免疫抑制法和免疫荧光定量法在肌酸激酶同工酶活性测定中的应用价值
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摘要
目的探讨免疫抑制法和免疫荧光定量法在肌酸激酶同工酶活性测定中应用价值。方法选取我院2014年1月~2015年12月收治的70例患者,根据疾病类型分为甲组及乙组,各35例。甲组为急性心肌梗死患者且发病时间在4~8 h,乙组为非心源性疾病且肌酸激酶同工酶(CK-MB)活性升高的患者,分别使用速率法及免疫抑制法测定两组患者的肌酸激酶(CK)活性及CK-MB活性,用免疫荧光定量法测试CK-MB质量浓度。结果甲组CK活性[(585.0±102.0)U/L]、CK-MB活性[(85.0±22.0)U/L]与CK-MB质量浓度[(18.5±2.2)ng/ml]均升高;乙组CK活性正常,CK-MB活性升高,但CK-MB质量浓度不升高,结果不一致。结论 CK-MB的活性测定方法一般均为免疫抑制法,但由于方法学的局限性,可引起测定结果假性升高,出现异常升高时,及时和临床取得联系,可结合患者的病情,进一步用免疫荧光定量测定CK-MB的质量浓度,为患者提供更准确的检测结果。
Objective To explore the application value of immunesuppression and immune fluorescence quantitative method in the determination of creatine kinase isozyme activity.Methods 70 patients in our hospital from January 2014 to December 2015 were selected and divided into two groups according to the disease type,with 35 cases in each group.The A group was acute myocardial infarction(AMI) and the duration was in 4-8 h;the B group was non-cardiac disease and high CK-MB activity.The CK activity and CK-MB activity of patients in two groups were respectively determinated using the velocity method and immunesuppression method,and the quality of CK-MB was determined using immune fluorescence quantitative method.Results The CK activity [(585.0±102.0)U/L],CK-MB activity [(85.0±22.0) U/L] and quality of CK-MB [(18.5±2.2) ng/ml] of patients in group A were all raised;the CK activity of patients in group B was normal,the CK-MB activity was raised with a inconsistent results that the quality of CK-MB was not raised.Conclusion The method to determinate the CK-MB activity in general is immunesuppression method.But because of the limitation of the methodology,the activity of CK-MB may falsely raise.On this occasion,doctors should combine the clinic and patients′conditions,using the immune fluorescence quantitative method to make further determination of the quality of CK-MB,in order to provide more accurate test results for the patients.
Objective To explore the application value of immunesuppression and immune fluorescence quantitative method in the determination of creatine kinase isozyme activity.Methods 70 patients in our hospital from January 2014 to December 2015 were selected and divided into two groups according to the disease type,with 35 cases in each group.The A group was acute myocardial infarction(AMI) and the duration was in 4-8 h;the B group was non-cardiac disease and high CK-MB activity.The CK activity and CK-MB activity of patients in two groups were respectively determinated using the velocity method and immunesuppression method,and the quality of CK-MB was determined using immune fluorescence quantitative method.Results The CK activity [(585.0±102.0)U/L],CK-MB activity [(85.0±22.0) U/L] and quality of CK-MB [(18.5±2.2) ng/ml] of patients in group A were all raised;the CK activity of patients in group B was normal,the CK-MB activity was raised with a inconsistent results that the quality of CK-MB was not raised.Conclusion The method to determinate the CK-MB activity in general is immunesuppression method.But because of the limitation of the methodology,the activity of CK-MB may falsely raise.On this occasion,doctors should combine the clinic and patients′conditions,using the immune fluorescence quantitative method to make further determination of the quality of CK-MB,in order to provide more accurate test results for the patients.
引文
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[3]冯丹,曹华军.心肌标志物联合检测在急性心肌梗死早期诊断中的应用[J].中国急救医学,2014,21(9):840-842.
[4]严伟玲,严春玲,赖在真.小儿患者血清CK-MB检测结果分析及其临床意义[J].中国卫生检验杂志,2014,24(8):1137-1139.
