基于实验室数据信息库建立丙氨酸转氨酶生物参考区间  

Establishing biological reference intervals of alanine transaminase for clinical laboratory stored database

作　　者：郭玮[1] 宋斌斌[1] 沈隽霏[1] 吴炯[1] 张春燕 王蓓丽[1] 潘柏申[1] 

机构地区：[1]复旦大学附属中山医院检验科,上海200032

出　　处：《中华医学杂志》2015年第32期2599-2602,共4页National Medical Journal of China

基　　金：国家临床重点检验专科建设项目;“十二五”国家科技支撑计划课题（2012BA137801）;上海申康医院发展中心课题（SHDC22014017）;上海市卫生系统先进适宜推广技术项目（2013SY065）

摘　　要：目的 利用实验室信息系统（LIS）中储存的丙氨酸转氨酶（ALT）检测结果,建立一种以数学统计为基础的间接法生物参考区间获取模式.方法 调取2014年门诊及健康体检人群的ALT检测结果,通过Box-Cox的数据正态性转换、分别使用四分位间距法和肖维纳准则进行离群值的剔除,同时使用非参数排序法和Hoffmann计算法得到参考区间,并引用参考变化值（RCV）为判断标准与直接法结果进行比较.结果 正态性转换后的ALT数据,使用四分位间距法联合Hoffmann计算法得到的参考区间分别为：门诊男性12～41 U/L;体检男性12～48 U/L;门诊女性9～32 U/L;体检女性8～ 35 U/L,与直接法参考区间进行比较,差异均小于RCV（54％）.结论 Box-Cox转换结合四分位间距法和Hoffmann计算法是一种简单且可靠的间接法参考区间获取模式,适用于临床实验室的推广和应用.Objective To establish an indirect reference interval based on the test results of alanine aminotransferase stored in a laboratory information system.Methods All alanine aminotransferase results were included for outpatients and physical examinations that were stored in the laboratory information system of Zhongshan Hospital during 2014.The original data were transformed using a Box-Cox transformation to obtain an approximate normal distribution.Outliers were identified and omitted using the Chauvenet and Tukey methods.The indirect reference intervals were obtained by simultaneously applying nonparametric and Hoffmann methods.The reference change value was selected to determine the statistical significance of the observed differences between the calculated and published reference intervals.Results The indirect reference intervals for alanine aminotransferase of all groups were 12 to 41 U/L （male,outpatient）,12 to 48 U/L （male,physical examination）,9 to 32 U/L （female,outpatient）,and 8 to 35 U/L （female,physical examination）,respectively.The absolute differences when compared with the direct results were all smaller than the reference change value of alanine aminotransferase.Conclusion The Box-Cox transformation combined with the Hoffmann and Tukey methods is a simple and reliable technique that should be promoted and used by clinical laboratories.

关 键 词：生物参考区间 丙氨酸转氨酶 间接法 参考变化值 

分 类 号：R446.1[医药卫生—诊断学]