The widespread use of ion-selective electrode causes the reference range of the anion gap (AG) to be lowered from 8-16 to 3-11 mmol/l. The use of the outdated reference range (8-16 mmol/l) leads to the misinterpretation of the value of the anion gap. To interpret the anion gap accurately, one must use an analyzer-specific reference range. This study established the reference ranges of the electrolyte and anion gap in four ion-selective electrode analyzers. We collected clotted and lithium-heparinized blood from 124 healthy volunteers. We determined the electrolyte in the Beckman E4A (serum), Beckman Synchron CX5 (serum), and Nova CRT (serum and plasma). The anion gap was calculated from the formula: [Na(+)-(Cl(-)+HCO3(-))]. Blood sodium, potassium and bicarbonate were determined using the Nova Stat Profile Ultra. We used the plasma chloride from the Nova CRT to calculate the value of the anion gap in the Nova Stat Profile Ultra. We established the reference ranges using the non-parametric percentile estimation method. Accuracy and precision of the electrolyte performances obtained from all analyzers were acceptable. Reference values of serum and plasma sodium, potassium, and chloride were similar in all analyzers. The value of blood sodium obtained from the Nova Stat Profile Ultra was slightly higher than the values for the serum and plasma sodium obtained from the other analyzers. The bicarbonate ranges obtained from the Nova analyzers were higher than the values obtained from the Beckman analyzers. For the anion gap, the reference ranges in this study were low but similar to other studies (3-11 mmol/l) using ion-selective electrode. However, our reference ranges were lower than the previous reference ranges obtained from the continuous-flow analyzer (8-16 or 9-18 mmol/l) incorporated with flame photometry and colorimetry techniques.

译文

离子选择电极的广泛使用导致阴离子间隙 (AG) 的参考范围从8-16降低到3-11 mmol/l。使用过时的参考范围 (8-16 mmol/l) 会导致对阴离子间隙值的误解。要准确解释阴离子间隙,必须使用特定于分析仪的参考范围。这项研究确定了四种离子选择电极分析仪中电解质和阴离子间隙的参考范围。我们从124名健康志愿者中收集了凝结的和锂肝素化的血液。我们确定了Beckman E4A (血清),Beckman Synchron CX5 (血清) 和Nova CRT (血清和血浆) 中的电解质。阴离子间隙由以下公式计算: [Na(+)-(Cl(-)+ HCO3(-))]。使用Nova Stat Profile Ultra测定血钠,钾和碳酸氢盐。我们使用来自Nova CRT的等离子氯化物来计算Nova Stat Profile Ultra中阴离子间隙的值。我们使用非参数百分位估计方法建立了参考范围。从所有分析仪获得的电解质性能的准确性和精密度都是可以接受的。在所有分析仪中,血清和血浆钠,钾和氯化物的参考值相似。从Nova Stat Profile Ultra获得的血钠值略高于从其他分析仪获得的血清和血浆钠值。从Nova分析仪获得的碳酸氢盐范围高于从Beckman分析仪获得的值。对于阴离子间隙,本研究中的参考范围较低,但与使用离子选择电极的其他研究 (3-11 mmol/l) 相似。但是,我们的参考范围低于先前从结合火焰光度法和比色法技术的连续流分析仪 (8-16或9-18 mmol/l) 获得的参考范围。

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