检验医学 ›› 2016, Vol. 31 ›› Issue (8): 635-639.DOI: 10.3969/j.issn.1673-8640.2016.08.001

• 临床应用研究·论著 •    下一篇

血清尿酸测定的基质效应

张江涛, 曾洁, 马嵘, 赵海舰, 周伟燕, 张天娇, 闫颖, 胡翠华, 汪静, 王冬环, 张传宝   

  1. 北京医院国家卫生计生委临床检验中心,北京 100730
  • 收稿日期:2015-09-02 出版日期:2016-08-31 发布日期:2016-09-01
  • 作者简介:null

    作者简介:张江涛,男,1977年生,硕士,助理研究员,主要从事临床检验标准化研究。

    通讯作者:张传宝,联系电话:010-58115059。

  • 基金资助:
    国家卫生和计划生育委员会科技基础性工作专项项目(2013FY113800)

Matrix effect on serum uric acid determination

ZHANG Jiangtao, ZENG Jie, MA Rong, ZHAO Haijian, ZHOU Weiyan, ZHANG Tianjiao, YAN Ying, HU Cuihua, WANG Jing, WANG Donghuan, ZHANG Chuanbao   

  1. National Center for Clinical Laboratories,Beijing Hospital,Beijing 100730,China
  • Received:2015-09-02 Online:2016-08-31 Published:2016-09-01

摘要:

目的 检测21种样本(血清及制备物)的尿酸水平,评价其对13种尿酸常规检测系统的基质效应。方法 根据卫生行业标准WS/T356-2011,以同位素稀释液相色谱串联质谱法(ID-LC/MS/MS)为比对方法,将不同厂商生产的13种尿酸检测试剂盒(均为酶法)分别与日立7180全自动生化分析仪组成常规检测系统,并以此为评价方法。样本包括4种校准品、5种室间质量评价(EQA)样本、6种质控品、3种制备物(1种猪血清和2种水溶液制备物)、1种美国国家标准与技术研究院(NIST)的标准参考物质(SRM)909c、2种国际临床化学与检验医学联合会(IFCC)检验医学参考实验室外部质量评价计划(RELA)样本,共计21种。用比对方法和评价方法分别测定40份新鲜冰冻血清和上述21种样本。将比对方法和评价方法尿酸测定结果进行直线回归分析,求得Y预测值双侧95%可信区间,评价血清及制备物的基质效应。结果 21种评价样本中有5种基质为新鲜血清或冻干血清的样本(2种EQA正确度验证血清、2种RELA样本和SRM 909c)在所有常规检测系统中均未观察到基质效应。2种校准品(朗道和迪瑞)仅在1种常规检测系统中有基质效应。5种EQA样本中除用于正确度验证的新鲜血清样本外,其他冻干血清样本在较多常规检测系统中存在基质效应。6种质控品中有4种在所有常规检测系统中无基质效应,2种高值质控品显示负基质效应。结论 新鲜血清基质样本是可靠的检测样本,可在标准物质制备、质控品制备和EQA中使用。某些校准品在非配套系统中可能存在基质效应而产生校准偏差,因此在使用这些校准品前最好经过基质效应评价或方法验证。

关键词: 尿酸, 基质效应, 酶实验, 同位素标记, 液相色谱, 串联质谱法

Abstract:

Objective To evaluate the matrix effect of 21 samples (sera and processed materials) on 13 routine determination systems in serum uric acid determination. Methods Determinations were performed according to the health industry standard WS/T356-2011. Isotope dilution liquid chromatography tandem mass spectrometry (ID-LC/MS/MS)was used as comparison method,and 13 kinds of uric acid kits(enzymic assay) were chosen as evaluation method with HITACHI 7180 analyzer. The 21 samples included 4 calibrators,5 kinds of external quality assessment(EQA) samples,6 kinds of quality control materials,3 processed materials (1 kind of spine serum and 2 kinds of liquid solutions),1 kind of standard reference material(SRM) 909c from the National Institute of Standards and Technology (NIST)and 2 kinds of the External Quality Assessment Scheme for Reference Laboratories in Laboratory Medicine (RELA)samples from the International Federation of Clinical Chemistry and Laboratory Medicine(IFCC). A total of 40 fresh frozen sera and the 21 samples were analyzed by comparison method and evaluation method. The results obtained by the 2 methods were analyzed by linear regression analysis. Two-tailed 95% confidence intervals for Y predictive value were computed,and the matrix effect of sera and processed materials was evaluated. Results A total of 5 kinds of evaluation samples (2 EQA samples,1 SRM 909c and 2 RELA samples)from fresh or lyophilized sera showed no matrix effect in all routine methods. Two calibrators (Landau and Dirui) showed matrix effect in 1 routine method. Of 5 EQA samples,except for fresh sera used for trueness verification,other lyophilized sera showed matrix effect in most routine methods. The 4 of 6 quality control materials showed no matrix effect,and 2 quality control materials with high values showed negative matrix effect. Conclusions Fresh serum is a reliable sample and could be used in SRM and quality control material preparation and EQA. Some calibrators could introduce calibration bias due to matrix effect on non-matching routine methods. Thus,matrix effect evaluation and methodological verification are proposed prior to using non-matching calibrators.

Key words: Uric acid, Matrix effect, Enzymic assay, Isotope dilution, Liquid chromatography, Tandem mass spectrometry

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