Nishida T
Clinical Laboratory, University of Tokushima, School of Dentistry.
Rinsho Byori. 1998 Aug;46(8):774-82.
Various characteristic clinical laboratory testing data related to clinical chemistry were collected from 11 institutes across the nation, and age-related clinical reference values, reference intervals and within-subject biological variations were calculated. Using these calculated results, characterization of aged-related reference ranges and the method of determining an aged subject's testing values were investigated. From these results, the following facts became clear. Estimation of health-associated reference intervals for aged subjects was very difficult. As the aged subject's reference values differ remarkably by sex and age on several test items, sex- and age-related clinical reference values are necessary. In case of the mass screening survey which utilizes preceding healthy values, we should decide by within-subject biological variation. We usually use reference ranges to decide whether the measured values are located within these ranges, and must use a differential value to speculate regarding a particular disease. These results indicate that multiple standard must be prepared for each clinical laboratory testing value, and that it is ideal to be able to select a suitable standard for the subjects state. To select a suitable standard clinically, we need an expert system. For this purpose, much more basic data concerning reference ranges, differential values and so on must be accumulated.
从全国11家机构收集了各类与临床化学相关的特征性临床实验室检测数据，并计算了与年龄相关的临床参考值、参考区间和个体内生物学变异。利用这些计算结果，研究了与年龄相关的参考范围的特征以及确定老年受试者检测值的方法。从这些结果中，以下事实变得清晰起来。估计老年受试者与健康相关的参考区间非常困难。由于老年受试者的参考值在几个检测项目上因性别和年龄差异显著，因此需要与性别和年龄相关的临床参考值。在利用既往健康值进行大规模筛查调查的情况下，我们应该根据个体内生物学变异来决定。我们通常使用参考范围来判断测量值是否在这些范围内，并且必须使用差值来推测特定疾病。这些结果表明，必须为每个临床实验室检测值准备多个标准，并且能够为受试者的状态选择合适的标准是理想的。为了在临床上选择合适的标准，我们需要一个专家系统。为此，必须积累更多关于参考范围、差值等的基础数据。
