影响肌酸激酶同工酶活性检测结果的因素探讨  

A preliminary study on factors influencing the outcomes of activities of CK-isozyme

作　　者：郑婉君[1] 邓敏茹 翁丽[1] 

机构地区：[1]广东省汕头市第二人民医院检验科,515011

出　　处：《国际检验医学杂志》2006年第5期407-408,415,共3页International Journal of Laboratory Medicine

摘　　要：目的探讨应用酶免疫抑制法检测血清肌酸激酶（CK）同工酶——CK—MB酶活力单位时，引起临床假阳性的因素，以科学合理地解释每一检测结果及解决方法。方法采用回顾性研究，分析125例非心肌梗死患者，应用酶免疫抑制法检测血清标本中CK、CK—MB酶活力单位，分析可能引起检测值CK—MB酶活力单位假性升高的影响因素。结果86例成人非心肌梗死患者中，总CK活力相对较低，癌症患者、脑梗死患者、变态反应疾病患者CK—MB假阳性比例较大，其中CK—MB占CK总活力大于5％有59例，其中53例在6％～21％，6例大于38％；38例新生儿中CK活性范围为145～1974U／L，其中1例新生儿呼吸窘迫综合征患儿CKMB占CK总活力达90％；另1例溶血标本也引起假阳性。结论应用酶免疫抑制法检测非心肌梗死患者CK—MB酶活力单位假性升高的影响因素，可能是血清中存在巨CK、CK—BB、AK等，影响试剂单克隆抗体与肌酸激酶中的M亚基结合，存在未被抑制的CK—M、M亚基同时与B亚基参加酶促反应，而且因计算时结果乘以2，更加扩大误差，是该方法学缺点造成的错误结果，不能作为诊断依据。Objective To study the false positive of enzyme linked immunoinhibition continuous assays to detect CK-MB in clinic, to reasonably explain the results of detection and to get correctly the project of solving. Methods A total of 125 serum specimen of non-myocardial infarction patients were detected by enzyme linked immunoinhibition continuous assays,in retrospective study. To analyze the factors which made the CK-MB enzymatic activity unit pseudo rising. Results Total CK-MB enzymatic activity was low in 86 serum specimen of adult patients with non-myocardial infarction,but in the patients with tumor, encephalie infarction and allergic disorder the pseudo-positive ratio of the CK-MB enzymatic activity was high, There were ,53 cases, in which CK-MB activity accounted for 6%-21% enzymatic activity of CK, and 6 cases accounted for more than 38% in 59 cases in which the CK-MB activity was more than 5% enzymatic activity of CK. In 38 neonate cases, the enzymatic activity of CK ranged from 145U/L to 1974U/L,In 1 case of neonatal respiratory distress syndrome CK-MB activity accounted for more than 90% enzymatic activity of CK. Another haemolytic sample led to false positive result. Conclusion The phenomenon of enzymatic activity rising in the serum specimen of non-myocardial infarction patients may be caused by the factors of lots CK, CK-BB and AK in serum. Those materials maybe have effects on the action between McAb and M subunit of the CK. Some non-inhibit CK-M and the M subunit with B subunit may participate the enzymatic activity together. Because of the shortcoming of method, the single assay should not be taken as the diagnostic basis.

关 键 词：肌酸激酶 免疫抑制法 

分 类 号：R446.6[医药卫生—诊断学]