湿化学法检测华氏巨球蛋白血症病人血清钙假性增高的原因分析  

CAUSE OF FALSE ESTIMATES OF ELEVATED CALCIUM BY THE WET CHEMICAL METHOD IN PATIENTS WITH WALDENSTROM MACROGLOBULINEMIA

作　　者：王中军[1] 张海平[1] 任立晟[1] 张少燕[1] 王盼[1] 初开秋[1] WANG Zhongjun;ZHANG Haiping;REN Lisheng;ZHANG Shaoyan;WANG Pan;CHU Kaiqiu(Department of Clinical Laboratory,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院检验科,山东青岛266003

出　　处：《青岛大学学报（医学版）》2022年第4期595-597,共3页Journal of Qingdao University(Medical Sciences)

基　　金：山东省自然科学基金面上项目(ZR2020MH318)。

摘　　要：目的探讨湿化学方法测定华氏巨球蛋白血症病人血清钙假性增高的原因。方法应用干化学和湿化学方法对15例华氏巨球蛋白血症病人血清钙水平分别进行测定,以15例健康人作为对照。同时检测两组血清IgM含量。结果华氏巨球蛋白血症病人湿化学法测定的血清钙水平明显高于干化学法测定的结果,差异有统计学意义(t=8.6,P<0.01),而健康对照者采用湿化学法与干化学法所测血清钙水平差异无显著性(t=0.5,P>0.05)。华氏巨球蛋白血症病人血清IgM含量明显高于健康对照者,差异具有统计学意义(t=6.6,P<0.01)。结论华氏巨球蛋白血症病人血清中含有大量的IgM,因此采用湿化学方法检测血清钙时,会受到这种大分子蛋白干扰,导致所测血清钙水平假性增高。去除IgM干扰或用干化学法测定可为临床提供真实可靠的检验结果。Objective To investigate the cause of false estimates of elevated calcium by the wet chemical method in patients with Waldenstrom macroglobulinemia.Methods The serum level of calcium was measured by the wet chemical method and the dry chemical method,respectively,for 15 patients with Waldenstrom macroglobulinemia,and 15 healthy individuals were enrolled as control.The serum level of IgM was also measured for the two groups.Results For the patients with Waldenstrom macroglobulinemia,the serum level of calcium measured by the wet chemical method was significantly higher than that measured by the dry chemical method(t=8.6,P<0.01),while there was no such significant difference in the healthy controls(t=0.5,P>0.05).The patients with Waldenstrom macroglobulinemia had a significantly higher serum level of IgM than the healthy controls(t=6.6,P<0.01).Conclusion There is a large amount of IgM in patients with Waldenstrom macroglobulinemia,which may lead to the false estimate of elevated calcium in serum when the wet chemical method is used to measure the serum level of calcium.Elimination of IgM interference or the use of the dry chemical method may provide reliable results for clinical practice.

关 键 词：血液化学分析 WALDENSTROM巨球蛋白血症 钙 免疫球蛋白M 

分 类 号：R446.11[医药卫生—诊断学] R553[医药卫生—临床医学]