全自动干式生化分析仪测定胆碱酯酶的实验研究

Experiment Research on Measuring Cholinesterase with Dry Chemistry Complete Automatic Biochemistry Analyzer

目的通过胆碱酯酶在全自动干式生化分析仪上测定的实验观察,从而建立一种临床上可靠的简单易行的胆碱酯酶测定方法。方法利用全自动干式生化分析仪来测定胆碱酯酶并进行方法学评价。结果高值与低值的批内批间的变异系数(CV)分别为3.8%,3.9%,3.2%,3.3%,与全自动生化分析仪测定结果相比,相关性好(r=0.962)。一定范围的胆红素、血红蛋白、抗坏血酸干扰小,但要避免溶血,试剂稳定,通过临床病例观察实验,在有机磷中毒的诊断中,其阳性结果预示值(PV+)和诊断灵敏度以及诊断特异性都达到94%,阳性似然比(PLR)为15.7,阴性似然比(NLR)为0.063。结论独特的测定原理和试剂片独立的包装,使该实验方法更可靠,有更好的临床实用价值,加上该实验方法操作简单、测定快速,更适于临床有机磷中毒急救中推广应用。

Objective By the experiment observation on measuring cholinesterase with the dry chemistry complete automatic biochemistry analyzer,thus build one kind of clinical reliable simple and easy to measure cholinesterase method. Methods Measuring the cholinesterase with the dry chemistry complete automatic biochemistry analyzer and advancing methodologys appraises. Results The high level of interior CV was 3.8% and the one between interior CV was 3.9 % ;the low level of interior CV was 3.2% and the one between interior CV was3.3%. Compared with the complete automatic biochemistry analyzer, the correlation was good （r= 0. 962）. Bilirubin,hemoglobin and ascorbic acid influence little on it in the fixed scope. The reagent was stable. By the experiment observing clinical case the positive prediction value（PV＋）and the diagnosed sensitivity and specificity all achieved 94% ;the positive likehood ratio（PLR） was 15.7 and the negative likehood ratio（NLR）was 0. 063 in the diagnosis of organic phosphorus being poisoned. Conclusions The unique measurement principle and the packing of independent reagent piece make that this experiment method is more reliable ,and have better clinical practical value. Because the experiment method measures quickly and operates simply ,it more suits clinical application and dissemination in the first aid of organic phosphorus to be poisoned.