两种血浆与血清中HDL—C用四种不同试剂检测的结果对比研究

Comparation of HDL- C in 2 Kinds of Plasma and Serum with 4 Different Reagents

目的探讨不同HDL—C试剂检测抗凝血浆与血清结果的可比性及抗凝血浆代替血清用于临床检验的可行性。方法用4种试剂（A、B、C、D）分别对52例同一人的肝素锂、EDTA—K2抗凝血浆与血清HDL—C进行检测，并对各试剂检测抗凝血浆与血清HDL—C结果进行比较。结果除B与D试剂检测结果无显著性差异外，AB、AC、AD、BC、BD试剂间均有显著性差异，但各试剂间线性相关良好，可通过建立线性回归方程评价各试剂间的系统误差。各试剂间相对偏倚sE（％）〈CLIA’88允许误差的1／2在临床可接受范围之内，检测结果具有可比性。肝素锂血浆与血清HDL—C结果比较：4种试剂血浆与血清间线性相关良好，B、D试剂检测肝素锂血浆与血清结果问无显著性差异，可代替血清用于临床；A、C试剂肝素锂血浆与血清结果间有显著性差异，可通过线性回归方程将血浆数值换算成对应血清值或建立血浆参考体系。EDTA—K2血浆与血清HDL—C结果比较：4种试剂血浆与血清间线性相关良好，A、D试剂EDTA—K2血浆与血清结果间无显著性差异，可代替血清用于临床；B、C试剂检测结果有显著性差异，可通过线性回归方程将血浆值换算成对应血清值或建立血浆参考体系。结论更换试剂检测同一项目时需进行结果比对和偏倚评估，评价其临床可接受性以保证检验结果的可比性；不能简单评价抗凝血浆是否可代替血清用于临床，需根据不同的检测试剂来确定，每个实验室应根据自己的实际情况来判断或建立血浆参考体系。

Objective To compare the results of anticoagulant plasma and serum tested with 4 different HDL - C reagents, and to explore the feasibility of anticoagulant plasma instead of serum in clinical examination. Methods HDL - C in heparin lithium and EDTA - K2 anticoagulant plasma as well as serum in 52 patients were tested with 4 different reagents （ A, B, C, D）. The results were then compared and analyzed. Results There were significant differ- ences between A and B,A and C,A and D,B and C,B and D. However,there were good linear correlations between these reagents, and systematic errors could be assessed by establishing linear regression equation. Testing results were comparable among these reagents. Results of HDL - C in heparin lithium plasma and serum samples ： there were good linear correlations among 4 reagents. There was no significant difference between B and D. Heparin lithium plasma could be used instead of serum. There was significant difference between A and C. The values of plasma could be con- vetted to serum values or reference system could be established by linear regression equation. Results of HDL - C in EDTA - K2 anticoagulant plasma and serum samples ： there were good linear correlations among 4 reagents. There was no significant difference between A and D. EDTA - K2 anticoagulant plasma could be used instead of serum. There was significant difference between B and C. The values of plasma could be converted to serum values or reference sys- tem could be established by linear regression equation. Conclusion Results should be compared and bias should be assessed changing reagents in the same item. Acceptability should be evaluated in order to guarantee the comparability of results. Whether serum can be replaced by anticoagulant plasma need to be confirmed according to different rea- gents. It can be estimated and reference system can be established on the basis of real situation of laboratories.