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对用于初级阿尔多斯特症查的阿尔多斯特和雷宁试验进行比较分析
Yuki Taki1, Takashi Kono1, Kyoko Teruyama2
1Department of Molecular Diagnosis, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan.
Scientific reports
|October 30, 2024
概括
转向化学发光酶免疫测试 (CLEIA) 检测血中阿尔多斯 (PAC) 度,提高了初级阿尔多斯 (PA) 诊断的准确性. 基于CLEIA的阿尔多与因比率 (ARR) 提供了比较旧的放射性免疫测试 (RIA) 方法更好的特异性.
科学领域:
- 内分泌学 在内分泌学.
- 临床化学 临床化学
- 诊断试验开发 诊断试验开发
背景情况:
- 化学发光酶免疫试验 (CLEIA) 广泛用于血中阿尔多素度 (PAC) 试验,这引发了对其对原发性阿尔多素 (PA) 诊断的影响的不确定性.
- 之前用于PAC的放射性免疫测试 (RIA) 方法可能影响了PA查中阿尔多与素比率 (ARR) 的准确性.
研究的目的:
- 用RIA,CLEIA和LC-MS/MS.来评估PAC测量之间的相关性.
- 通过使用CLEIA测量的ARR与PAC来确定PA诊断的可靠切断值.
- 调查弱矿物质皮质类药物 (WMs) 对PAC测量的影响及其对PA诊断的影响.
主要方法:
- 通过RIA,CLEIA和LC-MS/MS分析的312个血清PAC样本的回顾性分析.
- 使用Passing-Bablok回归进行方法比较的相关性分析.
- 接收器操作特征 (ROC) 曲线分析,以确定PA诊断的最佳ARR切线.
- 多重回归分析以评估WM对PAC差异 (ΔPAC) 的影响.
主要成果:
- 在PAC_CLEIA和PAC_LC-MS/MS值之间观察到很高的相关性.
- 使用PAC_RIA计算的ARR显示出较低的特异性和较高的假阳性率,而不是从PAC_CLEIA或PAC_LC-MS/MS.
- 弱矿物质皮质类药物在PA和非PA患者组中显著影响了ΔPAC,特别影响了RIA测量.
- 使用PAC_CLEIA的ARR证明了在建立PA诊断截止点方面具有临床实用性.
结论:
- 过渡到CLEIA用于PAC测定是有利于提高PA检测率.
- 与基于RIA的ARR相比,基于CLEIA的ARR提供了一种更具体,更可靠的方法来诊断PA.
- 较弱的矿物质皮质类药物会干扰PAC测量,特别是RIA方法,可能导致误诊.
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