临床常用β-内酰胺类抗生素对血清果糖胺检测的干扰分析  

Interference effect of common clinical β-lactam antibiotics on serum fructosamine assay

作　　者：姚孝明[1] 颜巍[1] 周竞[1] 蒋叶[1] 王婷[1] 张家明[1] 

机构地区：[1]江苏省中西医结合医院检验科,江苏南京210028

出　　处：《实验与检验医学》2013年第5期442-443,481,共3页Experimental and Laboratory Medicine

基　　金：江苏名医效方研究开发与评价建设项目(BM2009903)

摘　　要：目的评价临床常用β-内酰胺类抗生素对NBT法检测果糖胺的干扰效应。方法遵循CLSI EP7-A2文件,将临床常用13种β-内酰胺类抗生素配制成最高浓度为20倍血药峰浓度的系列溶液,按照5%体积加入到新鲜混合血清中,检测新鲜混合血清果糖胺的结果 ,分析干扰效应。结果替卡西林钠/克拉维酸、头孢硫脒对果糖胺检测存在正干扰,替卡西林钠/克拉维酸75%血药峰浓度、头孢硫脒50%血药峰浓度开始干扰造成果糖胺检测结果超出x+1.96s范围,且干扰值与干扰药物浓度呈正相关,其它11种β-内酰胺类抗生素对果糖胺检测没有干扰。结论替卡西林钠/克拉维酸、头孢硫脒对NBT法检测果糖胺存在正干扰,临床应在用药前或静脉滴注1～2个半衰期后采样检测果糖胺以避免干扰。Objective To evaluate the interference effect of common clinical β-laetam antibiotics on fructosamine assay by using the NBT method. Methods According to CLSI EPT-A2 file, 13 kinds of common clinical β-lactam antibiotics were prepared with the serial solutions with maximal concentration equal to 20 times that of peak plasma concentration. The serial solutions were then added to a freshly pooled serum with 5% volume to detect serum fructosamine and analyze the interference effect. Resuits Sodium ficarcillin/clavulanie acid and cefathiamidine exert a positive interference to the testing of fructosamine. Among them, 75% the peak plasma concentration of sodium ticarcillin/elavulanic acid and 50% the peak plasma concentration of cefathiamidine began to interfere, resulting in an exceeding ＋1.96s range in the assay of fructosamine; the interference value were posi- tively correlated with drug concentration. However, the other 11 kinds of [3-1actam antibiotics did not interfere with the assay of fructosamine. Conclusion Sodium ticarcillin/clavulanic acid and cefathiamidine positively interfere with the assay of fructosamine by using the NBT method. Thus, the blood sampling and fructosamine testing should be prior to drug treatment or after 1 to 2 half-lives of the individual drug.

关 键 词：Β-内酰胺类抗生素 果糖胺 干扰 

分 类 号：R446.112[医药卫生—诊断学]