摘要
目的比较慢性肾脏疾病(CKD)患者和健康对照人群血清脂蛋白(a)[Lp(a)]颗粒浓度与质量浓度检测结果的差异,并分析二者结果偏差的分布情况。方法连续选取2018年6月至2019年12月东部战区总医院的CKD患者196例和健康对照者97名,分别检测其血清Lp(a)颗粒浓度和质量浓度;Lp(a)颗粒浓度参考上限为75 nmol/L、质量浓度参考上限为300 mg/L;比较各组中Lp(a)颗粒浓度与质量浓度检测结果阳性率的差异;依据CKD患者Lp(a)质量浓度的四分位数将其等分为4个亚组,进一步比较各亚组中2种方法检测结果的差异。结果CKD组血清Lp(a)颗粒浓度[25.7(10.5,75.4)nmol/L比19.2(8.1,50.2)nmol/L,P=0.021]与质量浓度[157(64,432)mg/L比127(50,274)mg/L,P=0.023]均高于健康对照组。CKD组中Lp(a)颗粒浓度的阳性率显著低于质量浓度阳性率[25.0%(48/196)比37.2%(73/196),P=0.009],对照组中Lp(a)颗粒浓度阳性率与质量浓度阳性率差异无统计学意义[18.6%(18/97)比22.7%(22/97),P=0.478]。CKD组中Lp(a)质量浓度的高估率高于对照组[12.8%(25/196)比4.1%(4/97),P=0.020];CKD组亚组3[即Lp(a)质量浓度为157.00~432.25 mg/L]的Lp(a)颗粒浓度阳性率明显低于质量浓度阳性率[4.1%(2/49)比49.0%(24/49),P<0.001],且亚组3的Lp(a)质量浓度高估率[44.9%(22/49)]也高于其他3个亚组(P均<0.001);依据Lp(a)颗粒浓度试剂说明书提供的转换因子,将其检测结果转化为质量浓度,以四分位数分组的CKD患者其实际测得的Lp(a)质量浓度结果均高于Lp(a)颗粒浓度转换后的质量浓度结果(P均<0.05)。结论CKD患者中血清Lp(a)颗粒浓度检测的阳性率显著低于质量浓度阳性率,Lp(a)质量浓度检测存在明显的高估偏差。
Objective To compare the difference between serum lipoprotein(a)[Lp(a)]particle concentration and mass concentration in chronic kidney disease(CKD)patients and healthy controls,and to analyze the concentration distribution of the deviations between the two measurement methods.Methods Serum Lp(a)particle concentration and mass concentration were respectively detected in 196 patients with CKD and 97 healthy controls from Eastern Theater General Hospital during June 2018 to December 2019.The upper limit of reference value for Lp(a)particle concentration was set as 75 nmol/L and the upper limit of reference value for mass concentration was set as 300 mg/L,the difference on the positive rates of Lp(a)particle concentration and mass concentration in each group were compared.According to the quartile of Lp(a)concentration in patients with CKD,the patients were divided into 4 groups,and the results derived from the two methods were compared among groups.Results Serum Lp(a)particle concentration(25.7[10.5,75.4]nmol/L vs 19.2[8.1-50.2]nmol/L,P=0.021)and mass concentration(157[64,432]mg/L vs 127[50-274]mg/L,P=0.023)were significantly higher in patients with CKD than those in healthy controls.The positive rate of Lp(a)particle concentration was significantly lower than that of mass concentration(25.0%[48/196]vs 37.2%[73/196],P=0.009)in CKD patients.The positive rate of Lp(a)particle concentration and mass concentration was similar in healthy controls(18.6%[18/97]vs 22.7%[22/97],P=0.478).The overestimation rate of Lp(a)mass concentration in CKD patients was significantly higher than that in healthy controls(12.8%[25/196]vs 4.1%[4/97],P=0.020).Lp(a)mass concentration of groupⅢin CKD patients was between 157.00-432.25 mg/L,the positive rate of Lp(a)particle concentration was significantly lower than that of mass concentration(4.1%[2/49]vs 49%[24/49],P<0.001),and the overestimation rate(44.9%[22/49])of Lp(a)mass concentration in this group was also the highest(all P<0.001).According to the conversion factor provided by the reagent manual of Lp(a)particle concentration,the test results were converted into mass concentration.The actual mass concentration of Lp(a)in CKD patients grouped by quartile was significantly higher than that after Lp(a)particle concentration conversion(all P<0.05).Conclusions The positive rate of serum Lp(a)particle concentration is significantly lower than that of mass concentration in CKD patients and the obvious overestimation deviation of Lp(a)mass concentration is observed in this analysis.
作者
印中鹏
吴嘉
汪俊军
Yin Zhongpeng;Wu Jia;Wang Junjun(Departement of Clinical Laboratory,Eastern Theater General Hospital of PLA,Nanjing 210002,China)
出处
《中华检验医学杂志》
CAS
CSCD
北大核心
2021年第7期596-601,共6页
Chinese Journal of Laboratory Medicine
基金
国家自然科学基金(81572074,81871702)。
