4895例血清低密度脂蛋白胆固醇聚乙烯硫酸沉淀法测定结果的分析

Analysis of the results of measuring LDL-C levels in 4 895 samples by polyvinyl sulfate assay

目的通过比较聚乙烯硫酸(PVS)直接测定法和Friedewald公式计算法获得的血清低密度脂蛋白胆固醇(LDL-C)检测值,探讨PVS直接测定法在缺少全自动生化分析仪的基层检验单位的实际应用价值。方法对聚乙烯硫酸(PVS)沉淀法测定的4 895例标本的低密度脂蛋白胆固醇(LDL-C)值进行了总结,按甘油三酯(TG)浓度进行分组,对比直接测定和Friedewald公式计算所得的LDL-C值差异,同时对不同TG含量下Friedewald公式的计算常数进行推断。应用Lp(a)值对LDL-C值进行校正,分析Lp(a)值与校正后的LDL-C值的相关性。结果直接测定和Friedewald公式计算法所得LDL-C值均明显相关。但TG>4.52 mmol/L(400mg/dl)时Friedewald公式计算所得值偏低。TG≤4.52 mmol/L时Friedewald公式的常数在2.1左右,而TG>4.52 mmol/L时则为2.4左右。Lp(a)与用Lp(a)校正后的LDL-C值之间无明显相关。结论 PVS沉淀法测定LDL-C结果较为可靠,在高TG时也能测出LDL-C,适合在没有自动分析仪的基层单位应用。Lp(a)水平高低与LDL-C水平无明显相关性,在LDL-C较低而Lp(a)较高的病例,建议对LDL-C值进行校正。

[Objective] To compare polyvinyl sultate （PVS） precipitation assay and Friedewald formula for measuring sera LDL-C levels and analyze the influence of sera Lp（a） levels on LDL-C levels. Approach the practical application of PVS direct measurement in the absence of full automatic biochemical analyzer. [ Methods ] Measuring LDL-C levels in 4 895 samples with polyvinyl sulfate （PVS） assay and Friedewald, Algorithm respectively, and analyzing the difference of the two results under the different TG and Lp（a） levels. [Results] The serum level of LDL- C measured by polyvinyl sulfate assay and by Friedewald Algorithm are closely correlative. However, when TG〉4.52 mmol/L （400 mgM1）, the LDL-C levels calculated by Friedewald Algorithm were lower than those with polyvinyl sulfate assay. The predicted K values of Friedewald Mgorithm were 2.1 and 2.4 when TG was above and below 4.52 mmol/L respectively. The LDL-C values emended by Lp （a） level were not correlated with the Lp （a） level. [ Conclusions ] polyvinyl sulfate assay is a recommended method in Primary Health Centers without automatic biochemical analyzer. In the case of low level of LDL-C and high level of Lp（a）, we propose to adjust the LDL-C value.