血站内、外献血者丙氨酸氨基转移酶检测结果比对及影响因素分析

Comparison of the consistency of blood ALT test results inside and out-side station and analysis of the cause of the error

目的比较站内和站外献血者丙氨酸氨基转移酶(ALT)检测结果 ,制订相应的措施以保证不同仪器设备检测结果的一致性。方法采用全自动生化仪日立7100和半自动生化仪Photometer 4040对同一献血者进行ALT测定;以全自动生化仪日立7100的检查结果为标准结果 X,半自动生化仪Photometer 4040的检测结果为待评价结果 Y(采血车上Photometer 4040为Y_1,站内Photometer 4040为Y_2)计算Y_n减去X的差值d_n,比较d_1和d_2的差异,并做折线图直观反映站内、站外ALT检测结果的差异,对造成差异的影响因素进行分析。结果日立7100和血站外4040检测结果差值d_1为(5.07±4.33),日立7100和血站内4040检测结果差值d_2为(2.40±1.39),两者比较差异有统计学意义(t=7.513,P<0.05)。d_1的折线图波动幅度明显大于d_2。结论站外半自动生化仪ALT检测结果的不稳定性明显高于站内检测结果,造成这一结果的原因可能为实验操作的环境因素,仪器的电流、电压的稳定性,末梢血采集过程中出现溶血等血样的问题等。

Objective To compare the detection results of alanine aminotransferase（ALT） test of blood donors inside and outside the station, in order to develop corresponding measures to ensure the consistency of the results of different instruments and equipments. Methods The same donors′ blood ALT were measured by automatic biochemical analyzer Hitachi 7100 and semi-automatic biochemical analyzer Photometer 4040 respectively. The results obtained by the Hitachi 7100 were taken as standard results X, and the results of Photometer 4040 were takend as unevaluated results Y（the results of Photometer 4040 on the donation car were Y_1; the results of Photometer 4040 in the station were Y_2）. The dnwas calculated by Ynsubtracting X, the differences between d_1 and d_2 were compared, and line charts of dnwere made to directly reflect differences in ALT testing results outside and inside the station. The factors leading to different results were analyzed. Results Difference value d_1 of Hitachi 7100 and outside blood station 4040 test results was（5.07±4.33）,difference value d_2 of Hitachi 7100 and inside blood station 4040 test results was（2.40±1.39）, the difference was significant（t =7.513, P〈0.05）. The fluctuation range of the d_1 line chart was obviously higher than that of d_2 line chart.Conclusion The instability of the ALT results obtained by semiautomatic biochemical analyzer outside the station is significantly higher than that inside the station. There are many reasons for this result, such as environmental factors of experimental operation, the stability of electric current and voltage of instrument and hemolysis as well as other blood problems in blood collection process.