中国实验诊断学
中國實驗診斷學
중국실험진단학
CHINESE JOURNAL OF LABORATORY DIAGNOSIS
2015年
1期
1-6
,共6页
脂肪酶%酶比色法%全自动生化分析仪
脂肪酶%酶比色法%全自動生化分析儀
지방매%매비색법%전자동생화분석의
Lipase%Enzyme colorimetry%Automatic biochemical analyzer
目的:评估4种脂肪酶(Lipase,LPS)检测系统的分析性能。方法方法学评价研究。应用美国临床和实验室标准化协会(CLSI)EP5-A2、EP15-A2、EP7-A2、EP6-A、EP9-A2方法验证4种脂肪酶检测系统的精密度、正确度、抗干扰性、分析测量范围(AMR)、相关及偏差。采用美国病理学家协会(CAP)发放的室间质评物(C-A和 C-B)验证不同系统检测 LPS正确度。回归分析采用Passing-Bablok检验,回归线性检测采用Cusum方法,相关分析采用Pear-son检验,偏差分析应用Bland-Altman曲线。结果 LPS在25-240 U/L时,4种检测系统的批内CV均<TEa的1/4(9.47%),批间CV均<TEa的1/3(12.63%)。正确度验证测定美国CAP室间质评物显示仅 A、C系统较为理想,其95%验证区间包含了指定均值,且符合生物学变异设定的总允许误差(TEa:<37.88%);回收试验显示除 B系统高回收标本外,其它系统均未超出±10%。抗干扰性评估显示 Hb≥5g/L时,对B、C系统低水平有>10%的正干扰,在15 g/L时,对D系统低水平有>10%的正干扰;Bil≤600μmol/L时对4种系统均无明显干扰现象;TG≥8 mmol/L时,对A、C系统均有>10%的负干扰。4种系统 AMR上限分别为341、494、529、379 U/L。相关分析以选取上述性能较为理想的C系统为参考对象,A、B、D与C系统比较相关性较好,r均>0.975(P<0.01),Bland-Altman偏差分析显示平均绝对偏差分别为-9.7、-21.7、-21.1 U/L,平均相对偏差分别为-10.12%、-11.96%、-13.51%,计算医学决定水平(Xc)时的预期偏差显示在 Xc=60 U/L时,A、B、D系统均符合生物学变异设定的1/3总允许误差(12.63%),在Xc=180 U/L时,B、D系统的允许偏差不在预期偏差的可信区间内且小于可信区间下限,证实 B、D系统在 Xc=180 U/L时与C系统的性能不相当,结果可比性差,不可接受。结论4种检测系统的性能之间存在差异。
目的:評估4種脂肪酶(Lipase,LPS)檢測繫統的分析性能。方法方法學評價研究。應用美國臨床和實驗室標準化協會(CLSI)EP5-A2、EP15-A2、EP7-A2、EP6-A、EP9-A2方法驗證4種脂肪酶檢測繫統的精密度、正確度、抗榦擾性、分析測量範圍(AMR)、相關及偏差。採用美國病理學傢協會(CAP)髮放的室間質評物(C-A和 C-B)驗證不同繫統檢測 LPS正確度。迴歸分析採用Passing-Bablok檢驗,迴歸線性檢測採用Cusum方法,相關分析採用Pear-son檢驗,偏差分析應用Bland-Altman麯線。結果 LPS在25-240 U/L時,4種檢測繫統的批內CV均<TEa的1/4(9.47%),批間CV均<TEa的1/3(12.63%)。正確度驗證測定美國CAP室間質評物顯示僅 A、C繫統較為理想,其95%驗證區間包含瞭指定均值,且符閤生物學變異設定的總允許誤差(TEa:<37.88%);迴收試驗顯示除 B繫統高迴收標本外,其它繫統均未超齣±10%。抗榦擾性評估顯示 Hb≥5g/L時,對B、C繫統低水平有>10%的正榦擾,在15 g/L時,對D繫統低水平有>10%的正榦擾;Bil≤600μmol/L時對4種繫統均無明顯榦擾現象;TG≥8 mmol/L時,對A、C繫統均有>10%的負榦擾。4種繫統 AMR上限分彆為341、494、529、379 U/L。相關分析以選取上述性能較為理想的C繫統為參攷對象,A、B、D與C繫統比較相關性較好,r均>0.975(P<0.01),Bland-Altman偏差分析顯示平均絕對偏差分彆為-9.7、-21.7、-21.1 U/L,平均相對偏差分彆為-10.12%、-11.96%、-13.51%,計算醫學決定水平(Xc)時的預期偏差顯示在 Xc=60 U/L時,A、B、D繫統均符閤生物學變異設定的1/3總允許誤差(12.63%),在Xc=180 U/L時,B、D繫統的允許偏差不在預期偏差的可信區間內且小于可信區間下限,證實 B、D繫統在 Xc=180 U/L時與C繫統的性能不相噹,結果可比性差,不可接受。結論4種檢測繫統的性能之間存在差異。
목적:평고4충지방매(Lipase,LPS)검측계통적분석성능。방법방법학평개연구。응용미국림상화실험실표준화협회(CLSI)EP5-A2、EP15-A2、EP7-A2、EP6-A、EP9-A2방법험증4충지방매검측계통적정밀도、정학도、항간우성、분석측량범위(AMR)、상관급편차。채용미국병이학가협회(CAP)발방적실간질평물(C-A화 C-B)험증불동계통검측 LPS정학도。회귀분석채용Passing-Bablok검험,회귀선성검측채용Cusum방법,상관분석채용Pear-son검험,편차분석응용Bland-Altman곡선。결과 LPS재25-240 U/L시,4충검측계통적비내CV균<TEa적1/4(9.47%),비간CV균<TEa적1/3(12.63%)。정학도험증측정미국CAP실간질평물현시부 A、C계통교위이상,기95%험증구간포함료지정균치,차부합생물학변이설정적총윤허오차(TEa:<37.88%);회수시험현시제 B계통고회수표본외,기타계통균미초출±10%。항간우성평고현시 Hb≥5g/L시,대B、C계통저수평유>10%적정간우,재15 g/L시,대D계통저수평유>10%적정간우;Bil≤600μmol/L시대4충계통균무명현간우현상;TG≥8 mmol/L시,대A、C계통균유>10%적부간우。4충계통 AMR상한분별위341、494、529、379 U/L。상관분석이선취상술성능교위이상적C계통위삼고대상,A、B、D여C계통비교상관성교호,r균>0.975(P<0.01),Bland-Altman편차분석현시평균절대편차분별위-9.7、-21.7、-21.1 U/L,평균상대편차분별위-10.12%、-11.96%、-13.51%,계산의학결정수평(Xc)시적예기편차현시재 Xc=60 U/L시,A、B、D계통균부합생물학변이설정적1/3총윤허오차(12.63%),재Xc=180 U/L시,B、D계통적윤허편차불재예기편차적가신구간내차소우가신구간하한,증실 B、D계통재 Xc=180 U/L시여C계통적성능불상당,결과가비성차,불가접수。결론4충검측계통적성능지간존재차이。
