利用室间质评回报结果对临床生化检验常规项目不确定度评定的方法探讨

目的采用A、B类评定方法，探索检验医学临床生化常规项目测量不确定度的评估方法。方法利用批内、批间变异、厂家提供的标准品不确定度以及2010～2012年室间质评数据来计算实验室主要常规生化项目的测量合成不确定度以及扩展不确定度。结果在构成不确定度的分量中，系统偏倚对不确定度的贡献量最大，其次为不精密度分量，再次为校准品分量。总胆红素、直接胆红素、尿素氮以及磷的不确定度均较高；三酰甘油、尿酸、肌酸激酶、镁等项目达到了比较理想的水平，其他项目均达到了合格的水平。结论该测量不确定度的评定方法简便易行，便于直观地表达不同因素对测量结果的影响程度，但是将其切实用于临床还需要更多的摸索。

Method study on evaluation of measurement uncertainty in clinical biochemical routine detection items by return report results of external quality assessment

Objective To adopt the type A and B evaluation methods to study the evaluation method of the measurement uncertainty of clinical biochemical routine test items. Methods The variations of within-run and be- tween-run,the uncertainty of the standard substance provided by manufacturers and the data of the external quality assessment（EQA） during 2010--2012 were adopted to calculated the combined and expanded uncertainties of the main routine clinical biochemistcal test items. Results Among the components constituting the uncertainty,the sys~ tematic bias contributed most to the measurement uncertainty, followed by the imprecision component and the calibra- tor component. The measurement uncertainties o{ TBil,DBil, BUN and phosphorus were higher~ TG, UA,CK and Mg reached the more ideal level, and the other items were qualified. Conclusion This evaluation method is simple, easy to operate and convenient to intuitively express the influence degree of different factors on the detection results,hut its practical application in clinic needs more exploration.