不同程度乳糜状高甘油三酯血清标本对常规生化指标检测结果影响的可接受性探讨  

Exploration on the acceptability of routine biochemical test results for serum samples with varying degrees of chylous high triglyceride

作　　者：张曦[1] 杨晴 亢涛[1] 李格[1] 王志阳[1] 张莉[1] 王雪 李佩[1] 钟侃 谭延国[1] ZHANG Xi;YANG Qing;KANG Tao;LI Ge;WANG Zhiyang;ZHANG Li;WANG Xue;LI Pei;ZHONG Kan;TAN Yanguo(Department of Clinical Laboratory,Fuxing Hospital,Capital Medical University,Beijing 100038,China;Department of Laboratory Medicine,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属复兴医院检验科,北京100038 [2]首都医科大学医学检验系,北京100038

出　　处：《国际检验医学杂志》2025年第7期780-785,共6页International Journal of Laboratory Medicine

基　　金：首都医科大学教育教学改革研究课题项目(2023JYY266)。

摘　　要：目的探讨不同程度乳糜状高甘油三酯(TG)血清标本常规生化指标检测结果影响的可接受性。方法收集不同程度乳糜状高TG血清标本69例,其中轻中度脂血[1.7 mmol/L≤TG<5.6 mmol/L]33例、重度脂血(TG≥5.6 mmol/L)36例,检测高速离心前后29项常规生化指标水平;以高速离心后结果为金标准[TG、总胆固醇(TC)以离心前为准],分析未高速离心结果的可接受性。可接受标准为(须同时符合下述3个条件)离心前后结果:(1)相关系数R^(2)≥0.95;(2)线性回归方程的斜率在1.00±0.05;(3)对同一指标,90%以上标本离心前后结果的偏倚≤1/2允许总误差(TEa)。结果轻中度脂血组中,可接受的有22项,不可接受的有7项[包括总蛋白(TP)、白蛋白(ALB)、TG、天门冬氨酸氨基转化酶(AST)、二氧化碳(CO_(2))、α-L-岩藻糖苷酶(AFU)、乳酸脱氢酶(LDH),偏倚以<10%居多],符合率为75.9%;重度脂血组中有12项可接受,不可接受的共17项[包括前白蛋白(PA)、AFU、γ-谷氨酰转移酶(γ-GT)、LDH、AST、TC、直接胆红素(DBIL)、CO_(2)、5′-核苷酸酶(5′-NT)、小而低密度脂蛋白胆固醇(sd-LDL-C)、TG、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、腺苷脱氨酶(ADA)、胱抑素C(CysC)、糖化白蛋白(GA)、总胆红素(TBIL),偏倚以>10%居多],符合率为41.4%,两组符合率比较差异有统计学意义(P<0.05)。连续监测法和终点法对结果的可接受性比较差异无统计学意义(P>0.05)。结论轻中度脂血标本多数项目直接测定结果可接受,且不可接受项目的偏倚较小(<10%),建议直接测定出具检验报告。而重度脂血标本因不可接受的项目较多,且偏倚较大(>10%),应高速离心后测定。Objective To explore the acceptability of routine biochemical test results for serum samples with varying degrees of chylous high triglyceride(TG).Methods Blood samples of 69 patients with different degrees of lipids were collected,including 33 patients with mild to moderate lipids(1.7 mmol/L≤TG<5.6 mmol/L)and 36 patients with severe lipids(TG≥5.6 mmol/L).Twenty-nine biochemical tests were detected before and after high-speed centrifugation.The result acceptability before high speed centrifugation of serum was compared with the results after high speed centrifugation as the gold standard[TG and total cholesterol(TC)before centrifugation].The acceptable criteria were subject to the following three conditions at the same time.Firstly,correlation coefficient(R~2)was greater than or equal to 0.95.Secondly,the slope of linear regression equation was 1.00±0.05.Thirdly,for the same index,the number of samples whose result bias before and after centrifugation was less than 1/2 total allowable error(TEa)in more than 90%of the total sample numbers.Results Firstly,in the mild to moderate lipemia group,22 tests met the criteria,7 tests did not,including total protein(TP),albumin(ALB),TG,aspartate aminotransferase(AST),carbon dioxide(CO_2),α-L-fucosidase(AFU),lactate dehydrogenase(LDH)(bias<10%),and the coincidence rate was 75.9%.In the severe lipemia group,12 tests met the criteria,17 tests did not,including pre-albumin(PA),AFU,γ-glutamyltransferase(γ-GT),LDH,AST,TC,direct bilirubin(DBIL),CO_2,5′-nucleotidase(5′-NT),small and low-density lipoprotein cholesterol(sd-LDL-C),high density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),adenosine deaminase(ADA),cystatin C(CysC),glycosylated albumin(GA),total bilirubin(TBIL)(bias>10%),the coincidence rate was 41.4%,and there was a statistically significant difference in the coincidence rate between the two groups(P<0.05).Secondly,there was no statistically significant difference in the acceptability of results between continuous monitoring meth

关 键 词：脂血 高速离心 甘油三酯 生化检验 

分 类 号：R446.1[医药卫生—诊断学]