肌氨酸氧化酶法和碱性苦味酸速率法检测血清肌酐结果比较和偏倚评估  

Comparision and bias analysis of enzymatic and jaffe kinetic methods for the serum creatinine determination

作　　者：黄霞梅[1] 伍惠玲[1] 钟慧芝[1] 李海炜[1] 秦雪[1] 李山[2] 

机构地区：[1]广西医科大学第一附属医院临床医学实验部,南宁530021 [2]广西医科大学医学检验系,南宁530021

出　　处：《重庆医学》2011年第33期3372-3374,I0002,共4页Chongqing medicine

基　　金：广西卫生厅科研课题(z2008158)

摘　　要：目的比较肌氨酸氧化酶法和碱性苦味酸速率法测定血清肌酐的结果,并探讨胆红素对两种测定方法的影响。方法同时用两种方法检测非黄疸标本和黄疸标本,对测定结果用Excel2003和SPSS13.0软件进行处理。结果两种方法检测血清肌酐结果高度相关,有很好的可比性(P<0.05),但碱性苦味酸速率法的测定结果比肌氨酸氧化酶法高。两种方法测定肌酐结果有恒定偏倚,且预期偏倚随肌酐浓度的降低而增大。用黄疸患者血清标本进行比较,肌氨酸氧化酶法和碱性苦味酸速率法测定结果仍具有很好的相关性(P<0.05)。用粉剂总胆红素标准品作为干扰物发现胆红素对两种方法检测血清肌酐值均有正干扰,而换Beckman总胆红素标准液则得出结果为两种方法均不受胆红素的影响。结论两种方法检测非黄疸血清肌酐结果具有很好的可比性,因其方法原理和仪器不同,肌酐测定需建立不同参考值范围。Objective To compare the results of serum creatinine detected by both Enzymatic and Jaffe kinetic methods, and study the impact of jaundice serum on two determination methods. Methods Non-jaundice serum and jaundice serum were detected respectively by both Enzymatic assay and Jaffe kinetic assay with automatic biochemical analyzer Hitachi 7600 and Beckman Coulter LX20. The results were analyzed by SPSS13.0 and Excel2003. Results The results of the serum creatinine detected by the two methods were highly relevant and having commendable comparability（P^0.05） ,but the results of Jaffe kinetic assay were higher than those of Enzymatic assay. There were constant bias between Enzymatic assay and Jaffe kinetic assay for detecting serum ereati- nine,and the expected bias decreased with the increase of creatinine concentration. When use jaudice serum for experiment, the re- sults of the serum creatinine detected by the two methods still were of good relevant. Interference experiment with powder bilirubin standards as interference substance in two methods presented that bilirubin had positive impact on creatinine determination. How ever,we found bilirubin had no interference in both methods when using Beckmanrs bilirubin standard as interference substance. Conclusion The two methods of detecting serum creatinine had good comparability. Ascribed to different methods and analyzers, refe fence range for creatinine should be established correspondingly.

关 键 词：肌氨酸氧化酶 碱性苦味酸速率法 血清肌酐 比对 

分 类 号：R446.1[医药卫生—诊断学]