检验医学 ›› 2012, Vol. 27 ›› Issue (9): 713-718.

• 生物化学检验论著 • 上一篇    下一篇

酶学项目自建检测系统检测结果的可比性研究

  

  1. 上海市临床检验中心,上海 200126
  • 出版日期:2012-09-12 发布日期:2012-09-12
  • 通讯作者: 居漪,联系电话:021-68316300。
  • 作者简介:虞啸炫,男,1986年生,学士,技师,主要从事临床化学标准化工作。
  • 基金资助:

    上海市科委2009年度“创新行动计划”医疗器械领域重点定向项目(09DZ1907200)

The comparability study on the result of serum enzymes determined by self-established detecting system

  1. Shanghai Center for Clinical Laboratory,Shanghai 200126,China
  • Online:2012-09-12 Published:2012-09-12

摘要: 目的 通过对自建检测系统校准方法的研究,用患者样本比对实验分析,为自建检测系统酶学项目的溯源性与可比性提供实验依据。方法 参考美国临床和实验室标准化协会(CLSI)EP9-A2文件,以日立7180生化分析仪、罗氏原装试剂和罗氏多项生化校准品(C.f.a.s)组成的检测系统为目标系统,分别用厂家自带校准品、C.f.a.s、日本酶参考物质和IFCC一级参考测量方法赋值血清4种校准方案对FX、KH和FH 3种自建系统进行校准,用40份患者新鲜血清对丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、γ-谷氨酰基转移酶(GGT)和乳酸脱氢酶(LDH)进行比对实验,分别计算目标系统(X)与自建系统(Y)之间的相关系数(r)、回归方程、医学决定水平处的相对偏倚、4种不同校准方案对自建系统校准后同一项目结果的变异系数(CV)的均值,并与原装配套检测系统(罗氏和贝克曼)常规实验室定值样本CV均值进行比对。结果 5项酶的3种自建系统的偏倚均有趋势性变化,酶参考物质与参考方法赋值血清校准后的结果优于厂家自带校准品和C.f.a.s校准方案。酶参考物质与参考方法赋值的血清校准后同一项目结果的CV均值达到甚至优于原装配套检测系统定值室间样本的CV均值,厂家自带校准方案和C.f.a.s校准方案的ALT、AST、ALP项目检测结果可比性较差。 结论 用酶参考物质和参考方法赋值血清校准5项酶的3个自建检测系统,其患者样本的检测结果具有可比性和正确性。

关键词: 酶, 比对研究, 评估

Abstract: Objective To provide the reference for traceability and comparability of calibration method of self-established detecting system through analyzing patient samples.   Methods According to document EP9-A2 of Clinical and Laboratory Standards Institute (CLSI),3 self-established detecting system FX,KH and FH (assessment methods) were calibrated by 4 different programs on a standard detecting system (reference method) composed of Hitachi 7180 biochemical analyzer and Roche reagents and calibrators (C.f.a.s). Based on 5 serum enzyme items including alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),gamma-glutamyltransferase(GGT) and lactic dehydrogenase(LDH) from 40 fresh samples,the differences between self-established detecting systems(Y) and the standard system(X) were analyzed,which included the correlation coefficient(r),regression equation and the relative bias at medicine deciding level. Moreover,the coefficient of variation (CV) mean after calibration was compared with those of original detecting systems (Roche and Beckmann).   Results The bias of 3 assessment methods had a obvious trend of changes. The results that calibrated by Japanese Certified Enzyme Reference Material(JCERM) and International Federation of Clinical Chemistry and Laboratory Medicine(IFCC) reference method were significantly better than those by calibrators from company and C.f.a.s. The CV mean of same enzyme item measured by JCERM and IFCC reference methods met or exceeded that of the original detecting system. Poor comparability of ALT,AST and ALP was shown by calibrators from company and C.f.a.s.  Conclusions JCERM and IFCC reference methods are used to calibrate 5 enzyme items of the 3 self-established detecting systems with comparability and accuracy.

Key words: Enzyme, Comparative study, Assessment