摘要
目的了解急性心肌梗死（AMI）患者心肌肌钙蛋白Ⅰ（cTnI）自身抗体阳性的血清对临床常用的5个cTnI检测系统的负性干扰情况。方法从121份AMI患者血清中筛查出13份cTnI自身抗体阳性血清，分别在5个cTnI检测系统上进行cTnI浓度和回收率的测定。结果13份cTnI自身抗体阳性患者血清在各cTnI检测系统测定时，会出现测定值不同程度的假性降低，甚至假阴性。各检测系统中、低回收率各不相同，Access-2上出现cTnI低回收的血清l份；Architect i2000（Abbott）上出现cTnI中、低回收的血清各1份；Axsym（Abbott）上出现cTnI中、低回收的血清分别为2份和1份；Dimension X Pand（Dade Behring）上出现cTnI中、低回收的血清分别是3份和2份；Vidas（Biomerieux）上出现cTnI中、低回收的血清分别是1份和4份。血清自身抗体水平（A450）与自身抗体对cTnI测定的负性干扰程度相关，血清cTnI自身抗体A450值和cTnI回收率之间的R。在Access-2、Architect i2000（Abbott）、Axsym（Abbott）、Dimension X Pand（Dade Behring）、Vidas（Biomerieux）上分别为0．841（P〈0．01）、0．808（P〈0．01）、0．772（P〈0．01）、0．707（P〈0．01）和0．424（P〈0．05）。结论cTnI自身抗体对常用cTnI检测系统均出现较显著负性干扰，影响了临床对cTnI检测结果的判断。
Objective To explore the possible negative interference of circulating cardiac troponin Ⅰ （cTnI） autoantibedy on the immunoassay of cTnI in five commonly used cTnI detection systems. Methods Thirteen patients with positive cTnI autoantibodies in their serum samples were firstly screened and selected from 121 acute myocardial infarction （AMI） patients using ELISA assay. The serum cTnI values and their recovery rates were then carefully measured and analyzed. Results cTnI values in these 13 samples showed amazing difference in the five detection systems, demonstrating various degrees of pseudo-drop, or even falsenegative. One sample with low recovery was detected in Access-2 system. One sample with low recovery as well as one sample with moderate recovery were detected in Architect i2000 （Abbott）. Two samples with moderate recovery and one sample with low recovery were detected in Axsym（Abbott）. Three samples with moderate recovery and two samples with low recovery were detected in Dimension X Pand（ Dade Behring）and one sample with moderate recovery together with four samples with low recovery were detected in Vidas （Biomerieux）. And the serum levels of autoantibodies （A450） positively correlated with the degrees of their negative interference for the detection of cTnI. The R2 and P values on each system were 0. 841 （P 〈0. 01 ） vs Access-2, 0. 808 （ P 〈 0. 01 ） vs Architect i2000 （ Abbott）, 0. 772 （ P 〈 0. 01 ） vs Axsym （ Abbott）, 0. 707 （ P 〈 0. 01 ） vs Dimension X Pand （ Dade Behring ） and 0. 424 （ P 〈 0. 05 ） vs Vidas （ Biomerieux ）, respectively. Conclusion Circulating autoantibodies of cTnl can induce considerable negative interference in all the 5 commonly used cTnI detection systems, which might then lead to incorrect judgments of the obtained results of cTnI in daily clinical work.
出处
《中华检验医学杂志》
CAS
CSCD
北大核心
2009年第7期749-753,共5页
Chinese Journal of Laboratory Medicine
