随机尿微量白蛋白测定的影响因素  

Influencing factors in random urine micro-albumin

作　　者：李红[1] 林长缨[1] 张勐[1] 郭婧[1] 高文晖[1] 李疆[1] 张晶[1] LI Hong;LIN Chang-ying;ZHANG Meng;GUO Jing;GAO Wen-hui;LI Jiang;ZHANG Jing(Beijing Center for Disease Prevention and Control,Beijing 100013,China)

机构地区：[1]北京市疾病预防控制中心,100013

出　　处：《首都公共卫生》2022年第2期121-124,共4页Capital Journal of Public Health

摘　　要：目的探讨随机尿微量白蛋白测定的影响因素。方法采用仪器正常清洗和设置特殊清洗检测,尿样直接和混匀后检测,新鲜尿样和-20℃冷冻保存3个月检测,使用Bland-Altman法统计处理比较随机尿微量白蛋白的检测结果。结果仪器正常清洗检测结果:差值的均值d=14.1 mg/L,差值的标准差s_(d)=10.0 mg/L,4.35%(2/46)的点在一致性界限以外,在一致性界限内差值的绝对值最大值对结果影响大,一致性差;设置特殊清洗检测结果:差值的均值d=0.0 mg/L,差值的标准差s_(d)=1.9 mg/L,5.56%(2/36)的点在一致性界限以外,在一致性界限内差值的绝对值最大值对结果影响小,一致性好;直接和混匀后检测结果:差值的均值d=-2.1 mg/L,差值的标准差s_(d)=3.2 mg/L,7.27%(4/55)的点在一致性界限以外,在一致性界限内差值的绝对值最大值对结果影响大,一致性差;新鲜尿样和-20℃冷冻保存检测结果:差值的均值d=-0.8 mg/L,差值的标准差s_(d)=2.4 mg/L,33个点全部在一致性界限以内,在一致性界限内差值的绝对值最大值对结果影响小,一致性好。结论苦味酸法肌酐试剂对检测随机尿微量白蛋白有影响,预先设置特殊清洗解决携带污染问题;浑浊尿液在分析前离心或过滤处理;不能及时检测尿样可低温冷冻保存。Objective To investigate the factors affecting the result of random urine micro-albumin.Methods The urine samples were test under various conditions,including testing with standard or special cleaning procedures,direct testing or testing after mixing,and testing for fresh urine samples and the samples after 3 months storage at-20℃.The result of random urine micro-albumin were compared using Bland-Altman method.Results For the result with standard cleaning,the mean value of the difference(d)was 14.1 mg/L with a standard deviation(s_(d))of 10.0 mg/L while 4.35%(2/46)of the plotted dots exceeded the limit of agreement.The maximal absolute value of the difference within the limit of agreement had a significant effect on the result,with poor agreement.For the test result with special cleaning process,d was 0.0 mg/L with s_(d) of 1.9 mg/L while 5.56%(2/36)of the dots exceeded the limit of agreement.The maximal absolute value of the difference within the limit of agreement had less effect on the result,with better agreement.For the result of direct testing and testing after mixing,d was-2.1 mg/L with s_(d) of 3.2 mg/L while 7.27%(4/55)of the dots exceeded the limit of agreement.The maximal absolute value of the difference within the limit of agreement had a significant effect on the result,with poor agreement.For the result of fresh urine samples and the samples stored at-20℃,d was 0.8 mg/L with s_(d) of 2.4 mg/L while all 33 dots were within the limit of agreement.The maximal absolute value of the difference within the limit of agreement had less effect on the result,with better agreement.Conclusions The creatinine picrate reagent influenced the result of random urine micro-albumin.The pre-set special cleaning procedure may solve the problem of carry-over contamination.Turbid urine samples should be centrifuged or filtered before analysis.Urine samples should be frozen-stored at low temperature if immediate testing is not feasible.

关 键 词：随机尿微量白蛋白 比对实验 携带污染 

分 类 号：R446.1[医药卫生—诊断学]