CAJ | 학술논문

目的：了解国内医院对肝脏疾病生化检测项目的组合设置情况，为更合理地运用这些项目提供参考。方法通过收集26家不同规模医院的原始检验申请单，或电话、邮件访问确认其肝脏疾病生化检验项目的设置情况，包括开展的具体项目名称、设置的组合种类、每种组合具体包括的检验项目，对调查访问获得的信息进行汇总分析。结果26家医院开展的针对肝脏疾病的生化检测项目共24项，另有2家医院将乙型肝炎病毒标志物也纳入了组合项目。医院均以不同组合的方式向临床提供肝脏疾病生化检测项目组合，提供3种组合的医院数量最多，达到10家；只提供1种组合的医院次之，为8家；也有3家医院提供5种不同的组合。组合包含的项目数变化较大，最小的组合仅包括丙氨酸氨基转移酶（ALT）和天门冬氨酸氨基转移酶（AST）2项，最大的组合包括16个项目。13家医院设置了包含9～16个项目的组合。各医院开展的肝脏疾病生化检测项目最普遍的前8项，分别是A L T、总胆红素（TBIL）、直接胆红素（DBIL）、AST、总蛋白（TP）、碱性磷酸酶（ALP）、清蛋白（Alb）和γ-谷氨酰转移酶（GGT），不少医院都存在组合种类较多、组合项目偏多的情况，个别医院将视黄醇结合蛋白（Rbp）、载脂蛋白 E （ApoE）、血清蛋白电泳（SPE）、AST、乙型肝炎病毒标志物纳入了常规组合。结论国内医院对肝脏疾病生化检验项目的开展和设置差异很大，未遵循循证实验诊断的原则，迫切需要行业作出指引，进行规范。
목적：료해국내의원대간장질병생화검측항목적조합설치정황，위경합리지운용저사항목제공삼고。방법통과수집26가불동규모의원적원시검험신청단，혹전화、유건방문학인기간장질병생화검험항목적설치정황，포괄개전적구체항목명칭、설치적조합충류、매충조합구체포괄적검험항목，대조사방문획득적신식진행회총분석。결과26가의원개전적침대간장질병적생화검측항목공24항，령유2가의원장을형간염병독표지물야납입료조합항목。의원균이불동조합적방식향림상제공간장질병생화검측항목조합，제공3충조합적의원수량최다，체도10가；지제공1충조합적의원차지，위8가；야유3가의원제공5충불동적조합。조합포함적항목수변화교대，최소적조합부포괄병안산안기전이매（ALT）화천문동안산안기전이매（AST）2항，최대적조합포괄16개항목。13가의원설치료포함9～16개항목적조합。각의원개전적간장질병생화검측항목최보편적전8항，분별시A L T、총담홍소（TBIL）、직접담홍소（DBIL）、AST、총단백（TP）、감성린산매（ALP）、청단백（Alb）화γ-곡안선전이매（GGT），불소의원도존재조합충류교다、조합항목편다적정황，개별의원장시황순결합단백（Rbp）、재지단백 E （ApoE）、혈청단백전영（SPE）、AST、을형간염병독표지물납입료상규조합。결론국내의원대간장질병생화검험항목적개전화설치차이흔대，미준순순증실험진단적원칙，박절수요행업작출지인，진행규범。
Objective To investigate the item settings of laboratory diagnosis for hepatic function in domestic hospitals and to provide reference for proper application of these items .Methods The information of biochemistry i-tems of laboratory diagnosis for hepatic function in 26 hospitals of different ranks was achieved by collecting primary application forms or directly conforming the items by telephones and E-mails .The information was consisted of spe-cific names of item ,different kinds of combinations and items included in the combinations .All of these information were collected and analyzed .Results There were altogether 24 biochemistry items of laboratory diagnosis for hepatic function in 26 hospitals ,and tests serum markers of hepatitis B virus (HBV) were also added into the combination of hepatic function in 2 hospitals .Different kinds of combinations of the items for hepatic function were provided in all of the 26 hospitals ,among which 3 combinations were provided in 10 hospitals ,1 combination was provided in 8 hospi-tals ,and 5 combinations were provided in 3 hospitals .The amounts of items in different combinations varied a lot .The smallest combination only included 2 items ,including alanine aminotransferase (ALT) and aspartate aminotransferase (AST ) ,and the biggest combination included 16 items .Combinations of 9-16 items were provided in 13 hospitals . The most common combination included 8 items ,such as ALT ,total bilirubin (TBIL) ,direct bilirubin (DBIL) ,AST ,γ-glutamyltransferase (GGT) ,total protein (TP) ,albumin (ALB) and alkaline phosphatase (ALP) .Many hospitals had too many kinds of combinations ,which including too many items .There were still some hospitals putting retinol binding protein (Rbp) ,apolipoprotein E (ApoE) ,serum protein electrophoresis(SPE) ,mitochondrial isoenzymes of AST (ASTm) and serum markers of HBV into the routine combination for the detection of hepatic function .Conclu-sion There might be with obvious difference in the application and set of the combinations for laboratory diagnosis of hepatic function .The set of the combination might be usually not based on the disciplines of evidence-based labora-tory medicine ,which should be guided and standardized .