摘要
目的比较同型半胱氨酸临床不同测定方法(液质联用法及免疫类方法)的差异。方法本文选取2014年至2016年我室参加国内和国际权威机构:卫生部临检中心和美国病理学家协会室间质评活动的反馈结果数据,通过分析同型半胱氨酸反馈结果数据以及我室采用液质联用法和免疫类方法同时测定同型半胱氨酸的数据,比较了液质联用法及免疫类方法的差异。结果我室的检测方法为液质联用法,自2014年参与美国美国病理学家协会室间质评以来结果均在可接受范围内,与靶值偏倚<25%,在此机构的室间质评活动中所属组为色谱法组别;而自2014年起参与国内卫生部临检中心室间质评以来除低值(<20.0μmol/L)在可接受范围内,其他浓度值的测定结果均高于临检中心室间质评可接受范围,且偏倚程度与浓度的增加呈现正相关。而我室在临检中心室间质评中所属组为缺省组组别或所有组组别,参与临检中心室间质评的其他实验室大部分以免疫类方法检测。除此之外,我室在采用液质联用法和免疫类方法同时测定同型半胱氨酸时结果存在差异。结论液质联用法与免疫类方法测定同型半胱氨酸结果存在偏差,且偏差与浓度呈现正相关。血液样品存在着内源性成分复杂,基质干扰严重等问题,免疫类方法易受这些问题的影响,而液质联用法具有专属性强、准确度高的特点,采用标准曲线定量可以得到可靠的结果。
Objective To compare the variation of different detection methods of homocysteine in clinical laboratory. Methods In this paper, we obtained the quality assessment results of the Ministry of Health Clinical Laboratory and the American Association of Pathologists from 2014 to 2016. At the same time, our laboratory also conducted relevant experiments and generated data. The aim is to compare the differences between LC-MS/MS and immunological methods for homocysteine detection. Results Our detection method for homocysteine was LC-MS/MS. And the results in the chromatographic group were within the acceptable range during the process of the quality assessment by the American Association of Pathologists, with the target bias 〈 25%. However, we have participated in the quality evaluation of the Ministry of Health Clinical Laboratory since 2017, during which only the low values （ 〈 20.0 mol/L） of our results were within the acceptable range, while the other results were higher than the quality assessment target value of the Ministry of Health Clinical Laboratory and the deviation was positively correlated with the concentration. Most of the other labs participating in the quality assessment were adopted immunoassay methods for detection. Conclusion There is a deviation between the results of LC-MS/MS and immunoassay in determining homocysteine, and the deviation was positively correlated with the concentration. The endogenous components in blood samples are complex, and the matrix interference is serious. Immunoassay results is susceptible to the above problems. In contrast, LC-MS/MS is highly accurate and can effectively avoid these problems.
作者
贾永娟
解娜
翟瑞雪
倪君君
JIA Yong-juan;XIE Na;ZHAI Rui-xue;NI Jun-jun(Beijing Hehe Medical Diagnostic Technology Co.,Ltd.,Beijing 101111,China)
出处
《标记免疫分析与临床》
CAS
2018年第9期1391-1397,共7页
Labeled Immunoassays and Clinical Medicine
