异常免疫球蛋白对TEST1法测定血沉的影响

Effect of TEST1 ESR assay with abnormal immunoglobulin patients

目的:探讨异常免疫球蛋白对TEST1法测定血沉的影响。方法:采集63例异常免疫球蛋白(30例IgM、18例IgA和15例IgG)患者和63例正常免疫球蛋白患者(对照组)的血样。分别用TEST1与魏氏法测定血沉,免疫比浊法测定免疫球蛋白。测定结果通过Passing-Bablok回归法、Bland-Altman偏差法和线性回归进行统计分析。结果:异常免疫球蛋白组两法测定结果(y=0.65x-2.9)差异有统计学意义(P<0.05),尤其血沉>40 mm/h表现明显,而对照组(y=0.96x-2.2)具有较好的一致性。线性回归提示免疫球蛋白对魏氏法具有正相关性的影响,尤以IgM显著。结论:TEST1与魏氏法检测异常免疫球蛋白血沉的结果具有差异性,临床应用应引起重视。

Objective：To compare the difference between Westergren and TEST1 assay in determination of erythrocyte sedimentation rate（ESR） with the abnormal immunoglobulins patients,This could result in different influences on the tests by abnormal immunoglobulins.Methods：We investigated the effect of abnormal immunoglobulins on ESR readings by TEST1 and the Westergren,in 63 patients with paraproteinaemia（30 patients IgM,18 patients IgA and 15 patients IgG） and 63 control populations.Passing-Bablok,Bland-Altman plots and linear regression were investigated.Results：A poor agreement between the two methods was found in patients with an abnormal immunoglobulins（y=0.65x-2.9） in comparison with that of the control population（y=0.96 x-2.2）.Large differences between methods were present when ESR readings were.40 mm/hour,Linear regression showed a concentration dependent influence of abnormal immunoglobulin on ESR readings by the Westergren,especially for immunoglobulin class IgM.Conclusion：The difference between Westergren and TEST1 assay methods is due to the abnormal immunoglobulin concentration,and TEST1 readings are less influenced by the presence of a abnormal immunoglobulin than those of Westergren.