机构地区:[1]成都军区总医院检验科,高湿医学全军重点实验室,成都610083 [2]成都军区总医院医疗科,成都610083 [3]成都军区总医院中心实验室,成都610083
出 处:《军事医学》2016年第1期55-59,共5页Military Medical Sciences
摘 要:目的对野战快速检验系统(POCT,A型)生化模块急诊项目检测性能及野外复杂条件下的适用性进行评价。方法根据美国国家临床实验室标准委员会(NCCLS)标准对野战POCT(A型)检测白蛋白(ALB)、总胆红素(TBIL)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、血尿素氮(BUN)、肌酐(CREA)、血尿素(UA)、乳酸脱氢酶(LDH)、肌酸激酶(CK)、葡萄糖(GLU)的精密度及抗干扰能力进行系统分析;使用野战POCT(A型)与Coulter Beckman AU2700型全自动生化分析仪分别检测随机选取的22例临床血清标本,并对检测结果进行一致性分析;通过调节温湿度模拟野战环境,对不同环境下混合血清检测结果进行比较。结果野战POCT(A型)上述10项指标的总精密度变异系数分别为3.34%、6.54%、6.01%、4.80%、3.95%、5.59%、3.33%、6.19%、7.40%、4.56%(水平Ⅰ);3.08%、4.47%、4.02%、4.31%、3.76%、4.22%、2.93%、5.25%、6.39%、4.35%(水平Ⅱ)。当甘油三酯浓度为21 mmol/L时,所有项目干扰率均〈10%;胆红素浓度为120μmol/L时,ALT、AST、CREA干扰率分别为-33.33%、-22.99%、20.00%(水平Ⅰ),-22.13%、-14.55%、8.70%(水平Ⅱ);胆红素浓度为240μmol/L时,UA两水平干扰率分别为-16.67%、-24.69%;血红蛋白(Hb)浓度为170 mg/dl时,TBIL、LDH干扰率分别为20.00%、99.26%(水平Ⅰ),15.38%、40.79%(水平Ⅱ),Hb为340 mg/dl浓度时,ALT、AST干扰率分别为9.84%、13.79%(水平Ⅰ),12.30%、12.27%(水平Ⅱ),Hb为510 mg/dl浓度时,水平ⅠCREA、UA、CK干扰率分别为26.67%、16.67%、11.74%。与AU2700型全自动生化分析仪检测结果比较各项目直线回归R2分别为0.961、0.995、0.989、0.995、0.990、0.989、0.989、0.963、0.978、0.993。在气温35℃时仪器超出温度范围无法进行检测,在10~30℃或相对湿度(RH)70%~90%时与常温常湿(20℃,RH 50%)各项目检测结果差异无统计学意义(P〉0.05Objective To evaluate the performance of emergency test and the applicability under complex field conditions of biochemical modules of field point-of-care test( POCT) system( type A). Methods The precision and anti-interference ability of albumin( ALB),total bilirubin( TBIL),alanine transaminase( ALT),aspartate transaminase( AST),blood area nitrogen( BUN),creatinine( CREA),uric acid( UA),lactate dohydrogenase( LDH),creatine kinase( CK),and glucose( GLU) detected by field POCT system( A) were analyzed according to standards formulated by National Committee for Clinical Laboratory Standards( NCCLS). Field POCT system( A) and Coulter Beckman AU2700 automatic biochemical analyzer were used to detect the serum of 22 clinical cases respectively. After simulating the field environment by adjusting the temperature and humidity,we compared the results of mixed serum under different environment conditions.Results The coefficients of variation in total precision of ALB,TBIL,ALT,AST,BUN,CREA,UA,LDH,CK,and GLU detected by field POCT system( A) were 3. 34%,6. 54%,6. 01%,4. 80%,3. 95%,5. 59%,3. 33%,6. 19%,7. 40%,and4. 56%( LevelⅠ); and 3. 08%,4. 47%,4. 02%,4. 31%,3. 76%,4. 22%,2. 93%,5. 25%,6. 39%,and 4. 35%( LevelⅡ) respectively. When triglycerides( TG) level was at 21 mmol /L,the interference rate was below 10%. When bilirubin level was at 120 μmol / L,the interference rate of ALT,AST and CREA was- 33. 33%,- 22. 99%,20. 00%( LevelⅠ),and- 22. 13%,- 14. 55%,and 8. 70%( LevelⅡ),respectively. When its level was at 240 μmol / L,the interference rate of UA was- 16. 67% and- 24. 69%,respectively at two levels; if hemoglobin( Hb) was at 170 mg / dl,the interference rate of TBIL and LDH was 20. 00%,and 99. 26%( LevelⅠ),and 15. 38%,and 40. 79%( LevelⅡ),respectively; if it was at 340 mg / dl,the interference rate of ALT and AST was 9. 84% and 13. 79%( Level Ⅰ),and 12. 30%,and 12. 27%( LevelⅡ),respectively; if it was
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