不同方法检测外周血醛固酮的情况分析

Analysis of different methods for detecting peripheral blood aldosterone

目的比较化学发光法与高效液相色谱-串联质谱法(简称质谱法)检测高血压患者外周血醛固酮水平的一致性,并建立质谱法检测健康成人立位外周血醛固酮水平的参考值范围。方法采用来自3个厂家的化学发光法和质谱法检测42例健康成人、102例高血压患者外周血醛固酮水平,采用Spearman相关分析评价这4种方法检测结果的相关性;采用Bland-Altman评价这4种方法检测结果的一致性。结果不同方法检测外周血醛固酮水平存在明显差异(P<0.05),质谱法与3个厂家的化学发光法检测的外周血醛固酮水平呈正相关(r=0.876、0.885、0.945,P<0.05),Bland-Altman分析表明3个厂家的化学发光法与质谱法检测外的周血醛固酮水平不具有一致性。以P 2.5~P 97.5建立质谱法检测成人立位血醛固酮水平的参考值范围为5.73~76.29 pg/mL。结论检测外周血醛固酮水平时,不同的检测方法存在较大差异,即便是同一种检测方法,由于仪器和试剂的生产厂家不同,检测结果也不一致。

Objective To compare the consistency of chemiluminescence and high performance liquid chromatography-tandem mass spectrometry(mass spectrometry)in detecting peripheral blood aldosterone levels in hypertensive patients,and to establish a reference range for mass spectrometry to detect aldosterone levels in healthy adults.Methods Chemiluminescence and mass spectrometry from 3 manufacturers were used to detect peripheral blood aldosterone levels in 42 healthy adults and 102 hypertensive patients;Spearman was used to evaluate the correlation of these four methods;Bland-Altman was used to evaluate the consistency of these four methods.Results There were significant differences in the detection of aldosterone levels in peripheral blood by different methods(P<0.05).Mass spectrometry was positively correlated with the chemiluminescence method of 3 manufacturers in the detection of aldosterone levels in peripheral blood(r=0.876,0.885,0.945,P<0.05).Bland-Altman analysis showed that the chemiluminescence method and mass spectrometry of the three manufacturers were not consistent in the detection of aldosterone levels in peripheral blood.The reference value range of P 2.5-P 97.5 to establish mass spectrometry to detect adult orthostatic blood aldosterone level was 5.73-76.29 pg/mL.Conclusion When detecting the level of aldosterone in peripheral blood,different detection methods are quite different.Even if the same detection method is used,the detection results are not consistent due to different manufacturers of instruments and reagents.