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[9]陈建芸,石玉玲,李林海,等.CK-MB质量及其活性检测结果对比分析[J].华南国防医学杂志,2010,24(6):455-467.
[10]李晓,徐宗琴,陈建芸.血清CK-MB活性大于总CK活性的原因初探及处理[J].现代检验医学杂志,2010,25(6):78-82.
[11]彭兰,张娥,万芳,等.“CK-MB”测定的干扰现象及实验对策[J].中国实验诊断学,2011,15(12):2160-2161.
[12]吴凤丽,马晓光,孙玉珍,等.血清CK-MB活力假性增高原因分析及临床意义[J].中国实验诊断学,2007,11(8):1041-1043.
[13]郑婉君,邓敏茹,翁丽.影响肌酸激酶同工酶活性检测结果的因素探讨[J].国际检验医学杂志,2006,27(5):407.
[14]Lo KR,Hurst SM,Atkinson KR,et al.Development and validation of a sensitive immunoassay for the skeletal muscle isoform of creatine kinase[J].J Sci Med Sport,2010,13(1):117-119.
[15]Hoshino T,Sakai Y,Yamash ita K,et al.Development and performance of an enzymeimmunoassay to detect creatine kinase isoenzyme MB activity using anti-mi-tochondrial creatine kinase monoclonal antibodies[J].Scand J Clin Lab Invest,2009,69(6),687-695.
[2]王虹,刘石,邢艳琳,等.肌酸激酶同工酶质量判定肌病心肌损害的局限性[J].中国危重病急救医学,2011,23(12):723-726.
[3]冯丹,曹华军.心肌标志物联合检测在急性心肌梗死早期诊断中的应用[J].中国急救医学,2014,21(9):840-842.
[4]严伟玲,严春玲,赖在真.小儿患者血清CK-MB检测结果分析及其临床意义[J].中国卫生检验杂志,2014,24(8):1137-1139.
[5]叶应妩,王硫三,申子瑜,等.全国临床检验操作规程[M].3版.南京:东南大学出版社,2006:736-753.
[6]汤冬玲,李栋,田蒿,等.血清CK-MB活性假性增高原因探讨及对策[J].现代检验医学杂志,2013,28(4):89-93.
[7]于彩云,田豫平,周和平,等.肌酸激酶-MB假性升高原因及与疾病的关系研究[J].军事医学科学院院刊,2002,26(2):119.
[8]成守金,罗云杰,许风清,等.正常儿童血清肌酸激酶同工酶活性参考值[J]中国煤矿工业医学杂志,2004,7(7):638.
[9]陈建芸,石玉玲,李林海,等.CK-MB质量及其活性检测结果对比分析[J].华南国防医学杂志,2010,24(6):455-467.
[10]李晓,徐宗琴,陈建芸.血清CK-MB活性大于总CK活性的原因初探及处理[J].现代检验医学杂志,2010,25(6):78-82.
[11]彭兰,张娥,万芳,等.“CK-MB”测定的干扰现象及实验对策[J].中国实验诊断学,2011,15(12):2160-2161.
[12]吴凤丽,马晓光,孙玉珍,等.血清CK-MB活力假性增高原因分析及临床意义[J].中国实验诊断学,2007,11(8):1041-1043.
[13]郑婉君,邓敏茹,翁丽.影响肌酸激酶同工酶活性检测结果的因素探讨[J].国际检验医学杂志,2006,27(5):407.
[14]Lo KR,Hurst SM,Atkinson KR,et al.Development and validation of a sensitive immunoassay for the skeletal muscle isoform of creatine kinase[J].J Sci Med Sport,2010,13(1):117-119.
[15]Hoshino T,Sakai Y,Yamash ita K,et al.Development and performance of an enzymeimmunoassay to detect creatine kinase isoenzyme MB activity using anti-mi-tochondrial creatine kinase monoclonal antibodies[J].Scand J Clin Lab Invest,2009,69(6),687-695.