Clinica Chimica Acta:血清渗透压方程的关键评价

2020-08-09 MedSci原创 MedSci原创

已经有许多研究评估了血清渗透压方程的预测准确性。使用三十种已发布的方程式和区域医院实验室的患者数据,比较了选择可用方程式的不同方法。

已经有许多研究评估了血清渗透压方程的预测准确性。使用三十种已发布的方程式和区域医院实验室的患者数据,比较了选择可用方程式的不同方法。

在2017年1月1日至2018年12月31日期间,在某地区医院实验室提取实验室记录,同样分析测定血清渗透压、钠、钾、尿素和葡萄糖。采用Passing-Bablok和difference (Bland-Altman)进行差异分析。通过三种方法进行了比较:散弹枪方法,调整偏差,以及利用多元分析推导一个新的方程。成功的标准包括偏差≤0.7%,230 - 400 mOsm/kg范围,和在±10 mOsm/kg范围内的渗透压间隙(OG) 95%的参考限值。

研究结果显示,大多数方程产生成比例的负偏结果。散弹枪方法识别了两个偏差≤0.7%的方程(EQ19, EQ6),但OG参考限制不可行。偏压调整方法产生了几个偏压≤0.7%的方程,OG参考限制在或等于±10 mOsm/kg。生成的新方程(1.89Na+ + 1.71 K+ + 1.08尿素+ 1.08葡萄糖+ 13.7)随着偏倚的调整而得到改善,并不优于已校正的公式。

很少有公开的方程式可立即使用。校正偏差可得出几个可用的方程,其中最佳OG范围<20 mOsm / kg。本研究表明,校正偏差可以生成与新方程式具有相同或更高性能的方程式。

原始出处:

Emmanuel O. Ebonwu,Susanna E. Nagel,Critical evaluation of equations for serum osmolality: Proposals for effective clinical utility

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    2020-11-22 windight
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    2020-08-11 huagfeg