国际参考实验室能力验证样品的均匀性评价

摘要

Objective To evaluate the homogeneity of the proficiency test samples to verify whether it meets the requirements of the comparison in international reference laboratory.Methods According to the Guidance on Evaluating the Homogeneity and Stability of Samples Used for Proficiency Testing (CNAS-GL03),14 biochemical indexes including ALT,AST,ALP,GGT,CK,LDH,TP,T-Bil,Urea,Cr,UA,Glu,TG and TC in the past three years (from 2014 to 2016)were tested by the Roche detection system Modular P800 Biochemical analyzer.The mean ((x)),standard deviation (s)and coefficient of variation (CV)of the samples were calculated.One-way analysis of variance (ANOVA)was performed and the guideline of Ss ≤0.3σ was used to evaluate the between-bottle differences.Results The results showed that the CVs of AST in RELA 2014A and B were higher than 2.0％.The CVs of CK were over 2％ in all tests except for RELA 2016B.The results of ANOVA for RELA samples demonstrated that the F value of CK was over the critical value 4.39,which was statistically significant (P ＜ 0.05).The F values of the ALT and T-Bil in 2015B and the Cr in 2014A were also over 4.39 (P ＜ 0.05) respectively,while the F values of other measurements were less than the critical value of F,indicating there was no statistical significance (P ＞ 0.05).The CK measurement data Ss ＞ 0.3σ in all the samples by the guideline of Ss ≤ 0.3σ,suggesting that there was a between-bottle difference in CK.The other indexes were Ss ≤ 0.3σ,showing no between-bottle difference in those items.Conclusion There were significant differences between the bottles of the CK item in the past three years,and the homogeneity of all the other items in the samples could meet the requirements of Proficiency Testing for the international reference laboratory.%目的 评价国际参考实验室能力验证样品(RELA-A/B)的均匀性是否满足参考实验室比对的要求.方法 参照CNAS-GL03《能力验证样品均匀性和稳定性评价指南》,用Roche Modular P800生化分析仪测量2014至2016年连续3年RELA-A/B的14个项目,即丙氨酸氨基转移酶(A LT)、天冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、L-γ-谷氨酰基转移酶(GGT)、肌酸激酶(CK)、乳酸脱氢酶(LDH)、总蛋白(TP)、总胆红素(T-Bil)、尿素(Urea)、肌酐(Cr)、尿酸(UA)、葡萄糖(Glu)、三酰甘油(TG)、总胆固醇(TC).计算测量结果均值((x))、标准差(s)和变异系数(CV),用单因素方差分析和Ss≤0.3σ准则分析评价其瓶间差异.结果 RELA 2014A和2014B样品AST测量结果CV＞2.0％.除RELA 2016B样品CK测量结果CV＜2.0％外,其他样品CK测量结果CV均＞2％.单因素方差分析结果显示,所有样品中CK测量结果F均＞临界值4.39,差异有统计学意义(P ＜0.05);2015B样品ALT和T-Bil,2014A样品Cr测量结果F均＞临界值4.39,差异有统计学意义(P＜0.05);其他测量结果F均＜临界值4.39,差异无统计学意义(P＞0.05).Ss≤0.3σ准则分析结果显示,所有样品CK测量结果Ss ＞0.3σ,CK测量结果存在瓶间差异;其他项目测量结果Ss均≤0.3σ,其他项目测量结果无瓶间差异.结论 国际参考实验室能力验证样品CK项目存在瓶间差异,值得注意;其他项目均匀性能满足参考实验室能力验证要求.