Objective To evaluate the performance for four Lipase(LPS)analysis system.Methods This study be-longs to the methodological evaluation study,Analysed four Lipase systems and their correlation and deviation compared with A system.Precision,accuracy,anti-interference,analytical measuring range (AMR)were evaluated,according to the CLSI EP5-A2,EP15-A2,EP7-A2,EP6-A,EP9-A2 guidelines.To assess the accuracy,we used the EQA samples(C-A and C-B)from CAP.Regression using Passing-Bablok,linear regression was detected by Cusum method,analysis of correlation using pearson,analysis of deviation using Bland-Altman.Results For four lipase detection systems,the within-run CVs were all <1/4TEa(9.47%)and the between-run CVs were all <1/3TEa(12.63%)when the concen-tration of LPS was 25-240 U/L.The accuracy verification testing CAP EQA material showed that A and C system re-sults met the desirable,the 9 5% verification interval that contains the specified mean value,and in accordance with the total allowable error derived from biological variation set (TEa:<37.88%);Recovery test shows that except for the high recovery of specimens from B system,other systems were not exceed± 10%.Anti-interference analysis showed that had over 10% positive interference on the low level of B、C system while Hb≥5 g/L and on the low level of D sys-tem when Hb was 15 g/L;There was no significant interference for the four systems when Bil≤600μmol/L.It had o-ver 10% negative interference of A、C system while TG≥8 mmol/L;The upper limits of AMR for A,B,C and D sys-tem were 341,494,529 and 379 U/L respectively.Correlation analysis to select the C system the performance of ideal as the reference object,the A,B,D system correlation well with C system and the pearson correlation coefficient(r)>0.975 (P< 0.01);Compared with C system,the Bland-Altman results showed that the average absolute deviation were-9.7、-21.7、-21.1 U/L and the average relative devation were-10.12%、-11.96%、-13.51% respectively for the A,B,D system.By calculating expected deviation of medical decision level (Xc)showed that A,B,D systems were in line with 1/3 total allowable error (12.63%)of the biological variation set when Xc=60 U/L,the allowable deviation of B,D systems were not in the confidence interval (CI)and also less than the lower limit of the confidence interval from ex-pected deviation when Xc=180 U/L,and performance of B,D system by verified was not quite compared with the C system when the Xc=180 U/L,comparability of the results was difference and unacceptable.Conclusion There are differences between the performance of the four lipase detection system.