同型半胱氨酸对腺苷脱氨酶试剂交叉污染的分析

Assay of reagent carryover of homocysteine to adenosine deaminase

目的探讨筛查和确认交叉污染来源的思路,评估对应消除措施的效果。方法发现同型半胱氨酸(homocysteine,HCY)后紧跟腺苷脱氨酶(adenosine deaminase,ADA)检测存在交叉污染,通过用两个可比的生化检测系统配对分析一组20例患者标本和5例质控样本ADA结果来筛查交叉污染,分析试剂空白数据和实时反应曲线数据辨别其来源,然后分别采用加强清洗、特殊清洗和调整检测顺序来消除交叉污染并确认其效果。结果两组患者标本ADA差值为7.20±3.20U/L,质控样本差值为6.00±1.73 U/L,P<0.05存在统计学差异。交叉污染发生前后,ADA检测反应曲线加入试剂R2后第22点吸光度分别为0.01094±0.00129和0.03544±0.00605,提示ADA试剂R2被污染。将HCY调整至ADA之后检测,试剂空白吸光度回复正常,措施有效。结论合理设置生化项目检测顺序能够有效地避免试剂交叉污染的发生。

Objective To investigate the method of screening and confirming carryover and to assess the effect of correspond- ing means to eliminate it. Methods Carryover took place when ADA was analysed after HCY in clinical chemistry automatic ana- lyzer. ADA concentrations in serum of 20 patients and 5 control materials were measured on two set of clinical chemistry systems to screen carryover. Reagent blank data and reaction curve monitor data were checked to find out the source of carrywer. Extra rinse, special rinse and arrangement of assays order were used to eliminate reagent carryover and the effects were observed. Re- suits Differences of ADA concentration in patients were 7.20±3.20U/L and 6.00±1.73 U/L for those of control materials, showing statistical signification as P〈0.05. With occurrence of ADA reagent 2 carryover ,the absorbance data at the 22nd point of ADA re- action monitor curve were 0.03544±0.00605 against normal 0.01094±0.00129.When HCY was set after ADA, data of reagent blank of ADA recur normal. Conclusion Proper arrangement order of clinical chemistry assays can avoid reagent carryover.