检验医学 ›› 2013, Vol. 28 ›› Issue (8): 698-703.DOI: 10.3969/j.issn.1673-8640.2013.08.012

• 技术研究与评价.论著 • 上一篇    下一篇

同位素稀释质谱法、酶法和碱性苦味酸法测定血清肌酐方法比较

宋云霄1,欧美贤2,李水军2,张海晨1,余琛2   

  1. 1.上海市徐汇区中心医院检验科,上海 200031;
    2. 上海市徐汇区中心医院中心实验室,上海 200031
  • 收稿日期:2013-08-30 修回日期:2013-08-30 出版日期:2013-08-30 发布日期:2013-08-30
  • 通讯作者: 余 琛,联系电话:021-54031835。
  • 作者简介:宋云霄,男,1973年生,副主任技师,主要从事临床生物化学检验研究。
  • 基金资助:

    上海市徐汇区中心医院科研基金资助项目(2012XHXH02)

Methodology comparison of serum creatinine determined by isotope dilution liquid chromatography tandem mass spectrometry,enzymatic method and Jaffe method

SONG Yunxiao1,OU Meixian2,LI Shuijun2,ZHANG Haichen1,YU Chen2.   

  1. 1. Department of Clinical Laboratory,Shanghai Xuhui Central Hospital, Shanghai 200031, China;
    2. Central Laboratory, Shanghai Xuhui Central Hospital, Shanghai 200031, China
  • Received:2013-08-30 Revised:2013-08-30 Online:2013-08-30 Published:2013-08-30

摘要: 目的 对同位素稀释液相色谱串联质谱法(ID-LC-MS/MS)、肌氨酸氧化酶法(简称酶法)和碱性苦味酸法(简称Jaffe法)的血清肌酐检测结果进行方法比较,为临床实验室不同检测系统肌酐检测结果的一致性提供参考。方法 采用ID-LC-MS/MS、酶法和Jaffe法同时测定200例临床血清标本、50例溶血标本、50例高脂标本(甘油三酯1.88~17.60 mmol/L)和6例标准添加标本的肌酐水平,观察3种方法的精密度、回收率、方法偏差以及溶血和高脂对检测方法的干扰程度。结果 血清标准添加50和100 μmol/L肌酐,酶法、Jaffe法和ID-LC-MS/MS的变异系数(CV)分别为<1.14%、<2.39%、<3.84%;回收率分别为84.9%、82.2%,74.4%、70.8%,96.1%、96.3%。ID-LC-MS/MS与酶法、Jaffe法的线性回归方程分别为Y酶法=0.964XID-LC-MS/MS+0.385,r=0.994;YJaffe法=0.955XID-LC-MS/MS+13.14,r=0.979。与ID-LC-MS/MS比较,酶法和Jaffe法的平均偏差分别为-2.93%、13.9%。溶血和高脂对酶法、Jaffe法测定血清肌酐均有不同程度的负干扰。结论 酶法与ID-LC-MS/MS的血清肌酐测定结果可比性较好,Jaffe法的血清肌酐测定结果明显偏高。溶血和高脂可干扰酶法和Jaffe法的血清肌酐测定,使结果偏低。

关键词: 肌酐, 同位素稀释液相色谱串联质谱法, 肌氨酸氧化酶法, 碱性苦味酸法

Abstract: Objective To compare the results of the serum creatinine determined by isotope dilution liquid chromatography tandem mass spectrometry (ID-LC-MS/MS), sarcosine oxidase enzymatic method (enzymatic method) and Jaffe method, and provide the reference for concordance from different determination systems. Methods Serum creatinine levels in 200 clinical serum samples, 50 hemolyzed samples, 50 lipidic samples (triglyceride 1.88-17.60 mmol/L) and 6 standard serum samples were determined by ID-LC-MS/MS, enzymatic method and Jaffe method. The precisions, recoveries, relative biases and interferences to hemolysis and lipid were compared among the 3 methods. Results Adding 50 μmol/L and 100 μmol/L creatinine, the coefficients of variation (CV) were < 1.14%, < 2.39% and < 3.84%, the recoveries were 84.9%, 82.2%; 74.4%, 70.8% and 96.1%, 96.3% for enzymatic method, Jaffe method and ID-LC-MS/MS, respectively. Compared to ID-LC-MS/MS, the linearity regression equations of enzymatic method and Jaffe method were Yenzymatic method=0.964XID-LC-MS/MS+0.385(r=0.994) and YJaffe method=0.955XID-LC-MS/MS+13.14(r=0.979). Compared to ID-LC-MS/MS, the average relative bias of serum creatinine were -2.93% by enzymatic method and 13.9% by Jaffe method. Significant negative interferences were observed in hemolyzed and lipidic samples. Conclusions There is a good comparability on serum creatinine between enzymatic method and ID-LC-MS/MS. The serum creatinine level can be overestimated by Jaffe method. The serum creatinine levels can be underestimated in hemolyzed and lipidic samples by enzymatic method and Jaffe method.

Key words: Creatinine, Isotope dilution liquid chromatography tandem mass spectrometry, Sarcosine oxidase enzymatic method, Jaffe method

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