利用稳健Z比分数评价肌酐能力验证的数据  

Use of robust Z-score to assess creatinine proficiency testing data

作　　者：周琦[1] 谢伟[1] 徐建平[1] 李少男[1] 李小鹏[1] 

机构地区：[1]卫生部北京医院卫生部临床检验中心,100730

出　　处：《中华检验医学杂志》2011年第12期1144-1148,共5页Chinese Journal of Laboratory Medicine

摘　　要：目的 利用稳健Z比分数评价肌酐能力验证的数据.方法 肌酐数据来自2009年卫生部临床检验中心3次能力验证常规化学检测项目,分别有1 179、1169和1 168家实验室参加.按照检测方法的不同将肌酐能力验证的数据分为苦味酸组和酶组.利用Mann-Whitney检验作苦味酸法和酶法检测结果的可比性分析.利用四分位值建立的TUKEY区间剔除离群值.利用单样本Kolmogorov-Smirnov检验作原始数据和剔除离群值后数据的正态性分析.利用稳健Z比分数评价检测结果.Z比分数绝对值≤2的检测结果评价为满意值,2＜Z比分数绝对值＜3之间的检测结果评价为可疑值,Z比分数绝对值≥3的检测结果评价为不满意值.结果 苦味酸法和酶法的检测数据大部分（86.7％）不可比.所有研究组的原始数据是非正态分布,剔除离群值后,73.3％的数据是正态分布.2009年3次能力验证苦味酸组的满意率分别是89.8％ （495/551）、87.2％（ 468/537）和89.5％ （476/532）；不满意率分别是3.3％（ 18/551）、6.5％ （35/537）和4.5％ （24/532）.酶组的满意率分别是88.8％（ 558/628）、89.3％（ 564/632）和88.1％（560/636）；不满意率分别是5.6％（ 35/628）、5.2％ （33/632）和6.6％ （42/636）.结论 选择稳健Z比分数作为能力验证的评价指标是合理的,避免了离群值对评价结果的影响.Objective To evaluate creatinine proficiency testing data by robust Z-score analysis.Methods The data were collected from three proficiency surveys of routine biochemical test in 2009,to which 1 179,1 169 and 1 168 laboratories participated respectively.Creatinine data were divided into Jaffe group and enzymatic group based on the analytical method used.The results tested by both methods were compared using Mann-Whitney test.The outliers were deleted using the TUKEY fence established by quartile values.The normality of raw data and trimmed data was tested using one-sample Kolmogorov-Smirnov test.The performance of the laboratories was assessed using robust Z-score,whose values were considered satisfactory when ｜ Z-score｜ ≤2,questionable when 2 〈 ｜ Z-score ｜ 〈 3 and unsatisfactory when ｜ Z-score ｜ ≥3.Results 86.7% results tested using Jaffe and enzymatic methods were not comparable.The raw data in all research groups were not normally distributed.After deletion of outliers,73.3% trimmed data in most research groups were normally distributed.For the three proficiency tests in 2009,in Jaffe group,the satisfactory rates were 89.8% （ 495/551 ）,87.2% （ 468/537 ） and 89.5% （ 476/532 ） respectively,unsatisfactory rates were 3.3% （ 18/551 ）,6.5% （35/537） and 4.5% （24/532） respectively; while in enzymatic group,the satisfactory rates were 88.8% （558/628）,89.3% （564/632） and 88.1% （560/636） respectively,unsatisfactory rates were 5.6% （ 35/628 ）,5.2% （33/632） and 6.6% （42/636） respectively.Conclusion It is reasonable to choose robust Z-score as a proficiency testing assessment index,because it avoids the influence of the outliers on evaluation results.

关 键 词：肌酸酐 算法 正态分布 统计学 非参数 

分 类 号：R446.1[医药卫生—诊断学]