Tietz N W, Rinker A D, Morrison S R
Department of Pathology and Laboratory Medicine, University of Kentucky Medical Center, Lexington 40536-0084.
Clin Chem. 1994 Apr;40(4):546-51.
Although serum iron determinations play an important role in the diagnostic process, the accuracy of routine methods is suspect. The poor performance of currently used methods is well documented in the quarterly College of American Pathologists survey reports. Compared with the 1990 method of the International Committee for Standardization in Haematology (ICSH), the 1978 ICSH Reference Method shows a +3.4% bias and the standard method of the National Committee for Clinical Laboratory Standards shows a -17.8% bias for iron results. All routine methods checked--DuPont aca, Abbott TDx, Kodak Ektachem (except one lot), BM/Hitachi 717, and Synermed--show a negative bias over the entire analytical range, a significant negative intercept, and extremely poor correlation with the 1990 ICSH method for iron values < 750 micrograms/L. Individual discrepancies of several hundred percent were observed. Imprecision of the methods is not the reason for these discrepancies. We question whether most routine methods measuring low iron concentrations provide results sufficiently reliable for confirmation of iron deficiency.
尽管血清铁测定在诊断过程中发挥着重要作用，但常规方法的准确性令人怀疑。美国病理学家学会的季度调查报告充分记录了当前使用方法的不佳表现。与1990年国际血液学标准化委员会（ICSH）的方法相比，1978年ICSH参考方法显示铁结果存在+3.4%的偏差，而美国国家临床实验室标准委员会的标准方法显示铁结果存在-17.8%的偏差。所有检查的常规方法——杜邦aca、雅培TDx、柯达Ektachem（除一批外）、BM/日立717和Synermed——在整个分析范围内均显示负偏差、显著的负截距，并且对于铁值<750微克/升的情况，与1990年ICSH方法的相关性极差。观察到了几百%的个体差异。方法的不精密度并非这些差异的原因。我们质疑大多数测量低铁浓度的常规方法所提供的结果是否足够可靠以确诊缺铁。
