| 摘要: |
| 目的评价床旁检测(POCT)法检测心肌标志物的分析性能,为床旁检测选择方法提供参考。方法收集40例住院患者的血浆样本,用6种方法检测血浆肌红蛋白(Mb)、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(CTnI)的浓度,并以实验室Abbott化学发光法为标准,比较5种POCT法的分析性能,并评价其检测系统的批内精密度。结果与Abbott化学发光法比较,Getein 1100检测系统(荧光免疫定量)所测Mb、CK-MB、CTnI的符合率分别为84.6%、76.9%、53.8%,Kappa值分别为0.58、0.52、0.13;ZYbio-Q7检测系统(免疫层析法)所测Mb、CK-MB、CTnI的符合率分别为84.6%、92.3%、61.5%,Kappa值分别为0.58、0.84、0.27;Triage检测系统(荧光免疫定量)所测Mb、CK-MB、CTnI的符合率分别为87.5%、95.0%、80.0%,Kappa值分别为0.75、0.89、0.58;NRM-cl-200检测系统(化学发光法)所测Mb、CK-MB、CTnI的符合率分别为92.5%、75.0%、92.5%,Kappa值分别为0.85、0.53、0.85;AQT90检测系统(时间分辨免疫荧光法)所测Mb、CK-MB、CTnI的符合率分别为92.5%、92.5%、90.0%,Kappa值分别为0.85、0.84、0.80。Getein 1100、ZYbio-Q7、Triage、NRM-cl-200、AQT90各检测系统所测Mb的批内精密度分别为0.51%、1.38%、1.31%、1.87%、0.96%,所测CK-MB的批内精密度分别为3.23%、9.51%、3.54%、4.42%、2.12%,所测CTnI的批内精密度分别为4.56%、5.78%、6.47%、14.29%、2.29%。结论 5种POCT法之间检测结果存在差异,作为心肌标志物的POCT检测方法,国产试剂有必要进一步改进方法提高其敏感性。应尽量选择与实验室内大型分析仪检测结果保持一致的POCT检测系统,减少不必要的误诊、漏诊。 |
| 关键词: 床旁检测 心肌标志物 化学发光 评价研究 |
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| Comparison of Five POCT Methods and Abbott Chemiluminescence in Detecting Myocardial Markers |
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Xu Guoqiang;Kang Qingxiu1,2
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1.Li Wenkai;2.Suining Central Hospital
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| Abstract: |
| Objective To evaluate the performance of POCT in the detection of myocardial markers and provide a reference for the selection of bedside detection.Methods The plasma samples from 40 inpatients were collected and the plasma concentrations of Mb,CK-MB and CTnI were measured by six methods.Chemiluminescence was used as a standard to compare the analytical performance of five POCT methods and to evaluate the in-batch precision of the detection system.Results Compared with Abbott chemiluminescence method,the coincidence rates of Mb,CK-MB and CTnI in Getein 1100 detection system( fluorescence immunoassay method) were 84. 6%,76. 9% and 53. 8%respectively.The Kappa values were 0. 58,0. 52 and 0. 13 respectively. The coincidence rates of Mb,CK-MB and CTnI measured by ZYbio-Q7 detection system( immunochromatography method) were 84. 6%,92. 3% and 61. 5%respectively.The Kappa values were 0. 58,0. 84 and 0. 27 respectively.The coincidence rates of Mb,CK-MB and CTnI were 87. 5%,95. 0%,80. 0% and Kappa values were 0. 75,0. 89 and 0. 58 respectivelyin Triage detection system( fluorescence immunoassay method).The coincidence rates of Mb,CK-MB and CTnI were 92. 5%,75. 0% and 92. 5% respectivelyand the Kappa valueswere 0. 85,0. 53 and 0. 85 respectively in the NRM-cl-200 detection system( chemiluminescence method).The coincidence rates of Mb,CK-MB and CTnI were 92. 5%,92. 5%,90. 0% respectively and the Kappa valueswere 0. 85,0. 84 and 0. 80 respectively in the AQT90 detection system( time-resolved immunofluorescence method). The in-batch precision of Mb measured by Getein 1100,ZYbio-Q7,Triage,NRM-cl-200 and AQT90 was 0. 51%,1. 38%,1. 31%,1. 87% and 0. 96% respectively. The inbatch precision of CK-MB was 3. 23%,9. 51%,3. 54%,4. 42% and 2. 12% respectively. The in-batch precision of CTnI was 4. 56%,5. 78%,6. 47%,14. 29% and 2. 29%,respectively.Conclusion The detection results of the five POCT methods are different.As the POCT detection method of myocardial markers,it is necessary for domestic reagents to improve the sensitivity of the method and try to choose POCT detection system which test results are consistent tolarge laboratory analyzer so as to reduce unnecessary misdiagnosis or missed diagnosis |
| Key words: bedsidedetection cardiacmarkers chemiluminescence evaluationstudies |
