免疫检测干扰因素的分析、识别和对策

Analysis,identification and strategies on interferences in immunoassay

免疫检测法中能够改变被检测物浓度或改变被检物与相应检测抗体结合能力的物质，均可能对检测结果造成干扰。内源性干扰因素包括自身抗体、异嗜性抗体、人抗动物抗体及其他一些结合蛋白等。脂血、交叉反应、一些分析前变异、基质效应，甚至检测的设备不同，也可对免疫检测造成干扰。这些干扰可引起许多检测结果的假性升高或降低，包括激素、肿瘤标志、药物、肌钙蛋白和病原微生物的血清学检测等，进而影响临床对疾病的诊断和治疗评估。检验人员与临床医师都应充分认识免疫检测中的干扰因素，并在出现实验室检测结果与临床征象不符时进行充分沟通，查找是否存在干扰因素，并采取适当方案重新检测，以得出正确结果。

Substances that might potentially alter the measurable concentration of the analyte or alter the binding ability of detection antibody can lead to immunoassay interference. Endogenous interferences consist of autoantibodies, heterophiles antibodies, human anti-animal antibodies （HAAA） and some binding proteins. Lipidemia, cross-reactivity, pre-analytical variation, matrix and different detection equipments may also affect immunoassay. These interfering substances may cause falsely increased or decreased concentration in many analytes, including hormones, tumor markers, drugs, cardiac troponin and microbial serology, thus it will affect the diagnosis of patients and the evaluation of therapeutic strategies. Laboratorians and physicians should both be aware of the potential interference in immunoassays and communicate closely when any clinical discordance between the clinical and the laboratory data appears, avoiding a subsequent wrong diagnosis and unwarranted treatment. In this case, an alternative assay or measurement is needed for the potential correct results.