[1]孙瑞红,杨 璐,陶子琦,等.应用多元回归分析建立纠正高胆红素干扰酶法测定血清总胆固醇结果的校正公式及验证[J].现代检验医学杂志,2022,37(06):158-161+176.[doi:10.3969/j.issn.1671-7414.2022.06.030]
　SUN Rui-hong,YANG Lu,TAO Zi-qi,et al.Establish A Regression Formula for Correction of the Interference of High Bilirubin on Total Cholesterol Determined by Enzymatic Method and Its Verification[J].Journal of Modern Laboratory Medicine,2022,37(06):158-161+176.[doi:10.3969/j.issn.1671-7414.2022.06.030]
点击复制

应用多元回归分析建立纠正高胆红素干扰酶法测定血清总胆固醇结果的校正公式及验证()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第37卷
期数:
2022年06期
页码:
158-161+176
栏目:
研究简报·实验技术
出版日期:
2022-11-15

文章信息/Info

Title:
Establish A Regression Formula for Correction of the Interference of High Bilirubin on Total Cholesterol Determined by Enzymatic Method and Its Verification
文章编号:
1671-7414(2022)06-158-05
作者:
孙瑞红1; 2; 杨 璐1; 2; 陶子琦1; 2; 张世昌1; 2; 谢梦晓1; 2; 谢而付1; 2; 穆 原1; 2; 蒋 叶1; 2
(1. 南京医科大学第一附属医院检验学部，南京 210029；2. 国家医学检验临床医学研究中心分中心，南京 210029)
Author(s):
SUN Rui-hong1; 2;  YANG Lu1; 2; TAO Zi-qi1; 2;  ZHANG Shi-chang1; 2;  XIE Meng-xiao1; 2;  XIE Er-fu1; 2;  MU Yuan1; 2;  JIANG Ye 1; 2
(1. Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China; 2. Branch of National Clinical Research Center for Laboratory Medicine, Nanjing 210029, China)
关键词:
总胆固醇; 胆红素; 干扰; 校正
分类号:
R446
DOI:
10.3969/j.issn.1671-7414.2022.06.030
文献标志码:
A
摘要:
目的 评价不同浓度胆红素对酶法测定总胆固醇(total cholesterol, TC)的影响，应用多元回归分析建立校正公式并验证其校正效果。方法 收集100 例来自于南京医科大学第一附属医院2020 年12 月门诊或住院患者的新鲜无黄疸血清标本。配制一系列浓度梯度的胆红素溶液，分别加入其中50 例患者的血清标本中，检测各标本总胆红素(total bilirubin，TB)和TC 浓度，分析胆红素水平对TC 检测结果的影响及二者的相关性。应用多元回归分析建立校正公式，并利用另外50 例患者标本验证该校正公式的性能。结果 黄疸实验组与生理盐水对照组间差异具有统计学意义(F=3.947，P<0.01)，标本TC 浓度与TB 浓度呈负相关(r2=0.989 4)；在胆红素加入浓度分别为100，200，300，400，500 和600 μmol/L 的实验组中，TC 浓度的平均偏倚依次为：-6.65%±4.89%，-14.21%±8.89%，-29.00%±13.43%，-31.07%±14.62%，-38.21%±13.95% 和-43.51%±12.69%，且初始浓度TC ＜ 3 mmol/L 的标本产生的平均偏倚均明显高于TC ≥ 3 mmol/L 的标本，差异具有统计学意义(t=9.192 ～ 14.836，均P ＜ 0.01)；设无黄疸血清标本的TC 浓度为Y，其对应人工黄疸标本的TC 实测浓度为Z，TB 浓度为X，经多元回归分析，校正公式为Y =0.002 353·X + 0.973·Z+ 0.000 337·X·Z － 0.013 34；经公式校正后92.67% 的黄疸标本TC 浓度偏倚小于±10%。结论 黄疸患者血清标本中高胆红素水平可导致其TC 的检测结果偏低，偏倚大小与TB 浓度以及初始TC 浓度相关，运用校正公式可有效校正高胆红素对TC 测定的干扰，符合临床要求。
Abstract:
