Mackay Richard, George Peter, Kirk Jean
Clinical Biochemistry Unit, Canterbury Health Laboratories, Christchurch, New Zealand.
J Paediatr Child Health. 2006 Apr;42(4):160-4. doi: 10.1111/j.1440-1754.2006.00822.x.
Evolving diagnostic criteria for cystic fibrosis, broadening of the populations being tested and the need to interpret intermediate sweat test results have imposed a much greater need to standardize the collection and analysis of sweat.
To identify variations in sweat testing in New Zealand laboratories and compare these with guidelines from the UK and the USA.
All laboratories in New Zealand offering sweat testing were identified and data collected from these laboratories by structured questionnaire.
There were no New Zealand laboratories that conformed to either set of guidelines. Inconsistencies were observed in minimum sweat quantities, the nature of the iontophoresis solution, the sweat electrolytes analysed, quoted reference ranges and recommendations made as a consequence of the result.
Conformity to the guidelines would help to minimize variation in sweat testing in New Zealand. Performance of a sufficient number of tests to maintain expertise is critical, but geographical constraints make patient travel to distant centres difficult in a small, scattered population. A possible solution, where numbers permit, may be the collection of sweat locally, with referral to a major laboratory for analysis. This is only possible with adequate training in collection and follow-up audit of the sweat testing procedure both in the collection and in the analytical phase.
囊性纤维化诊断标准不断演变，检测人群范围不断扩大，且需要解读中间型汗液检测结果，这使得对汗液采集和分析进行标准化的需求大幅增加。
确定新西兰各实验室汗液检测的差异，并将这些差异与英国和美国的指南进行比较。
识别出新西兰所有提供汗液检测的实验室，并通过结构化问卷从这些实验室收集数据。
没有一家新西兰实验室符合任何一套指南。在最小汗液量、离子导入溶液的性质、分析的汗液电解质、引用的参考范围以及根据结果给出的建议等方面都存在不一致之处。
遵循这些指南将有助于减少新西兰汗液检测中的差异。进行足够数量的检测以保持专业水平至关重要，但在一个地域分散的小群体中，地理限制使得患者前往遥远的中心进行检测困难重重。在人数允许的情况下，一个可能的解决方案是在当地采集汗液，然后将样本送到大型实验室进行分析。这只有在采集阶段和分析阶段对汗液检测程序的采集和后续审核都进行充分培训的情况下才有可能实现。
