超敏C反应蛋白床旁检测的样品选择与正确度评价  

Sample selection and trueness evaluation of point-of-care highly sensitive C-reactive protein detection

作　　者：包安裕[1] 李艳[1] 邵华[1] 李栋[1] 

机构地区：[1]武汉大学人民医院检验科,430060

出　　处：《国际检验医学杂志》2011年第1期49-50,52,共3页International Journal of Laboratory Medicine

摘　　要：目的超敏C反应蛋白(hs-CRP)可在临床前阶段预测心血管疾病的发生风险。本研究探讨利用床旁检测(POCT)系统测定不同类别样品(静脉全血、血清与血浆)hs-CRP浓度的差异,并与参考检测系统进行相关性与偏倚分析,从而明确使用POCT设备检测hs-CRP的临床应用价值。方法研究对象为临床科室住院患者59例。使用促凝管和EDTA-K2抗凝管采集患者肘静脉血;离心获取血清和血浆样品,分别在荧光免疫床旁hs-CRP检测仪和检验科全自动生化分析仪上检测hs-CRP浓度。使用Pearson相关性分析、BlandandAltman偏倚图和配对t检验,评价2个不同检测设备测定hs-CRP浓度的相关性与差异,使用方差分析检验POCT设备测定不同类别样品(血清、血浆和全血)hs-CRP浓度的差异。结果 POCT系统测定hs-CRP的浓度与检验科生化分析仪的测定结果呈显著相关(血清、血浆和全血样品均有r>0.95);对于血清和全血样品,POCT设备与检验科生化分析仪测定hs-CRP浓度的差异无统计学意义(均有P>0.05)。POCT设备检测静脉全血、血清与血浆hs-CRP浓度的差异无统计学意义(P>0.05)。结论 POCT设备检测hs-CRP浓度与检验科参考系统的检测结果有良好的相关性与可比性;可以使用静脉全血、血清或者血浆样品测定hs-CRP的浓度,用于临床科室床旁检测。Objective To perform a trueness evaluation of highly sensitive C-reactive protein（hs CRP） detection at the point-ofcare through the comparison with laboratory reference system, and to get the correlation and bias between POCT and laboratory system. Also, we intended to investigate the difference of results with serum, plasma and whole blood samples at the determination of hs-CRP. Methods 59 in-patlent individuals in our hospital were involved in the study. Venous whole blood, serum and plasma samples were obtained from patients with.serum tube and EDTA-K2 added vacuum tube,and the samples were determined by POCT instrument and biocl^emical analyzer for hs-CRP concentration. Pearson correlation analysis, paired- test, Bland and Altman bias plot were used to observe the correlation and difference between POCT and laboratory reference system. ANOVA analysis was used to observe the difference among three types of sample for hs-CRP concentration. Results Hs-CRP concentration detected by POCT instrument correlated well with biochemical analyzer. Hs-CRP concentration in serum and whole blood detected by POCT analyzer did not differ significantly with that of biochemical analyzer（P〉0.05）. Hs-CRP concentration in serum, plasma and whole blood samples did not express significant difference（P〉0.05） at POCT. Conclusion Hs-CRP concentration detected by POCT instru- ment showed good correlation and comparability compared to laboratory reference system. Serum and whole blood can be used in POCT system for hs-CRP determination.

关 键 词：C反应蛋白质 床旁诊断化验信息系统 偏倚(流行病学) 

分 类 号：R446.6[医药卫生—诊断学]