2017-2021年甘肃省尿碘实验室能力验证结果分析

Capability verification results of urinary iodine laboratories in Gansu Province from 2017 to 2021

目的评价甘肃省尿碘实验室检测能力,分析存在的问题。方法采用Z比分法和不确定度分析评价甘肃省2017-2021年尿碘实验室外质控考核结果(数据采集自甘肃省疾病预防控制中心)。结果2017-2021年全省尿碘实验室累及考核参与率为100.0%(473/473),反馈率为99.8%(472/473),合格率为91.9%(434/472)。2017-2021年考核合格率分别为82.7%(62/75)、93.9%(93/99)、94.9%(93/98)、92.0%(92/100)和94.0%(94/100)。省、市、县考核合格率分别为5/5、98.6%(69/70)和90.7%(360/397)。全省实验室间│Z│≤2、2<│Z│<3和│Z│≥3的比例分别为84.5%(399/472)、9.3%(44/472)和6.2%(29/472),全省实验室内│Z│≤2、2<│Z│<3和│Z│≥3的比例分别为88.6%(418/472)、9.1%(43/472)和2.3%(11/472)。年度实验室间│Z│分值构成比较,差异有统计学意义(χ^(2)=24.60,P=0.002),│Z│≤2的比例从2017年的66.7%(50/75)升高到2021年的90.0%(90/100)。省级实验室间和实验室内的│Z│分值均≤2;市级和县级实验室间│Z│≤2的比例分别为91.4%(64/70)和83.1%(330/397),实验室内│Z│≤2的比例分别为92.9%(65/70)和87.7%(348/397)。省、市、县级实验室间和实验室内│Z│分值构成比较,差异均无统计学意义(均P>0.05)。全省两种浓度质控盲样的外质控考核结果均在不确定度范围内的比例为89.2%(421/472)。其中,2017-2021年分别为81.3%(61/75)、91.9%(91/99)、84.7%(83/98)、92.0%(92/100)和94.0%(94/100),差异有统计学意义(χ^(2)=9.69,P=0.021);省、市、县级实验室分别为5/5、95.7%(67/70)和87.9%(349/397),差异有统计学意义(χ^(2)=23.60,P=0.023)。结论通过对甘肃省所有建成的尿碘实验室开展持续的外质控考核,各级尿碘实验室检测能力总体不断提高,但今后仍需加强实验室检测能力,提升尿碘检测水平。

Objective To evaluate the testing capability of urinary iodine laboratories in Gansu Province and analyze the existing problems.Methods Z-score method and uncertainty analysis were used to analyze the external quality control assessment results of urinary iodine laboratories in Gansu Province from 2017 to 2021(data were collected from Gansu Center for Disease Prevention and Control).Results From 2017 to 2021,the participation rate in the assessment of urinary iodine laboratories in the province was 100.0%(473/473),the feedback rate was 99.8%(472/473),and the pass rate was 91.9%(434/472).The pass rates for assessment from 2017 to 2021 were 82.7%(62/75),93.9%(93/99),94.9%(93/98),92.0%(92/100),and 94.0%(94/100),respectively.The pass rates for provincial,municipal,and county assessments were 5/5,98.6%(69/70),and 90.7%(360/397),respectively.The proportions of│Z│≤2,2<│Z│<3,and│Z│≥3 between laboratories in the province were 84.5%(399/472),9.3%(44/472),and 6.2%(29/472),respectively.The proportions of│Z│≤2,2<│Z│<3,and│Z│≥3 within the laboratories were 88.6%(418/472),9.1%(43/472),and 2.3%(11/472),respectively.There was a significant difference in the composition of│Z│scores between laboratories annually(χ^(2)=24.60,P=0.002),the proportion of│Z│≤2 increased from 66.7%(50/75)in 2017 to 90.0%(90/100)in 2021.The│Z│scores between and within provincial laboratories were both≤2.The proportion of│Z│≤2 between municipal and county-level laboratories was 91.4%(64/70)and 83.1%(330/397),respectively,the proportion of│Z│≤2 within laboratories was 92.9%(65/70)and 87.7%(348/397),respectively.There was no difference in the composition of│Z│scores between and within provincial,municipal,and county-level laboratories(P<0.05).The proportion of two concentration quality control blind sample results in the province that were both within the uncertainty range was 89.2%(421/472).From 2017 to 2021,they were 81.3%(61/75),91.9%(91/99),84.7%(83/98),92.0%(92/100),and 94.0%(94/100),respectively,with statistically significant differences(χ^(2)=9.69,P=0.021);provinces,cities,and counties were 5/5,95.7%(67/70),and 87.9%(349/397),respectively,with statistically significant differences(χ^(2)=23.60,P=0.023).Conclusions Through continuous external quality control assessments of all established urinary iodine laboratories in Gansu Province,the overall testing capacity of urinary iodine laboratories at all levels has been continuously improved.However,in the future,it is still necessary to strengthen laboratory testing capabilities and improve the level of urine iodine detection.