Objective To investigate the effects of bilirubin on total cholesterol (TC) determined by enzymatic method and establish a regression formula and verify its correction effect. Methods Fresh non-icteric serum samples of 100 outpatients or inpatients in the First Affiliated Hospital of Nanjing Medical University were collected in December 2020. A series of bilirubin solutions were prepared and added to the serum samples of 50 patients, respectively. Total bilirubin (TB) and TC concentration in non-icteric serum and different degree icteric serum samples were measured. The impact of bilirubin on TC and the relationship between bilirubin and TC were analyzed. Multiple regression analysis was used to establish a correction formula, and its correction effect was verified with serum samples of another 50 patients. Results The difference between the icteric experimental groups and the saline control group was statistically significant (F=3.947, P ＜ 0.01), and the TC concentration was negatively correlated with the TB concentration(r2=0.989 4). In the icteric experimental groups with added bilirubin concentrations of 100, 200, 300, 400, 500 and 600 μmol/L, the average biases of TC concentrations were -6.65%±4.89%, -14.21%±8.89%, -29.00%±13.43%, -31.07%±14.62%, -38.21%±13.95% and -43.51%±12.69%, respectively. The average bias of samples with initial TC concentration ＜ 3 mmol/L was significantly higher than that of samples with initial TC concentration ≥ 3 mmol/L, and the differences were statistically significant (t=9.192 ～ 14.836, all P ＜ 0.01). Y and Z represented TC concentration of non-icteric serum and different degree icteric serum，while X represented TB concentration． Formulas for TC measurement were presented：Y = 0.002 353·X + 0.973·Z+ 0.000 337·X·Z-0.013 34. The bias of corrected TC in 92.67% of icteric samples was less than 10%. Conclusion The results indicate that the level of TC measured by enzymatic method was negatively affected by bilirubin. The bias was related to the TB concentration and the initial TC concentration. The formula of mathematical correction of TC results in icteric samples should be suitable for the requirements of clinical laboratory.

