两种方法对低清蛋白血症患者糖化清蛋白检测的影响

Effects of two methods on detection of glycosylated albumin in patients with hypoalbuminemia

目的探讨溴甲酚绿(BCG)法与改良溴甲酚紫(mBCP)法对低清蛋白血症患者糖化清蛋白(GA)检测的影响。方法选取西安交通大学第一附属医院2017年1月至2018年12月低清蛋白血症的患者21201例,检测其GA、清蛋白BCG、清蛋白mBCP的水平及清蛋白/球蛋白,分别计算GABCG、GAmBCP,分析比较两种方法检测结果的差异。结果在低清蛋白血症患者中,BCG法比mBCP法检测清蛋白平均水平高约2.22 g/L,GA%BCG低于GA%mBCP,平均偏差为-0.92%;随着清蛋白水平的降低,清蛋白BCG与清蛋白mBCP平均偏倚均增加;不同清蛋白水平中,两种方法检测得到的GA%一致性好,Kappa=0.783,GA%BCG与GA%mBCP有较强一致性;多重线性回归分析结果显示GA水平,血清清蛋白/球蛋白是两种方法GA%产生偏差的影响因素。结论在低清蛋白血症患者GA水平的检测中,与mBCP法比较,BCG法低估患者GA%的真实水平,其GA%多低于参考范围,因此糖尿病伴低清蛋白血症患者的GA水平的检测可能更适宜于采用mBCP法。

Objective To investigate the effect of bromocresol green(BCG)and modified bromocresol violet(mBCP)on the detection of glycosylated albumin(GA)in patients with hypoalbuminemia.Methods A total of 21201 patients with hypoalbuminemia in the First Affiliated Hospital of Xi′an Jiaotong University from January 2017 to December 2018 were selected.The levels of GA,albuminBCG,albuminmBCP and albumin/globulin were detected.GABCG and GAmBCP were calculated respectively,and the differences between the two methods were analyzed and compared.Results In patients with hypoalbuminemia,the average level of albumin detected by BCG method was 2.22 g/L,which was higher than that by mBCP method.The average deviation of GA%BCG was-0.92%,which was lower than that of GA%mBCP.With the decrease of albumin level,the average bias of albuminBCG and albuminmBCP increased;in different albumin levels,the consistency of GA%detected by two methods was good,Kappa=0.783,GA%BCG and GA%mBCP had strong consistency.Multiple linear regression analysis showed that the level of glycosylated albumin and albumin/globulin were the influencing factors of GA%deviation between the two methods.Conclusion In the detection of GA in patients with hypoalbuminemia,BCG method underestimates the true level of GA%in patients with hypoalbuminemia,and its GA%is lower than the reference range.Therefore,the detection of GA in diabetic patients with hypoalbuminemia may be more suitable for mBCP method.