5.97%和5.36%,高值质控品日间和日内精密度(CV)分别为6.35%和7.14%,均符合要求(CV<10%);最低检测限为0.02 ng/mL;线性范围为0.028~26.400 ng/mL;与化学发光法的相关性良好(r=0.988),检测cTnI的第99百位数值为0.1 ng/mL,第99百位数值的不精密度为18.5%。采用百分位数法计算99%参考区间上限值为0.5 ng/mL,同时结合试剂说明书中标示的参考区间(<0.3 ng/mL),确定基于快速免疫层析技术的儿童末梢血cTnI参考区间:<0.3 ng/mL为阴性、>0.5 ng/mL为阳性。cTnI为0.3~0.5 ng/mL时需进一步检查,以判断是否有心肌损伤。结论 初步建立了基于快速免疫层析法的上海地区儿童末梢血cTnI的参考区间。

关键词: 肌钙蛋白I, 快速免疫层析法, 心肌损伤

Abstract:

Objective To establish the pediatric reference interval of cardiac troponin I(cTnI) in Shanghai based on rapid immunochromatography,and to provide a reference for the clinical diagnosis of myocardial injury. Methods A total of 240 children aged from 7 months to 12 years were enrolled,and peripheral blood cTnI was determined by rapid immunochromatography. A methodology evaluation(accuracy,precision,minimum determination limit,linear range verification and method comparison) was carried out,and the reference interval of cTnI was determined by percentile method. Results The results of high-level and low-level quality control products determined by rapid immunochromatography were 4.73 and 0.49 ng/mL,respectively,which were in the expected range of quality control specification. The inter-day and intra-day precisions [coefficient of variation(CV)] for the quality control products with low level were 5.97% and 5.36%,and those with high level were 6.35% and 7.14%,respectively. They all met the requirements(CV<10%). The minimum determination limit was 0.02 ng/mL,and the linear range was 0.028-26.400 ng/mL. There was a good correlation with chemiluminescence(r=0.988). The 99th percentile of cTnI determination were 0.1 ng/mL,and the imprecision of the 99th percentile was 18.5%. The upper limit value of 99% reference interval(0.5 ng/mL) which was calculated by percentile method and the lower reference interval(<0.3 ng/mL) which was referred from reagent specification were used to establish the pediatric reference interval of serum cTnI based on rapid immunochromatography. The value of cTnI <0.3 ng/mL was negative,and the value of cTnI >0.5 ng/mL was positive. When the value of cTnI level was 0.3-0.5 ng/mL,further determination was required to perform and determine whether there was myocardial injury or not. Conclusions A rapid immunochromatography is preliminarily established for determining the reference interval of peripheral blood cTnI among children in Shanghai.

Key words: Cardiac troponin I, Rapid immunochromatography, Myocardial injury

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