上海市临床实验室2012年度肌酐、尿酸、尿素室间质量评价结果分析

Analysis on the external quality assessment results for creatinine,uric acid and urea of Shanghai clinical laboratories in 2012

目的：对上海市临床实验室2012年度室间质量评价（EQA）肾功能指标检测结果进行分析，了解上海市肌酐（Cr）、尿酸（UA）、尿素（UN）检测的现状，为标准化进程提供实验数据。方法通过向上海地区实验室发放10个批次不同浓度的质评物进行常规化学的EQA，将Cr、UA、UN按10套检测仪器分组分析。EQA数据分析按结果剔除离群值后计算各组的均值（x珋）、标准差（s）、变异系数（CV）。结果 EQA结果分析中，Cr、UA、UN不同检测仪器CV范围分别为1．30％～12．73％、1．06％～6．78％、1．55％～8．79％。Cr 进口1组实验室间的变异情况较好，检测质评物（46～574）μmol/L CV范围为1．70％～5．15％。UA进口3组实验室间的变异情况较好，检测质评物（132～550）μmol/L CV范围为1．49％～2．19％；UN进口2组实验室间的变异情况较好，检测质评物（3．15～18．13）mmol/L CV范围为1．55％～2．74％。结论就项目而言，上海市临床实验室Cr的检测性能还有待于进一步提高。就仪器而言，国产检测仪器的性能有待进一步提高。仍需通过开展实验室全面质量管理，逐步达到检测结果的互认，为临床提供可靠的诊疗依据。

Objective To analyze the external quality assessment（EQA）results for kidney function indices of Shanghai clinical laboratories in 2012,to understand the status of creatinine（Cr）,uric acid（UA）and urea（UN） determinations,and to provide the experimental data for standardization. Methods A total of 1 0 different concentrations of control materials were distributed to Shanghai laboratories for the routine chemical EQA.Data was classified into different groups,according to the instruments.The means（x）,standard deviation（s）and coefficient of variation （CV）were calculated for each group after eliminating outliers.Results In EQA results,the CV among laboratories of Cr,UA and UN were 1 .30%-1 2.73%,1 .06%-6.78% and 1 .55%-8.79%,respectively for different groups.The lowest variation of Cr was in Import 1 group.The range of CV was 1 .70%-5 .1 5% in detecting （46-574）μmol/L of Cr.The lowest variation of UA was in Import 3 group.The range of CV was 1 .49%-2.1 9% in detecting （1 32-550）μmol/L of UA.The lowest variation of UN was in Import 2 group.The range of CV was 1 .55%-2.74% in detecting （3.15-18.13）mmol/L of UN.Conclusions The determination performance of Cr needs to be further improved in Shanghai laboratories.The determination performance of homemade instruments remains to be further improved in terms of equipment.It is needed to strengthen the laboratory quality management to gradually achieve the mutual recognition of test results and to provide the reliable diagnosis and treatment references.