摘要
目的比较干化学与免疫比浊法(DCA Vantage)测定尿白蛋白的结果,了解两方法学检测性能,确定患者白蛋白检测方案。方法选择2016年1~12月期间在解放军总医院海南分院采集的同一次随机尿标本,同时进行免疫比浊法和干化学法(AX-4030)白蛋白检测,按照干化学法白蛋白值的大小,分层抽样439例。两种方法学之间一致性比较采用Kappa检验,两种方法出现差异的影响因素分析采用Logistic回归分析。结果一致性检验结果显示一致性一般(Kappa=0.44,P<0.01)。当干化学白蛋白为1 000 mg/L和2 000 mg/L时,免疫比浊法检测结果主要集中于检测上限,但当干化学法>2 000 mg/L时,免疫比浊法开始出现检测值的下降,呈现钩状效应。多因素Logistic回归分析结果显示,浊度是影响两种检测方法出现差异的影响因素(OR=1.571,P=0.001),当浊度每增加一个级别,出现差异的可能性增加1.571倍。结论尿白蛋白具体值可作为患者病情变化的标志,检测报告不应仅是报告其检测初始数值。对于DCA Vantage超过检测上限且干化学>1 000 mg/L的检测限内的样本应进行至少10倍或10倍以上稀释,然后再次检测,同时避免血尿、脓尿和高色素尿样本的检测。
Objective To compare the results of urine albumin check with dry chemistry method and immunoturbidimetry（DCA Vantage）, explore the detection performance of the two methods, and determine the serum albumin detection program. Methods From January 2016 to December 2016, the same random urine samples were collected from the Hainan Branch of PLA General Hospital, and immunoturbidimetry（DCA Vantage） and dry chemical method（AX-4030） were tested simultaneously to determine the specimens of albumin. According to the size of albumin value of dry chemical method, 439 cases was selected by stratified sampling. The consistency between two methods was compared by Kappa test. The related factors of the differences of two methods were analyzed by logistic regression analysis.Results The consistency test showed that the consistency was common（Kappa=0.44, P〈0.001）. When the dry chemical albumin was 1 000 mg/L and 2 000 mg/L, immune turbidimetry were mainly concentrated on the upper detection limit, but when the dry chemical albumin more than 2 000 mg/L, immunoturbidimetry began to decrease and showing hook effect. The results of multivariate logistic regression analysis showed that turbidity was an important factor influencing the difference between the two detection methods（OR=1.571, P=0.001）. When turbidity increases at one level, the likelihood of the difference increases by 1.571 times. Conclusion The specific value of urinary albumin can be used as a sign of the patient＇s condition, and the test report should not only report the initial value of the test. For DCA Vantage more than the upper detection limit and dry chemical exceeds the detection limit of 1 000 mg/L, the samples should be diluted at least10 times and then detected, while avoiding the detection of hematuria, pyuria and high pigment urine samples.
作者
于帅
洪超
刘双
丛琳
罗晴
肖征
YU Shuai;HONG Chao;LIU Shuang;CONG Lin;LUO Qing;XIAO Zheng(National Clinical Research Center for Geriatric Disease,Department of Clinical Laboratory;Department of Nephrology,National Clinical Research Center for Geriatric Disease,Hainan Branch of PLA General Hospital,Sanya 572013,Hainan,CHINA)
出处
《海南医学》
CAS
2018年第14期1988-1990,共3页
Hainan Medical Journal
基金
国家老年疾病临床医学研究中心开放课题(编号:NCRCG-PLAGH-2017018)
关键词
尿白蛋白
干化学法
免疫比浊法
Urine albumin
Dry chemical method
Immunoturbidimetry
