溴甲酚绿法测定血清白蛋白的应用评价及影响因素分析  

Assessment and influencing factors analysis of bromocresol green colorimetry for serum albumin

作　　者：陈辉[1] 彭灿辉[1] Chen Hui;Peng Canhui(Department of Clinical Laboratory,the Third Xiangya Hospital of Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅三医院检验科,长沙410013

出　　处：《中华预防医学杂志》2022年第8期1112-1117,共6页Chinese Journal of Preventive Medicine

基　　金：湖南省普惠性政策与创新环境建设计划-临床医疗技术创新引导项目(2020SK53617)。

摘　　要：对溴甲酚绿(BCG)法测量血清白蛋白(ALB)进行评价以及探讨其在不同疾病中发生偏倚的影响因素。本研究为横断面研究,以2021年7月在中南大学湘雅三医院肾内科、普外科、感染科等科室的128例住院患者作为研究对象,根据疾病类型分成慢性肾脏病组(47例)、肝病组(40例)、其他疾病组(41例),同时用BCG法和免疫比浊法检测患者血清ALB,所得结果分别用ALBBCG和ALBI表示。根据ALBI结果将各组再分成白蛋白相对高值、相对中间值、相对低值三个亚组,对所有组和亚组中的ALBI与ALBBCG进行配对T检验。用Passing-Bablok回归和Bland-Altman图评估ALBBCG在各组中的应用。以免疫比浊法为参考方法评估BCG法的偏倚,ALBI与ALBBCG的差异表示如下:ΔALB=ALBBCG-ALBI,分别用Pearson相关分析和多元线性回归分析评估各组中ΔALB与ALB自身浓度(ALBI)、α1-球蛋白、α2-球蛋白、β1-球蛋白、β2-球蛋白、γ-球蛋白、肌酐(Cr)、尿素(UN)、尿酸(UA)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆红素(TBil)、直接胆红素(DBil)、C反应蛋白(CRP)水平的相关性。结果显示,在总患者组、慢性肾脏病组、肝病组、其他疾病组的相对低值亚组中,ALBBCG均高于ALBI,差异具有统计学意义(t值分别为8.025,6.878,2.628,4.915,P均<0.05)。在相对高值亚组中,ALBBCG均低于ALBI,其中,在总患者组、肝病组、其他疾病组的相对高值亚组中,差异具有统计学意义(t值分别为-4.388,-2.927,-3.979,P均<0.05)。Passing-Bablok回归和Bland-Altman分析显示BCG方法存在比例偏倚。在慢性肾脏病组中,ALBI和Cr浓度对BCG方法偏倚影响最大,回归模型方程为ΔALB=5.437-0.146×ALBI-0.001×Cr,R2=0.505。在肝病组中,ALBI、α1-球蛋白和β1-球蛋白浓度对BCG方法偏倚影响最大,回归模型方程为ΔALB=3.652-0.230×ALBI+0.398×α1-球蛋白+1.171×β1-球蛋白,R2=0.658。在其他疾病组中,ALBI和α2-球蛋白浓度对BCG�To investigate the application of bromocresol green Colorimetry(BCG)method in measuring serum albumin(ALB)and to evaluate its influencing factors in different diseases.This study was a cross-sectional study that included 128 people admitted to the department of nephrology,department of general surgery,department of infectious diseases and other departments of the Third Xiangya Hospital of Central South University in July 2021.They were divided into groups according to disease types,including chronic kidney disease group(47 cases),liver disease group(40 cases),other diseases group(41 cases),serum ALB was detected by BCG method and immunoturbidimetry at the same time,and the results were expressed as ALBBCG and ALBI respectively,each group was subdivided into three subgroups according to ALBI results:relatively high-value subgroup,relatively intermediate-value subgroup and relatively low-value subgroup of albumin.ALBI and ALBBCG were compared in all groups and subgroups.Passing-Bablok regression and Bland-Altman diagram analysis were used to evaluate the application of ALBBCG in each group.Immunoturbidimetry was used as a reference method to evaluate the bias of ALBBCG,and the differences between ALBI and ALBBCG were shown as follows:ΔALB=ALBBCG-ALBI.Pearson correlation analysis and multiple linear regression analysis were used to assess the correlation betweenΔALB and ALB autoconcentration(ALBI),α1-globulin,α2-globulin,β1-globulin,β2-globulin,γ-globulin,creatinine(Cr),urea(UN),uric acid(UA),aspartate aminotransferase(AST),alanine aminotransferase(ALT),total bilirubin(TBil),direct bilirubin(DBil),and C-reactive protein(CRP)levels.The results showed that ALBBCG were higher than ALBI in the relative low subgroups of total patients group,chronic kidney disease group,liver disease group and other disease groups,and the differences were statistically significant(t value was 8.025,6.878,2.628,4.915,respectively,P<0.05).In the relatively high value subgroup,ALBBCG was lower than ALBI,and the differences were statis

关 键 词：血清白蛋白 慢性肾脏病 肝病 溴甲酚绿法 免疫比浊法 

分 类 号：R446.1[医药卫生—诊断学]