参考文献/References:

[1] 魏巍 , 张旭 , 李婉娇 , 等．临床甲亢和亚临床甲亢患者血清 Nrg4,TSK水平与血脂、甲状腺激素和基础代谢率的相关性分析 [J].现代检验医学杂志 , 2022, 37(1): 38-42, 47. WEI Wei, ZHANG Xu, LI Wanjiao, et al. Correlation analysis of serum Nrg4, TSK levels with blood lipids, thyroid hormones and basal metabolic rate in patients with clinical hyperthyroidism and subclinical hyperthy-roidism [J]. Journal of Modern Laboratory Medicine, 2022, 37(1): 38-42, 47.
[2] NICOLAY A, LOREC A M, GOMEZ G, et al. Icteric human samples: Icterus index and method of estimating an interference-free value for 16 biochemical analyses[J]. Journal of Clinical Laboratory Analysis, 2018, 32(2): e22229.
[3] HUANG Yi, LIU Dan. Application of serum indices of ABBOTT c16000 automated analyzer in biochemistry detection[J]. Practical Journal of Clinical Medicine, 2016, 13(5): 77-80.
[4] 王忠 , 郭鸿雁 , 王颖 , 等 .胆红素对胆固醇检测的干扰 [J]．国际检验医学杂志 , 2013, 34(22): 3052-3054. WANG Zhong, GUO Hongyan, WANG Ying, et al. Interference of bilirubin on cholesterol detection [J]. International Journal of Laboratory Medicine, 2013, 34(22): 3052-3054.
[5] 颜巍 , 王凌云 , 钟丽 , 等．高胆红素患者血清高密度脂蛋白胆固醇减低原因的探讨 [J]．实验与检验医学 , 2020, 38(5): 906-908. YAN Wei, WANG Lingyun, ZHONG Li, et al. Study on the reduction of serum high density lipoprotein cholesterol in patients with hyperbilirubinemia [J]. Experimental and Laboratory Medicine, 2020, 38(5): 906-908.
[6] JI J Z, MENG Q H. Evaluation of the interference of hemoglobin, bilirubin, and lipids on Roche Cobas 6000 assays[J]. Clinica Chimica Acta, 2011, 412(17/18): 1550-1553.
[7] 孙丹丹 , 秦绪珍 , 童飞 , 等 .血清样本溶血、黄疸和脂血对 3种检测系统 9项生化指标检测结果的干扰评估 [J].中国医学装备 , 2021, 18(11):46-51. SUN Dandan, QIN Xuzhen, TONG Fei, et al. Inter-ference assessment of hemolysis, icterus and lipemia of serum specimen on nine biochemical parameters of three analytical systems [J]. China Medical Equipment, 2021, 18(11): 46-51.
[8] 陈明坤 , 李闻捷 , 张建荣．溶血、脂血、黄疸样本对生化项目检测的干扰机制及消除 [J].国际检验医学杂志 , 2014, 35(16):2272, 2275. CHEN Mingkun, LI Wenjie, ZHANG Jianrong. Interference mechanism and elimination of hemolysis, lipemia and icterus on biochemical analysis[J]. International Journal of Laboratory Medicine, 2014, 35(16): 2272, 2275.
[9] 汪玄文．胆红素氧化酶法消除胆红素对酶法测定胆固醇的干扰 [J].医学检验与临床 , 2008, 19(3)： 126, 128． WANG Xuanwen. Elimination of the interference of bilirubin on enzymatic determination of cholesterol by bilirubin oxidase method [J]. Medical Laboratory Science and Clinics, 2008, 19(3): 126, 128.
[10] VERMEER H J, STEEN G, NAUS A J, et al. Correction of patient results for Beckman Coulter LX-20 assays affected by interference due to hemoglobin, bilirubin or lipids: a practical approach[J]. Clinical Chemistry and Laboratory Medicine, 2007, 45(1): 114-119.

相似文献/References:

[1]邸 茜,邱 玲,侯立安,等.五种血脂检测系统测定结果的可比性调查[J].现代检验医学杂志,2016,31(03):36.[doi:10.3969/j.issn.1671-7414.2016.03.011]
　DI Qian,QIU Ling,HOU Li-an,et al.Investigation on the Consistency of Five Measurement Systems for Serum Lipids[J].Journal of Modern Laboratory Medicine,2016,31(06):36.[doi:10.3969/j.issn.1671-7414.2016.03.011]
[2]杨伏猛,刘倩,王文军.胆红素对ACL TOP700全自动血凝仪检测凝血四项结果的影响[J].现代检验医学杂志,2015,30(05):132.[doi:10.3969/j.issn.1671-7414.2015.05.041]
　YANG Fu-meng,LIU Qian,WANG Wen-jun.Effects of Bilirubin on ACL TOP700 Automated Coagulation Analyzer to Detect Four Indexes of Coagulation[J].Journal of Modern Laboratory Medicine,2015,30(06):132.[doi:10.3969/j.issn.1671-7414.2015.05.041]

备注/Memo

备注/Memo:
基金项目：国家自然科学基金(82101902)：TAZ-miR-34a-smyd Z 轴通过抑制STAT6 赖氨酸甲基化促进RA 中Mφ 极化失衡的机制。
作者简介：孙瑞红(1981-)，女，本科，实验师，研究方向：临床检验诊断学，E-mail: sungirl1515@163.com。
通讯作者：蒋叶(1981-)，女，硕士，副研究员，研究方向：临床生物化学检验，E-mail: oneadd317@163.com。
更新日期/Last Update: 2022-11-15