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[临床实践中的实验室检查结果:在临床背景下解读的重要性]

[Laboratory results in clinical practice: importance of interpretation in the clinical context].

作者信息

Baumgartner Annic, Schuetz Philipp

机构信息

Endokrinologie/Diabetes/klinische Ernährung & Innere Medizin, Kantonsspital Aarau und Medizinische Universitätsklinik der Universität Basel.

出版信息

Ther Umsch. 2015 Feb;72(2):119-23. doi: 10.1024/0040-5930/a000653.

Abstract

Recently, a plenitude of novel laboratory tests has become available for physicians to improve the diagnostic and prognostic work up of patients. Yet, as with all tests, laboratory test can be falsely positive or falsely negative and potentially misguide clinicians and caregivers. Shortcomings of pre-analytical factors, test performance as well as an inappropriate ordering of laboratory tests contributes to diagnostic errors and potentially generate unnecessary costs. Laboratory tests should only be ordered, if results have clinical consequences and improve the assessment of the patient. Within this review focusing on the example of the inflammatory biomarker "Procalcitonin" for antibiotic stewardship and the hormonal marker testosterone, we aim to exemplify important draw backs and shortcomings in laboratory tests and the importance of interpretation of these results in the context of the clinical situation.

摘要

最近,大量新型实验室检查可供医生使用,以改善对患者的诊断和预后评估。然而,与所有检查一样,实验室检查可能出现假阳性或假阴性结果,从而可能误导临床医生和护理人员。分析前因素、检查性能的不足以及实验室检查的不当开具都会导致诊断错误,并可能产生不必要的费用。只有当检查结果具有临床意义并能改善对患者的评估时,才应开具实验室检查。在本综述中,我们以炎症生物标志物“降钙素原”用于抗生素管理以及激素标志物睾酮为例,旨在举例说明实验室检查中的重要缺陷和不足,以及在临床情况下解读这些结果的重要性。

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