摘要
目的建立血浆游离肉碱测定方法及探讨血浆游离肉碱测定的临床意义。方法用放射性同位素酶化学法测定血浆游离肉碱，然后检测健康献血员及血液透析（血透）患者各３０例，并与透析时间及透析并发症发生率作相关分析。结果同位素酶化学法血浆游离肉碱最小测定浓度为２．５μｍｏｌ／Ｌ，灵敏度为９４ｃｐｍ／μｍｏｌ／Ｌ，批内误差３．５％，批间误差４．１％，回收率９６．１％～１０５．９％。与３０名健康献血员血浆游离肉碱水平（５３．８±８．１μｍｏｌ／Ｌ）比较，血透患者透析前血浆肉碱水平显著降低（３３．５±１２．７μｍｏｌ／Ｌ，Ｐ＜０．０１），透析后更低。血浆肉碱水平与透析时间、透析低血压、肌痉挛和透析后无力发生率显著相关（ｒ分别为－０．９６５，－０．９５７和－０．９８９）。结论放射性同位素酶化学法测定血浆游离肉碱浓度灵敏、精确、可靠、重复性好，适于检测血透病人肉碱缺乏症和评价左旋肉碱疗效。
Objective To establish a method for the determination of free carnitine and explore its clinical significance in hemodialysis patients. Methods Plasma free carnitine was detected with radiochemical enzymatic assay which was evaluated statistically in 30 health blood donors and 30 hemodialysis patients. Results The detection limit of the assay corresponded the plasma concentration of 2.5 μmol/L for free carnitine. The sensitivity was 94 cpm/μmol/L. The intra assay and inter assay CV was 3.5% and 4.1%, respectively. The analytical recovery was 96.1%～105.9%. Plasma free carnitine levels in hemodialysis patients were significantly lower than those in the control (33.5±12.7 μmol/L vs 53.8±8.1 μmol/L P <0.01). Posthemodialysis concentrations were lower than those before hemodialysis ( P <0.01). Plasma free carnitine levels were correlated with hemodialysis duration and complication.Conclusions Carnitine assay represents a reliable, precise and well reproducible method, suitable for the determination of plasma free carnitine and evaluation of efficiency of carnitine supplement in hemodialysis patients.
关键词
血液透析
测定
肉碱
Hemodialysis Determination Carnitine
