间接法建立新疆克拉玛依地区常规肝功能和血脂生化项目参考区间

Establishment of reference intervals for routine liver function and blood lipid biochemical items in Karamay,Xinjiang by indirect method

目的采用间接法利用大数据建立新疆克拉玛依地区常规肝功能和血脂生化项目参考区间。方法收集新疆克拉玛依市中西医结合医院(市人民医院)2018-2020年体检人群数据,并对数据进行删减、去重、正态性检验、数据对数转换和离群值剔除。采用Z检验考察参考区间年龄和性别分区,应用非参数法计算参考区间,并以参考变化值(RCV)作为验证依据验证该研究中建立的参考区间可靠性。结果纳入分析的有效数据为:总蛋白(TP)27492例,丙氨酸氨基转移酶(ALT)60798例,天冬氨酸氨基转移酶(AST)37080例,甘油三酯(TG)30287例,总胆固醇(TC)35778例,高密度脂蛋白胆固醇(HDL-C)34194例,低密度脂蛋白胆固醇(LDL-C)33087例,白蛋白(ALB)37893例。ALT、AST和TG的参考区间存在性别差异(Z>Z*)。新疆克拉玛依地区常规肝功能和血脂生化项目参考区间为TP 69~85 g/L,ALB 41~51 g/L,TC 3.06~6.00 mmol/L,LDL-C<3.81 mmol/L,HDL-C 0.87~1.91 mmol/L;ALT男性为9~42 U/L、女性为7~39 U/L,AST男性为14~30 U/L、女性为12~28 U/L,TG男性为0.55~2.20 mmol/L、女性为0.47~2.10 mmol/L。除ALB外,其余指标参考区间与现行参考区间相比,均小于RCV。结论间接法建立的肝功能和血脂生化项目的参考区间简单、可靠,可在该地区实验室推广和应用。

Objective To establish reference intervals for routine liver function and blood lipid biochemical items in Karamay,Xinjiang by indirect method.Methods Collect the examination population data from^(2)018 to 2020 at Xinjiang Karamay Hospital of Integrated Traditional Chinese and Western Medicine(Karamay People′s Hospital),and perform deletion,deduplication,normality test,data logarithmic transformation,and outlier removal.The Z test was used to examine the age and gender partitions of the reference interval,and the non-parametric method was used to calculate the reference interval,and the reference change value(RCV)was used as a verification basis to verify the reliability of the reference interval established in this study.Results The valid data included in the analysis were 27492 cases of total protein(TP),60798 cases of alanine aminotransferase(ALT),37080 cases of aspartate aminotransferase(AST),30287 cases of triglyceride(TG),35778 cases of total cholesterol(TC),34194 cases of high density lipoprotein cholesterol(HDL-C),33087 cases of low density lipoprotein cholesterol(LDL-C),and 37893 cases of albumin(ALB).The reference intervals of ALT,AST and TG were different among different genders(Z>Z*).The reference intervals for routine liver function and blood lipids in Karamay were TP 69-85 g/L,ALB 41-51 g/L,TC 3.06-6.00 mmol/L,LDL-C<3.81 mmol/L,HDL-C 0.87-1.91 mmol/L;ALT 9-42 U/L for men,7-39 U/L for women;AST 14-30 U/L for men,12-28 U/L for women;TG 0.55-2.20 mmol/L for men,0.47-2.10 mmol/L for women.Compared with the current reference interval,the reference intervals of other indicators except ALB in this study were all smaller than RCV.Conclusion The establishment of reference interval by indirect method is simple and reliable,and can be popularized and applied in laboratories in this area.