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临床输血与检验

临床输血与检验 ›› 2020, Vol. 22 ›› Issue (1): 39-45.DOI: 10.3969/j.issn.1671-2587.2020.01.010

• 临床检验 • 上一篇    下一篇

健康成人23项常规检验项目的生物学变异分析*

王瑛, 蒋筠斐, 钟政荣   

  1. 201999 上海交通大学医学院附属第九人民医院检验科
  • 收稿日期:2018-10-09 出版日期:2020-02-20 发布日期:2020-02-28
  • 通讯作者: 钟政荣,男,博士,副主任技师,(E-mail)zrzhong@126.com。
  • 作者简介:王瑛(1970–),女,上海人,主管技师,学士,主要从事实验室质量控制和免疫学检验工作,(E-mail)wangying@foxmail.com。
  • 基金资助:
    *本课题受国家高技术研究发展计划(863计划)项目(No.2014AA022304)资助

Assessment of Biological Variation for 23 Laboratory Routine Tests from Healthy Adults for 5 Consecutive Years

WANG Yin, JIANG Yun-fei, ZHONG Zheng-rong   

  1. Department of clinical laboratory,Shanghai Ninth People's Hospital,Shanghai JiaoTong University School of Medicine,Shanghai 201999
  • Received:2018-10-09 Online:2020-02-20 Published:2020-02-28

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摘要： 目的 评估健康成人23项常规检验项目连续五年长期的生物学变异情况。方法 收集连续五年每年一次在某三级医院检验科健康体检人员100名,空腹采集血液标本,分别在血液分析仪或生化分析仪上检测全血或血清中的血液学和生化学常规项目共23项,包括白细胞计数(WBC)、红细胞计数(RBC)、血红蛋白(HGB)、红细胞压积(HCT)、平均红细胞体积(MCV)、平均血红蛋白浓度(MCH)、平均血红蛋白量(MCHC)和血小板计数(PLT)、总胆红素(TBIL)、总蛋白(TP)、白蛋白(ALB)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)、尿酸(URIC)、尿素(UREA)、肌酐(CREA)、葡萄糖(GLU)、甘油三酯(TG)、总胆固醇(CH)、高密度脂蛋白胆固醇(HDL)、低密度脂蛋白胆固醇(LDL),计算连续五年的个体内生物学变异(CVI)和个体间生物学变异(CVG)。结果 CVI从1.26%~26.42%不等,其中大于20%的有TBIL、ALT、GGT、TG,小于5%的有RBC、HGB、HCT、MCV、MCH、MCHC、TP、ALB;CVG不同项目差异更大,从MCHC的2.49%到GGT的52.98%,超过30%的分别有TBIL(30.25%)、ALT(37.72%)、TG(39.70%)和GGT(52.98%),小于5%的仅有MCHC(2.49%)、MCV(3.71%)、MCH(3.73%);大多数项目的生物学变异略高于Westgard在线报道数据,但也有一些指标的生物变异低于Westgard在线数据,如RBC、MCH、PLT的CVI和MCV、MCH、PLT、ALT、ALP、CH、HDL、LDL的CVG。结论 本研究与Westgard在线数据趋势基本一致,但也存在一定差异,弥补了数据库中没有长期生物学变异的不足。

关键词: 生物学变异, 常规, 质量目标

Abstract: Objective To assess biological variation of 23 routine laboratory tests from 100 healthy subjects for 5 consecutive years. Methods One hundred healthy study participants were enrolled from a tertiary hospital and fasting blood samples were collected once a year for 5 consecutive years and analyzed for 23 routine laboratory tests, including white blood cell counting (WBC), red blood cell counting (RBC), hemoglobin (HGB), Hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), platelet count (PLT), total bilirubin (TBIL), total protein (TP), albumin (ALB), Alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutathione transdermal enzyme (GGT), alkaline phosphatase (ALP), uric acid (URIC), urea (UREA), creatinine (CREA), glucose (GLU), triglyceride (TG), total cholesterol (CH), high density lipoprotein cholesterol (HDL) and Low density lipoprotein cholesterol (LDL), using a Hematology analyzer or biochemical analyzer. The data were subject to within-subject biological variation (CVI) and between-subjects biological variation (CVG) analysis. Results We found that CVI varied from 1.26% to 26.42%. Of these CVI, those of TBIL, ALT, GGT and TG were displayed above 20% while those of RBC, HGB, HCT, MCV, MCH, MCHC, TP and ALB were less than 5%. For CVG, there were more significantly different among these parameters. The estimates of CVG were obtained from 2.49% for MCHC to 52.98% for GGT. Of 23 parametres, CVG of TBIL (30.25%), ALT (37.72%), TG (39.70%) and GGT (52.98%) were above 30%, whereas those of MCHC, MCV and MCH were less than 5%, 2.49%, 3.71% and 3.73%, respectively. Most CVI and CVG estimates appear to be higher than those previously published in the online 2014 Westgard updated database. However, a few CVI and CVG estimates were superior to those online, such as CVI for RBC, MCH and PLT and CVG for MCV, MCH, PLT, ALT, ALP, CH, HDL and LDL. Conclousions Most biological variation estimates in this study were similar with the online database in Westgard website except a few of parametres. And our study made up for the lack of long-term biological variation in the database.

Key words: Biological variation, Routine, Quality goal

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