M蛋白干扰临床实验室检测项目的研究进展  

Advancements in M protein interference in the clinical laboratory detection

作　　者：潘晓园 石慧 曹季军 施新明[3] 史册[3] PAN Xiaoyuan;SHI Hui;CAO Jijun;SHI Xinming;SHI Ce(Department of Medical Laboratory Center,The First People’s Hospital of Taicang,Taicang Affiliated Hospital of Soochow University,Taicang 215400;Department of Rheumatology and Immunology,Ruijin Hospital,Shanghai JiaoTong University School of Medicine,Shanghai 200025;Department of Laboratory Medicine,Ruijin Hospital,Shanghai JiaoTong University School of Medicine,Shanghai 200025)

机构地区：[1]江苏省苏州市苏州大学附属太仓市第一人民医院检验科,江苏太仓215400 [2]上海交通大学医学院附属瑞金医院风湿免疫科,上海200025 [3]上海交通大学医学院附属瑞金医院检验科,上海200025

出　　处：《诊断学理论与实践》2023年第4期407-411,共5页Journal of Diagnostics Concepts & Practice

基　　金：国家自然科学基金(82271820,82371799)。

摘　　要：M蛋白是一种特殊的免疫球蛋白,其存在可能影响一些临床血液检验项目的实验室检测结果。M蛋白的干扰存在于检验前、检验中和检验后,严重影响其他检测项目的准确性。在血清肌酐、尿酸、脂蛋白、总蛋白、胆红素、血糖、血磷、血红蛋白、糖化白蛋白检测中,高浓度的M蛋白可造成结果出现假性高值或假性低值;在25‐OH维生素D、促甲状腺素、C反应蛋白、万古霉素、庆大霉素、丙戊酸钠药物浓度的检测中,M蛋白的异常存在干扰了实际检测结果。针对以上问题,解决方案包括如检验前稀释血清或去除蛋白、检验中使用蛋白稳定剂或优化反应条件等。临床上,还可以发现隐匿性的M蛋白,能够在疾病发生前有效检出M蛋白,对于疾病的治疗和预后发展都将出现新的转机。M protein is a unique immunoglobulin type that often affects the laboratory results of certain blood tests.The M protein interference exits in the pre‐analytical,analytical and post‐analytical process,seriously affecting the accuracy of tests.For example,high concentrations of M protein in serum creatinine,uric acid,lipoprotein,total protein,bilirubin,blood glucose,phosphorus,hemoglobin,glycosylated albumin can cause false high or false low results.The abnormal presence of M protein in 25‐OH vitamin D,thyroid‐stimulating hormone,c‐reactive protein,vancomycin,gentamicin and sodium valproate concentrations interferes with the actual detection results.Solutions to the above problems include diluting serum or removing protein before testing,using protein stabilizers during testing or optimizing reaction conditions.Furthermore,in clinical practice,hidden M protein can be uncovered,and effective detection prior to the onset of disease can open new avenues for disease management and prognosis.

关 键 词：M蛋白 干扰 实验室检测 

分 类 号：R59[医药卫生—内科学]