不同方法检测华氏巨球蛋白血症患者血清肌酐水平的效果分析  

The effect analysis of different methods for detecting serum creatinine levels in patients with Waldenström's macroglobulinemia

作　　者：周长学[1] 王臻[2] 唐敏 王姗姗 王国磊[1] ZHOU Chang-xue;WANG Zhen;TANG Min(Department of Nephrology,Zaozhuang Municipal Hospital,Zaozhuang 277102,China)

机构地区：[1]枣庄市立医院肾内科,277102 [2]枣庄市立医院检验科,277102

出　　处：《中国实用医药》2025年第1期63-66,共4页China Practical Medicine

摘　　要：目的探讨不同方法检测华氏巨球蛋白血症(WM)患者血清肌酐水平的效果。方法选取15例WM患者,分别采用湿化学酶法、干化学酶法、苦味酸法对超滤前后血清总蛋白及肌酐水平进行检测,并进行比较。结果超滤前,血清总蛋白平均值为(105.42±17.32)g/L,采用湿化学酶法检测血清肌酐平均值为(407.46±323.82)μmol/L,高于干化学酶法检测的(69.13±22.05)μmol/L及苦味酸法检测的(70.22±21.07)μmol/L,差异有统计学意义(t=4.037、4.025,P<0.05);但干化学酶法与苦酸法检测的血清肌酐平均值比较,差异无统计学意义(t=0.138,P>0.05)。超滤后,血清总蛋白平均值为(3.83±0.42)g/L,较超滤前明显下降,差异有统计学意义(t=22.710,P<0.05);湿化学酶法检测血清肌酐平均值为(77.52±42.33)μmol/L,较超滤前明显降低,差异有统计学意义(t=3.913,P<0.05);湿化学酶法、干化学酶法、苦味酸法检测的血清肌酐平均值两两比较,差异均无统计学意义(P>0.05)。结论当WM患者出现与临床症状不符的高血清肌酐值时,应该考虑到巨球蛋白的影响。为了确保检测准确性,可以使用干化学酶法或苦味酸法进行再次测定,或者离心超滤后再次进行血清肌酐的检测,以减少临床上的误诊和误治,从而为医生提供真实可靠的检验结果。Objective To explore the effect of different methods for detecting serum creatinine levels in patients with Waldenström's macroglobulinemia(WM).Methods 15 patients with WM were selected as the study subjects.The serum levels of total protein and creatinine were detected before and after ultrafiltration using dry chemical enzyme method,wet chemical enzyme method and picric acid method,and then compared the results.Results Before ultrafiltration,the average total protein level was(105.42±17.32)g/L.The average serum creatinine detected by wet chemical enzyme method was(407.46±323.82)μmol/L,which was significantly higher than(69.13±22.05)μmol/L by dry chemical enzyme method and(70.22±21.07)μmol/L by picric acid method.The differences were statistically significant(t=4.037,4.025;P<0.05).However,there was no statistically significant difference in the serum creatinine levels detected by the dry chemical enzyme method and the picric acid method(t=0.138,P>0.05).After ultrafiltration,the mean serum total protein was(3.83±0.42)g/L,which was significantly lower than that before ultrafiltration,and the difference was statistically significant(t=22.710,P<0.05).The mean serum creatinine detected by wet chemical enzyme method was(77.52±42.33)μmol/L,which was significantly lower than that before ultrafiltration,and the difference was statistically significant(t=3.913,P<0.05).There was no significant difference in mean serum creatinine detected by every two of wet chemical enzyme method,dry chemical enzyme method and picric acid method(P>0.05).Conclusion When high creatinine levels appear in WM patients that do not match clinical symptoms,the influence of macroglobulin should be considered.To ensure accuracy,dry chemical enzyme or picric acid methods can be used for retesting,or blood creatinine can be tested again after centrifugation and ultrafiltration.This helps to prevent misdiagnosis and mistreatment in clinical practice,thereby providing doctors with authentic and reliable test results.

关 键 词：华氏巨球蛋白血症 血清肌酐 湿化学酶法 干化学酶法 苦味酸法 

分 类 号：G63[文化科学—教育学]