全国血气和酸碱分析室间质评及室内质控数据调查结果分析

Analysis of the inter-lab comparability and intra-lab precision of blood gas and acid-base testing

目的通过开展全国血气和酸碱分析室间质量评价（EQA）活动及室内质量控制（IQC）数据调查，了解临床实验室血气和酸碱分析检测结果实验室间的可比性和实验室内精密度性能。方法将15个批号的血气和酸碱分析质控物质通过邮政特快专递分发到参加实验室，实验室在规定时间内分批对样本进行检测后，通过网络将检测结果上报，同时提交2012年4月份室内质量控制在控数据的变异系数（CV）。对所有实验室检测结果按仪器进行分组统计，计算各组的及格率、实验室间CV，对室内质量控制数据的CV进行仪器间和项目间比较。结果570家实验室参加了本次EQA；同一仪器分组的不同项目中，PO2检测项目实验室间CV最大；对于同样的项目，Siemens组实验室间CV最大。525家实验室提交了有效的室内质控数据，实验室内CV未表现出明显的项目间和仪器问的差异。结论我国血气和酸碱分析大部分项目检测结果具有较好的实验室间的可比性，部分项目还有改进的余地。实验室应重视室内质量控制工作，以保证检测结果的可靠性。

Objective To investigate the comparability between laboratories and the performance of precision in clinical laboratories for blood gas and acid-base analysis by external quality assessment （EQA） and internal quality control （ IQC ） . Methods Fifteen vials of EQA materials were distributed to the laboratories by global Express Mail Services （EMS）. The activities were carried out three times, five-level samples were determined every time. After the measurement resuhs and coefficients of variation of internal quality control data of April were reported, the collected data were divided into peer groups based on laboratory instruments. The medians of each group were taken as the target value to analyse the pass rate and coefficient of variation （ CV ） of each group after the removal of outliers. Internal quality control data was collected by Web-based the EQA software acquisition system which collect the CVs of the control data of nationwide blood gas and acid-base analysis project in April 2012 internal quality control, the CVs of IQC data were compared according to analyzers and testing items after the removal of outliers. All the data were analyzed using EXCEL 2007 and SPSS. Results A total of 570 laboratories participate in the EQA scheme. The CV of Inter-laboratory of PO2 was largest in all the same instrument groups ; For the same item, Siemens group displayed larger CVs than other instrument groups. A total of 525 laboratories returned internal quality control data in accordance with the provisions, there are no significant difference in CVs among the same instrument group and among the same test of inter-instrument. Conclusions The comparability of results for blood gas and acid-base analysis are mostly good between laboratories in China, besides, some of which need to improve. The laboratories should pay more attention to IQC so as to secure the reliability of results.