LDL-C值直接测定法与公式计算法的对比研究  

Comparative Study of Direct Measurement of LDL-C Value and Formula Calculation

作　　者：于培霞 任雅萍 孟芝君[2] 王海如 YU Peixia;REN Yaping;MENG Zhijun;WANG Hairu(Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital,Third Hospital of Shanxi Medical University,Taiyuan 030032,Shanxi,China)

机构地区：[1]山西白求恩医院,山西医学科学院,同济山西医院,山西医科大学第三医院,太原030032 [2]山西省人民医院,太原030012

出　　处：《中西医结合心脑血管病杂志》2023年第19期3575-3580,共6页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家自然科学基金青年项目(No.82300492)。

摘　　要：目的:Friedewald公式、Martin-Hopkins公式和Sampson公式计算低密度脂蛋白胆固醇(LDL-C)值与直接测定结果间的对比研究。方法:选取2020年1月—12月于山西白求恩医院接受体检且检测了血脂4项[总胆固醇(TC)、三酰甘油(TG)和高密度脂蛋白胆固醇(HDL-C)和LDL-C]的人群9865名进行回顾性研究。从医院信息系统提取出研究对象的人口学信息和血脂检测结果进行数据分析。根据TG浓度进行亚组分析,分为TG<400 mg/dL(4.516 mmol/L)组(9591名)和TG≥400 mg/dL组(274名)。采用Bland-Altman法分析LDL-C公式计算结果与直接测定结果间的一致程度,采用Passing-Bablok回归和Deming回归分析LDL-C公式计算结果与直接测定结果间的关系,并进行亚组分析。结果:Bland-Altman法分析结果显示,Sampson公式计算结果的准确度明显优于Friedewald公式和Martin-Hopkins公式,3个公式的估计精确度大致相似。对于TG≥400 mg/dL的人群,3种公式的估计准确度和精密度都不佳。Passing-Bablok和Deming回归分析结果也表明,Sampson公式计算结果与实测结果的一致性高于Friedewald公式和Martin-Hopkins公式。结论:对TG≥400 mg/dL的人群建议通过直接检测法检测LDL-C值,而对于TG<400 mg/dL的人群,则应优先使用公式计算法,尤其推荐Sampson公式,可快速、经济地对动脉粥样硬化性心血管疾病(ASCVD)事件发生风险做出判断,从而指导临床诊断与治疗决策。Objective:To compare the consistency of low density lipoprotein cholesterol(LDL-C)values calculated by Friedewald formula,Martin-Hopkins formula and Sampson formula with direct measurement results.Methods:A retrospective study was conducted of 9865 subjects who underwent physical examination and blood lipids[total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),and LDL-C]tests.The demographic information and blood lipid test results of the subjects were extracted from the information system of the hospital for data analysis.Subgroup analysis was performed according to TG concentration,which was divided into TG<400 mg/dL group(9591 participants)and TG≥400 mg/dL group(274 participants).Bland-Altman method was used to analyze the consistency between the calculation results of LDL-C formula and the direct determination results.Passing-Bablok regression and Deming regression were used to analyze the relationship between the calculated results of LDL-C formula and the direct measurement results,and subgroup analysis was performed.Results:The analysis results of Bland-Altman method showed that the accuracy of Sampson formula was obviously better than that of Friedewald formula and Martin-Hopkins formula,and the accuracy of the three formulas was roughly similar.For subjects with TG≥400 mg/dL,the estimation accuracy and precision of the three formulas were not ideal.The results of Passing-Bablok and Deming regression analysis also indicated that the consistency between the Sampson formula and the measured results was higher than that between the Friedewald formula and the measured results,Martin Hopkins formula and the measured results.Conclusion:It is recommended to provide LDL-C results through measurement for individuals with triglycerides≥400 mg/dL.For individuals with triglycerides<400 mg/dL,formula calculation should be given priority,especially the Sampson formula,which can quickly and economically determine the risk of atherosclerotic cardiovascular disease(ASCVD)events and then

关 键 词：低密度脂蛋白胆固醇 动脉粥样硬化性心血管疾病 FRIEDEWALD公式 Martin-Hopkins公式 Sampson公式 

分 类 号：R54[医药卫生—心血管疾病]