心血管标志物POCT院内质量管理实践

In-hospital Management of POCT for Cardiovascular Biomarkers

目的心脏标志物point-of-care testing(POCT)检测因其快速、便捷的特点已经成为急重症临床科室的需求对象。本文介绍了阜外医院在规范化管理心脏标志物POCT实践中的积极探索以及遇到的问题。方法对实施规范化管理后3个月的室内质控数据进行统计分析。结果院内心脏标志POCT检测的室内质控100%开展,两个品牌共11台仪器中cardiac troponin I(c Tn I)、N-terminal prohormone of brain natriuretic peptide(NT-pro BNP)和D-二聚体的室内质控总不精密度和偏倚达到预期的质量管理目标。一致性比较显示两个品牌检测c Tn I和NT-pro BNP的结果与中心实验室的结果相关性良好,而D-二聚体的检测结果也具有一定可比性。结论证实通过探索和努力建立了切实可行的心脏标志物POCT院内管理体系,该体系能够保证POCT检测的稳定性和质量。

Objective The Point- of- care testing （POCT） for cardiovascular biomarkers is universally employed by emergency department due to the advantage of simple operation and rapid results. We introduced here the Fuwai hospital practice in in-hospital management of POCT for cardiovascular biomarkers. Methods After the standardized management of POCT was performed for three consecutive months, the data of internal quality control were collected and analyzed. Results The standardized internal quality control were implemented in all clinical units. The total imprecision and bias of Cardiac troponin I （ cTnI）, N- terminal prohormone of brain natriuretic peptide （ NT- proBNP） and D- dimerfrom from 11 POCT devices of two brands met our aim of POCT quality control. The two POCT for cTnI and NT-proBNP showed good correlations with auto-analyzer from clinical laboratory. For D-dimer analyst the moderate correlation was observed. Conclusion Fuwai＇s in-hospital management of POCT for Cardiovascular biomarkers is practical and efficient to guarantee the stability and quality of POCT.