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对比Jaffe和酶的方法,以测量肌素在各种阴道水平,以及它们对肝移植分配的影响
Neda Soleimani1,2, Sima Dehghani1, Mohammad Hossein Anbardar1,2
1Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
International journal of analytical chemistry
|October 27, 2023
概括
胆红素干扰会影响肌素测量,影响肝移植MELD得分. 酵素方法对黄斑样本比贾菲方法更可靠,特别是超过4mg/dL的 bilirubin.
科学领域:
- 临床化学 临床化学
- 移植医学 移植医学 移植医学
- 生物化学 生化学
背景情况:
- 末期肝病模型 (MELD) 评分对于肝移植优先级和疾病严重程度评估至关重要.
- MELD得分计算依赖于包括肌素在内的参数,可以使用不同的方法来测量.
- 肌素测量的变化,特别是由于胆红素干扰 (黄),可能导致不一致的MELD得分.
研究的目的:
- 建立可靠的切断对胆红素干扰在肌素测量.
- 为了评估不同黄水平对肌素测定的影响.
- 通过MELD得分准确度评估这些变异对肝移植分配的影响.
主要方法:
- 分析了400个血清样本,按黄指数和总胆红素水平 (非,轻度,中度,严重的黄) 分类.
- 在所有样本组中使用化学Jaffe和酶方法测量了肌素.
- 对83名肝移植候选人的不同胆红素水平的肌素结果和计算的MELD得分进行了比较.
主要成果:
- 酶方法在黄样本中产生了比贾菲方法更高的肌氨酸度,平均差异随着黄的严重程度 (0.08至1.95) 的增加而增加.
- 酶方法导致肝移植候选人的肌素和MELD得分更高.
- 当 bilirubin 超过 4 mg/dL 的方法之间观察到肌素和 MELD 评分的显著差异 (肌素的 p < 0.0001,MELD 的 p = 0.027).
结论:
- 测量肌素的化学Jaffe方法具有成本效益,但容易受到icterus的干扰.
- 酶的方法提供了更高的准确性,用于测量肌在样品.
- 实验室应考虑使用酶方法或为肌素测定确定特定的胆红素干扰切断值 (约4 mg/dL),以确保准确的MELD评分和肝移植分配.
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