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临床输血与检验

临床输血与检验 ›› 2021, Vol. 23 ›› Issue (1): 91-95.DOI: 10.3969/j.issn.1671-2587.2021.01.023

• 临床检验 • 上一篇    下一篇

不同模式检测尿素水平对透析充分性评估的影响

赵勇, 曾玮荣, 余福安, 孙建斌   

  1. 430060 武汉市第三医院检验科
  • 收稿日期:2020-02-10 发布日期:2021-02-22
  • 通讯作者: 孙建斌,男,主任检验师,硕士,主要从事临床病毒学检验工作,（E-mail）sjb3h@sina.com。
  • 作者简介:赵勇（1986-）,男,湖北十堰人,主管检验师,硕士,主要从事分子检验诊断工作,（E-mail）zhaoyongbrave@163.com。

Effect of Different Modes of Urea Nitrogen Detection on Dialysis Adequacy Evaluation

ZHAO Yong, ZENG Wei-rong, YU Fu-an, et al   

  1. Clinical Laboratory,Wuhan Third Hospital,Wuhan 430060
  • Received:2020-02-10 Published:2021-02-22

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摘要： 目的 探讨脲酶速率法原倍和稀释模式下检测血清尿素（UREA）、肌酐（CREA）水平及尿素清除率（URR）的差异对透析充分性评估的影响。方法 随机收集本院住院患者（UREA水平基本均匀覆盖试剂线性范围）148例作为A组,同期收集透析患者134例作为B组。采用原倍、稀释5倍模式检测A组的UREA和CREA水平,分析不同模式检测下两指标水平的差异。采用原倍、3倍稀释和5倍稀释模式检测B组透析前后的血清UREA水平,计算每个患者URR,分析不同模式检测结果、URR以及透析充分性评估结果的差异。结果 稀释模式检测全量程UREA结果和原倍模式结果差异显著（P<0.05）,且产生的相对误差和UREA水平呈正相关（r=0.57,P<0.05）,而CREA水平基本无影响（P>0.05）;两种稀释模式检测B组UREA水平和URR明显高于原倍模式检测UREA水平和URR（P<0.05）;稀释模式评估的透析充分百分比显著高于原倍模式（P<0.01）,且不同稀释模式对透析充分性评估结果无显著差异（P>0.05）。结论 稀释模式下脲酶速率法影响UREA的检测结果,导致透析患者URR升高,降低患者透析充分性评估的准确性。

关键词: 尿素, 尿素清除率, 透析充分性评估

Abstract: Objective To investigate the difference of serum urea（UREA）,creatinine （CREA）and urea removal rate（URR）between urease rate method and dilution mode and its effect on the evaluation of dialysis adequacy. Methods one hundred and forty-eight inpatients（UREA level basically uniform covering linear range） in our hospital were enrolled as group A and one hundred and thirty-four dialytic patients were enrolled as group B. The level of UREA and CREA levels in group A were detected in original concentration and 5-fold dilution mode. The levels of UREA in serum of group B before and after dialysis were detected by original concentration,3-fold dilution mode and 5-fold dilution mode respectively. We calculated the URR of each patient and compared the difference of urea,URR and dialysis adequacy evaluation. Results The results of full-range UREA detected by dilution mode were significantly different from those of original mode,and the relative error was positively correlated with the level of UREA（r=0.57,P<0.05）,while the CREA level has no effect（P>0.05）. In group B,the levels of UREA and URR detected by dilution modes were significantly higher than those of original mode （P<0.05）.The percentage of dialysis adequacy evaluated by dilution modes were significantly higher than that of original mode（P<0.01）,and there was no significant difference among different dilution modes（P>0.05）. Conclusion Urease rate method in dilution mode affects the detection results of UREA,which leads to the increase of URR in dialysis patients and reduces the accuracy of dialysis adequacy evaluation.

Key words: UREA, Urea removal rate, Dialysis adequacy evaluation

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