非配套生化检测系统酶类项目吸光度阈值与自动稀释重测设定的临床应用

Clinical application of absorbance threshold and retesting setting of automatic dilution of enzyme item test of non-matching biochemical analytic system

目的:临床检验中通过在非配套生化检测系统设定酶类项目的吸光度阈值和自动稀释重测,使超过该检测系统测定线性上限的检测结果能够自动拦截并自动稀释重测,杜绝异常高值结果的漏检和误检。方法:选取接近试剂说明书提供线性上限的丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰基转肽酶(GGT)、碱性磷酸酶(ALP)、乳酸脱氢酶(LDH)以及α-羟丁酸脱氢酶(HBDH)和肌酸激酶(CK)7个酶类项目检测样本各10份进行检测,读取吸光度值,并以此为依据设定吸光度阈值参数;另选取并检测大于线性上限样本各30份,确认超过线性的结果是否被有效识别;设置自动稀释重测参数,并进行手工稀释和仪器自动稀释结果的比较,分析两种稀释方式结果的差异性。结果:正确设置吸光度阈值分别为ALT(0.80)、AST(0.85)、GGT(1.80)、ALP(1.40)、LDH(0.60)、HBDH(1.35)和CK(3.00),仪器自动识别所有超线性上限的结果并附带警示标志上升反应(u)或下降反应(d)。同一样本手工稀释和仪器稀释结果比较,差异均无统计学意义,其结果一致。结论:通过吸光度阈值的设定和应用,有效拦截、标识超过线性上限酶类结果,结合自动稀释重测,得到准确可靠检测结果的同时提高工作效率;实现对非配套生化检测系统酶类项目反应过程的监控。

Objective:To set absorbance threshold and retesting setting of automatic dilution in clinical examination through non-matching biochemical analytic system so as to take the detection results that exceed to the linear upper limit of this detecting system to automatically hold up and automatically dilute and retest for complete eradicating the leak detection and false detection of the abnormally high value.Methods:10 detection samples,which approached linear upper limit,of each classification of 7 enzyme items included alanine aminotransferase(ALT),aspartate aminotransferase(AST),γ-glutamyl transpeptidase(GGT),alkaline phosphatase(ALP),lactic dehydrogenase(LDH),α-hydroxybutyric acid(HBDH)and creatine kinase(CK)were selected to implement detection and read absorbance value.And these values were used as basis to set parameters of absorbance threshold value.Besides,30 samples which were larger than linear upper limit were selected and detected so as to determine whether the results that exceeded to linear upper limit could be effectively recognized.The retested parameters of automatic dilution were set,and the results of manual dilution and automatic dilution were further compared,and the difference of the results between the two dilution methods were analyzed.Results:After the absorbance threshold values of ALT,AST,GGT,ALP,LDH HBDH and CK were correctly set as 0.80,0.85,1.80,1.40,0.60,1.35 and 3.00,the machine could automatically recognize the results of all linear upper limit and could attach ascending reaction(u)or decline reaction(d)of warning mark.The difference of same sample between manual dilution and instrument dilution was no significant,and the results of them were coincidence.Conclusion:By setting and applying the absorbance threshold value,all results of enzymes that exceeds the linear upper limit can be effectively held up and identified,and the work efficiency can be increased when accurate and reliable detection results are obtained by combining automatic dilution retest.And the supervisory control on the reaction process of enzymes item of non-matching biochemical analytic system can be realized.