同位素稀释质谱法、酶法和碱性苦味酸法测定血清肌酐方法比较  

Methodology comparison of serum creatinine determined by isotope dilution liquid chromatography tandem mass spectrometry,enzymatic method and Jaffe method

作　　者：宋云霄[1] 欧美贤[2] 李水军[2] 张海晨[1] 余琛[2] 

机构地区：[1]上海市徐汇区中心医院检验科,上海200031 [2]上海市徐汇区中心医院中心实验室,上海200031

出　　处：《检验医学》2013年第8期698-703,共6页Laboratory Medicine

基　　金：上海市徐汇区中心医院科研基金资助项目(2012XHXH02)

摘　　要：目的对同位素稀释液相色谱串联质谱法(ID-LC-MS/MS)、肌氨酸氧化酶法(简称酶法)和碱性苦味酸法(简称Jaffe法)的血清肌酐检测结果进行方法比较,为临床实验室不同检测系统肌酐检测结果的一致性提供参考。方法采用ID-LC-MS/MS、酶法和Jaffe法同时测定200例临床血清标本、50例溶血标本、50例高脂标本(甘油三酯1.88～17.60 mmol/L)和6例标准添加标本的肌酐水平,观察3种方法的精密度、回收率、方法偏差以及溶血和高脂对检测方法的干扰程度。结果血清标准添加50和100μmol/L肌酐,酶法、Jaffe法和ID-LC-MS/MS的变异系数(CV)分别为<1.14%、<2.39%、<3.84%;回收率分别为84.9%、82.2%,74.4%、70.8%,96.1%、96.3%。ID-LC-MS/MS与酶法、Jaffe法的线性回归方程分别为Y酶法=0.964XID-LC-MS/MS+0.385,r=0.994;YJaffe法=0.955XID-LC-MS/MS+13.14,r=0.979。与ID-LC-MS/MS比较,酶法和Jaffe法的平均偏差分别为-2.93%、13.9%。溶血和高脂对酶法、Jaffe法测定血清肌酐均有不同程度的负干扰。结论酶法与ID-LC-MS/MS的血清肌酐测定结果可比性较好,Jaffe法的血清肌酐测定结果明显偏高。溶血和高脂可干扰酶法和Jaffe法的血清肌酐测定,使结果偏低。Objective To compare the results of the serum creatinine determined by isotope dilution liquid chromatography tandem mass spectrometry （ID-LC-MS/MS）, sarcosine oxidase enzymatic method （enzymatic method） and Jaffe method, and provide the reference for concordance from different determination systems. Methods Serum creatinine levels in 200 clinical serum samples, 50 hemolyzed samples, 50 lipidic samples （triglyceride 1.88-17.60 mmol/L） and 6 standard serum samples were determined by ID-LC-MS/MS, enzymatic method and Jaffe method. The precisions, recoveries, relative biases and interferences to hemolysis and lipid were compared among the 3 methods. Results Adding 50 μmol/L and 100 μmol/L creatinine, the coefficients of variation （CV） were 〈 1. 14%, 〈 2.39% and 〈 3.84% , the recoveries were 84.9%, 82.2% ; 74.4%, 70.8% and 96.1%, 96.3% for enzymatic method, Jaffe method and ID-LC-MS/MS, respectively. Compared to ID-LC-MS/MS, the linearity regression equations of enzymatic method and Jaffe method were Yenzymatic method = 0. 964XID.LC.MS/MS ＋ 0. 385 （ r = 0. 994 ） and YJaffe method = 0. 955XID-LC-MS/MS ＋ 13. 14（r = 0. 979）. Compared to ID-LC-MS/MS, the average relative bias of serum creatinine were -2.93% by enzymatic method and 13.9% by Jaffe method. Significant negative interferences were observed in hemolyzed and lipidic samples. Conclusions There is a good comparability on serum creatinine between enzymatic method and ID-LC-MS/MS. The serum creatinine level can be overestimated by Jaffe method. The serum creatinine levels can be underestimated in hemolyzed and lipidic samples by enzymatic method and Jaffe method.

关 键 词：肌酐 同位素稀释液相色谱串联质谱法 肌氨酸氧化酶法 碱性苦味酸法 

分 类 号：R446.1[医药卫生—诊断学]