运用间接法建立杭州地区血清钾、钠、氯、钙、镁、磷的参考区间

Establishing of the reference intervals of serum K,Na,Cl,Ca,Mg and P in Hangzhou by indirect method

目的运用间接法建立杭州地区血清钾、钠、氯、钙、镁、磷的参考区间,与行业标准推荐的参考区间进行比较,探究间接法的可靠性,并为地区人群参考区间的建立提供参考。方法选用2016年本院体检人群数据,利用偏度-峰度值检验数据的正态性,若非正态则使用BOX-COX转换成近似正态,四分位距法剔除离群值后用Hoffmann法获得参考区间,计算同直接法的偏差,与各项目参考变化值(RCV)进行比较,并用20例体检结果正常的个体进行参考区间的验证。结果间接法建立6个项目钾、钠、氯、钙、镁、磷的参考区间相对偏差均<RCV(<13. 13%、2. 87%、4. 17%、8. 16%、11. 99%、23. 50%),通过20例健康个体验证了间接法得到的参考区间。结论运用间接法建立的参考区间同直接法比较差异无统计学意义,具有一定的参考价值,考虑到地区因素,间接法可用于地区实验室对该地区的人群建立适合自身的参考区间。

Objective To establish reference intervals of serum K, Na, C1, Ca, Mg and P in Hangzhou by indirect method and to explore the reliability by comparing it with the industry standard reference interval. Methods The data were extracted from health examination in 2016. Skewness - Kurtosis test was used to detect the normality of data, the original data was transformed through Box - Cox transformation to obtain an approximate normal distri~）ution if it was not normal distribution. The outliers were identified and omitted by Turkey method and the indirect reference intervals were calculated with Hoffmann method. The reference change value（RCV） was selected to investigate the statistical significance between the calculated and industry standard reference intervals. Then the serums from 20 healthy individuals were tested to verify the reference intervals. Results The differences between the reference intervals of these indices, including the K, Na, C1, Ca, Mg and P, were less than their RCV （ 〈 13.13% , 2.87%, 4.17% , 8.16% , 11.99% , 23.50% ）. The reference intervals were validated by 20 healthy individuals. Conclusion There is no significant difference between the indirect method and direct method. The indirect method has a certain value on establishing the reference intervals. It can be used by regional laboratory in a certain area.