尿液稀释对尿肌酐结果测定的影响  

Effect of Urine Dilution on the Determination of Urine Creatinine Results

作　　者：何平 王华斌[1] HE Ping;WANG Hua-bin(Clinical Laboratory,Jinhua Hospital of Zhejiang University,Jinhua,Zhejiang 321000)

机构地区：[1]金华市中心医院检验科,浙江金华321000

出　　处：《智慧健康》2018年第29期7-8,17,共3页Smart Healthcare

摘　　要：目的探讨尿液稀释20倍后与原倍尿液在全自动生化分析仪上测定尿肌酐结果的差异分析。方法随机抽取150份7月份在我院住院病人测定ACR(尿微量白蛋白/尿肌酐的比值)的尿液标本,在全自动生化分析仪上用苦味酸法试剂盒分别测定原倍与稀释20倍后的尿肌酐结果,并用SPSS 19.0对两组数据结果进行配对t检验及线性回归分析,采用MedCalc对两组数据做bland-altman分析图进行分析。结果稀释20倍后与原倍的尿肌酐结果配对t检验差异显著,有统计学意义(P<0.05)。由bland-altman分析图结果发现当尿肌酐结果小于10000μmol/L时,其值散在分布于均值两侧,与稀释20倍后的尿肌酐结果进行配对t检验,无显著差异(P=0.096),当尿肌酐结果大于10000μmol/L时,在图中偏于一侧,与稀释20倍后的尿肌酐结果进行配对t检验两者差异显著(P<0.05),有统计学意义。对两组数据拟合线性回归分析,得到线性回归方程y=1.2743x-1321.3,随机抽取50份新尿液标本,由此方程计算出理论尿肌酐值,与稀释20倍后上机实测结果进行配对t检验,两者无显著差异(P=0.129)。结论尿液稀释20倍后与原倍尿液在全自动生化分析仪上测得尿肌酐的结果有显著差异,两者有统计学意义。尤其当尿肌酐结果大于10000μmol/L时,应对尿液标本进行稀释后上机检测,才能得到更准确的结果。Objective To investigate the difference of urine creatinine after urine dilution of 20 times and the result of original times in automatic biochemical analyzer. Methods A total of 150 urine specimens of ACR（the ratio of urinary microalbumin/urinary creatinine） were randomly selected from patients admitted to our hospital in July. The results of urinary creatinine after primary times and after dilution by 20 times were respectively determined by the Picric acid method on the automatic biochemical analyzer, Both Paired t test,linear regression analysis and bland-altman analysis graph were performed on the two groups of data by SPSS and MedCalc. Results The paired t-test was significantly different with the result of urea creatinine after dilution of 20 times（P 0.05）. According to the results of bland-altman analysis, when the result of urinary creatinine was less than 10,000μmol/L, its value was scattered on both sides of the mean and paired with the result of urinary creatinine diluted 20 times, showing no significant difference（P=0.096）.But when it＇s more than 10,000μmol/L, it show significantly difference（P0.05）.The linear regression analysis was performed to fit the data of the two groups, obtaine the linear regression equation y=1.2743 x-1321.3, 50 new urine specimens were randomly selected. The theoretical urine creatinine value was calculated from the equation, paired with the measured results after being diluted 20 times,it show no significant difference（P=0.129）. Conclusion There was a significant difference between the results of urine creatinine measured on the automatic biochemical analyzer after urine dilution of 20 times and that of the original urine,especially when the result of urine creatinine is greater than 10,000μmol/L, the urine specimens should be diluted, so that more accurate results can be obtained.

关 键 词：尿肌酐 稀释 苦味酸法 

分 类 号：R446.12[医药卫生—诊断学]