摘要
目的探讨血清肌酐(Scr)现行参考区间(采用2015年卫生行业标准)和原参考区间(采用第三版临床检验操作规程)的临床应用价值。方法收集2019年2月至4月在河北医科大学第一医院就诊的360例年龄在20~79岁(其中20~59岁男性90例,20~59岁女性90例,60~79岁男性90例,60~79岁女性90例)门诊和住院患者作为研究对象。采集研究对象血标本,测定胱抑素C的浓度,结合Scr浓度,以估算的肾小球滤过率(eGFR)结果作为标准进行判断。通过卡方检验对肌酐新旧参考区间判断的结果与eGFR的符合情况进行统计学分析。结果在360例20~79岁人群中,血清Scr与eGFR结果的总符合率:现行参考区间83.40%,原参考区间77.00%,前者符合率明显高于后者(P=0.03)。其中214例eGFR异常结果符合率:现行参考区间94.86%,原参考区间41.59%,前者符合率明显高于后者(P<0.01);146例eGFR正常结果符合率为:现行参考区间74.66%,原参考区间99.32%,后者符合率明显高于前者(P<0.01)。在20~59岁女性人群、20~59岁男性人群和60~79岁女性人群中显示与上述一致的结果;在60~79岁男性人群中,Scr与eGFR判断结果的总符合率:现行参考区间75.56%,原参考区间88.89%,后者符合率明显高于前者(P=0.01);二者异常结果符合率:现行参考区间57.69%,原参考区间98.08%,后者符合率明显高于前者(P<0.01);二者正常符合率:现行参考区间100%,原参考区间76.32%,前者符合率明显高于后者(P<0.01)。结论现行参考区间对肾小球滤过率下降的筛查能力优于原参考区间,更有利于肾功能轻度下降患者的早期识别。但是在60~79岁男性人群中,现行参考区间的准确性和对肾小球滤过率下降的筛查能力均差于原参考区间。
Objective Explored the clinical application value of the current reference interval of serum creatinine(using the 2015 health industry standard)and the original reference interval(using the third edition of the clinical laboratory operating procedures).Methods This paper is a retrospective study.The study collected 360 normal serum samples of the adults who visited the First Hospital of Hebei Medical University from February to April 2019 and,aged 20-79 years old(including 90 males aged 20-59,90 females aged 20-59,90 males aged 60-79,and 90 females aged 60-79).The concentration of cystatin C was determined in the above specimens,combined with the concentration of creatinine,and the results calculated by the Glomerular Filtration Rate Estimation Formula(eGFR)was used as the standard for judgment.In this study,the chi-square test was used to statistically analyze the agreement between the results of the new and old reference intervals of creatinine and the results calculated by the eGFR formula.Results The total coincidence rate of Scr and eGFR in 360 adults aged 20-79 years was 83.40% in the current RI,and 77.00% in the original RI.The coincidence rate of the former was significantly higher than that of the latter(P=0.03).The positive coincidence rate of Scr and eGFR(214 patients with eGFR positive)was 91.86% in current RI,41.59% in the original RI,the coincidence rate of the former was significantly higher than that of the latter(P<0.01).The negative coincidence rate of Scr and eGFR(146 patients with eGFR negative)was 74.66% in current RI,and 99.32% in original RI,the coincidence rate of the latter was significantly higher than that of the former(P<0.01).Consistent results were shown in groups of males aged 20-59,females aged 20-59 and females aged 60-79.However,in the group of males aged 60-79 years,the total coincidence rate of Scr and eGFR was 75.56% in current RI,and 88.89% in original RI,the coincidence rate of the latter was significantly higher than that of the former(P=0.01);positive coincidence rate of Scr and eGFR was 57.69% in current RI,and 98.08% in original RI,the coincidence rate of the latter was significantly higher than that of the former(P<0.01);negative coincidence rate of Scr and eGFR was 100.0% in current RI,and 76.32% in original RI,the coincidence rate of the former was significantly higher than that of the latter(P<0.01).Conclusions The current reference interval is better than the original reference interval in screening for decreased glomerular filtration rate,and it is favorable for the early detection of patients with mildly decreased renal function.However,among males aged 60-79 years old,the accuracy of the current RI and the ability to screen for decreased glomerular filtration rate are inferior to the original RI,which needs to be further observed and studied.
作者
武艳
秘玉静
闫会敏
白雪梅
周君瑞
闫国超
Wu Yan;Mi Yujing;Yan Huimin;Bai Xuemei;Zhou Junrui;Yan Guochao(Department of Clinical Laboratory,First Hospital of Hebei Medical University,Shijiazhuang 050031,China)
出处
《中华检验医学杂志》
CAS
CSCD
北大核心
2021年第3期217-221,共5页
Chinese Journal of Laboratory Medicine
关键词
血清肌酐
参考区间
肾小球滤过率
Serum creatinine
Reference interval
Glomerular filtration rate
