开发一种自动实验室计算机标记系统，以识别可能受到抗原过剩影响的尿液白蛋白样本（“钩状效应”）。
Development of an automatic laboratory computer flagging system to identify urine albumin samples potentially affected by antigen excess ('hooking').
机构信息
Clinical Pathology, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK.
出版信息
Ann Clin Biochem. 2012 May;49(Pt 3):289-91. doi: 10.1258/acb.2011.011210. Epub 2012 Apr 5.
BACKGROUND
Immunoassays for urinary albumin are often subject to the problem of antigen excess (the 'hook' effect) at high albumin concentrations. We developed an automated protocol to identify such samples based on urinary albumin to creatinine ratio (uACR) and urinary total protein (uTP) results.
METHODS
An automated flagging system was designed and written into the laboratory computer system to alert technical staff to samples potentially affected by the 'hook effect'. This flag was activated when there was a combination of an uTP of ≥2400 mg/L and an uACR of <30 mg/mmol.
RESULTS
The potential rate of false-negative uACR results was approximately 0.17% in samples from primary care and diabetic clinic sources.
CONCLUSIONS
Samples with falsely low uACR results were identified, allowing the vast majority of results to be authorized without intervention. The protocol prevented the reporting of false-negative uACR results which might impact on the management of patients.
背景
尿液白蛋白免疫测定法在检测高浓度白蛋白时经常受到抗原过量（“钩状”效应）的问题的影响。我们开发了一种基于尿白蛋白与肌酐比值（uACR）和尿总蛋白（uTP）结果的自动方案来识别此类样本。
方法
设计了一个自动标记系统并将其写入实验室计算机系统，以提醒技术人员注意可能受到“钩状”效应影响的样本。当 uTP 大于等于 2400mg/L 且 uACR 小于 30mg/mmol 时，此标记会被激活。
结果
初级保健和糖尿病诊所来源的样本中，假阴性 uACR 结果的潜在发生率约为 0.17%。
结论
识别出了具有假性低 uACR 结果的样本，从而允许绝大多数结果在无需干预的情况下获得授权。该方案防止了可能影响患者管理的假阴性 uACR 结果的报告。
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