内源性尿素对化学发光法检测TgAb、TPOAb和TSH的干扰研究

doi:10.3969/j.issn.1673-8640.2020.07.012

摘要/Abstract

摘要：

目的探讨内源性尿素对化学发光法（CLIA）测定甲状腺球蛋白抗体（TgAb）、甲状腺过氧化物酶抗体（TPOAb）和促甲状腺激素（TSH）的干扰作用。方法采用CLIA分别测定30例肾功能衰竭患者透析前、后血清TgAb、TPOAb和TSH浓度。在体检健康者混合血清中加入不同浓度（20、10、30、40、50、60 mmol/L）的尿素,比较TgAb、TPOAb和TSH浓度的变化。分别在肾功能衰竭患者透析前、后的血清中加入800 U/L尿素酶,比较血清TgAb、TPOAb和TSH浓度的变化。结果肾功能衰竭患者透析后血清TgAb、TPOAb和TSH浓度高于透析前（P<0.001）。TPOAb<15.0 IU/mL、TgAb<15.0 IU/mL的患者透析前、后TPOAb、TgAb发光值差异均无统计学意义（P>0.05）。随着混合血清中尿素浓度的升高,TgAb、TPOAb、TSH测定结果逐渐降低。加入800 U/L尿素酶后,肾功能衰竭患者透析前、后血清TgAb、TPOAb、TSH浓度差异均无统计学意义（P>0.05）。结论较高浓度的内源性尿素可干扰CLIA测定TgAb、TPOAb和TSH结果,加入尿素酶后可以消除内源性尿素的干扰。

关键词: 尿素, 化学发光法, 尿素酶, 肾功能衰竭

Abstract:

Objective To investigate the interference of endogenous urea in the determinations of thyroglobulin antibody（TgAb）,thyroid peroxidase antibody（TPOAb） and thyroid-stimulating hormone（TSH） by chemiluminescence immunoassay（CLIA）. Methods CLIA was used to determine the levels of serum TgAb,TPOAb and TSH in 30 patients with renal function failure before and after dialysis. Different levels（20,10,30,40,50 and 60 mmol/L） of urea were added to the mixed sera of healthy subjects,and the changes of TgAb,TPOAb and TSH levels were compared. The 800 U/L urease was added to serum samples from patients with renal function failure before and after dialysis,and the changes of TgAb,TPOAb and TSH levels were compared. Results Serum levels of TgAb,TPOAb and TSH of patients with renal function failure after dialysis were higher than those before dialysis（P<0.001）. There was no statistical significance for TPOAb and TgAb in TPOAb<15.0 IU/mL and TgAb<15.0 IU/mL dialysis patients before and after dialysis（P>0.05）. With the increasing of urea in the mixed sera of healthy subjects,the levels of TgAb,TPOAb and TSH were gradually decreased. After adding 800 U/L urease,there was no statistical significance in TgAb,TPOAb and TSH levels before and after dialysis in patients with renal function failure（P>0.05）. Conclusions High level of endogenous urea can interfere with the determinations of TgAb,TPOAb and TSH by CLIA. The addition of urease can eliminate the interference of endogenous urea.

Key words: Urea, Chemiluminescence immunoassay, Urease, Renal function failure

中图分类号:

R446.1

李立和, 孙国忠, 张超. 内源性尿素对化学发光法检测TgAb、TPOAb和TSH的干扰研究[J]. 检验医学, 2020, 35(7): 682-685.

LI Lihe, SUN Guozhong, ZHANG Chao. Interference of endogenous urea in the determinations of TgAb,TPOAb and TSH by chemiluminescence immunoassay[J]. Laboratory Medicine, 2020, 35(7): 682-685.

图/表 5

参考文献 8

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组别	例数	TgAb/（IU/mL）	TPOAb/（IU/mL）	TSH/（mIU/L）
透析前	30	69.1（20.8~161.2）	144.7（47.2~153.6）	1.66±0.62
透析后	30	72.8（21.1~162.2）	145.8（54.0~155.1）	1.70±0.63
统计值		-4.784	-4.627	-6.345
P值		<0.001	<0.001	<0.001

组别	例数	TgAb/（IU/mL）	TPOAb/（IU/mL）	TSH/（mIU/L）
透析前	30	69.1（20.8~161.2）	144.7（47.2~153.6）	1.66±0.62
透析后	30	72.8（21.1~162.2）	145.8（54.0~155.1）	1.70±0.63
统计值		-4.784	-4.627	-6.345
P值		<0.001	<0.001	<0.001

组别	例数	TgAb	TPOAb
透析前	5	6.58±0.38	3.29（3.16~31.10）
透析后	5	6.63±0.19	3.10（3.06~31.40）
统计值		-0.620	-0.135
P值		0.569	0.893

组别	例数	TgAb	TPOAb
透析前	5	6.58±0.38	3.29（3.16~31.10）
透析后	5	6.63±0.19	3.10（3.06~31.40）
统计值		-0.620	-0.135
P值		0.569	0.893

项目	TgAb		TPOAb		TSH		BUN/ （mmol/L）
项目	测定值/ （IU/L）	发光值/ RLU	测定值/ （IU/L）	发光值/ RLU	测定值/ （mIU/L）	发光值/ RLU	BUN/ （mmol/L）
加入尿素前	25.1	601 126	241.5	102 788	3.40	390 696	5.26
加入尿素后
10 mmol/L	23.9	570 499	237.0	99 524	3.36	371 878	15.23
20 mmol/L	22.3	555 802	228.6	97 593	3.29	358 084	25.14
30 mmol/L	20.6	531 844	214.3	94 325	3.02	336 226	34.76
40 mmol/L	18.7	514 368	204.1	91 456	2.78	315 266	44.87
50 mmol/L	17.9	476 320	192.4	86 321	2.42	292 588	54.44
60 mmol/L	16.8	426 580	187.6	77 859	2.18	254 063	63.66