EMIT和FPIA测定丙戊酸、甲氨喋呤和环孢霉素A血药浓度的比较研究

Comparison of EMIT and FPIA Method in Determination of Valproic Acid,Methotrexate and Cyclosporine A Blood Concentration

目的比较均相酶放大免疫分析法(EMIT)和荧光偏振免疫分析法(FPIA)测定丙戊酸(VPA)、甲氨喋呤(MTX)和环孢霉素A(CsA)血药浓度结果,并评价两种测定方法所得结果的相关性。方法收集患者服药后的血样,采用EMIT和FPIA同时测定VPA、MTX和CsA血药浓度;以FPIA测定值为X,以EMIT测定值为Y,进行线性回归,评价其相关性。结果所得线性回归方程如下:YVPA=1.894 1+1.190 3X,r=0.983;YMTX=0.099 24+1.136X,r=0.992;YCsA=1.146 5+0.846 1X,r=0.971。EMIT测定血浆中VPA血药浓度较FPIA高11.2μg.mL 1,EMIT测定MTX血药浓度较FPIA高0.22μmol.L 1,EMIT测定CsA血药浓度较FPIA低20.6 ng.mL 1,差异有统计学意义(P<0.05)。结论 EMIT与FPIA测定VPA、MTX和CsA血药浓度差异具有统计学意义,在治疗药物监测中应予以注意。

OBJECTIVE To compare enzyme-multiplied immunoassay technique（EMIT） and fluorescence polarization immunoassay（FPIA） method in the determination of valproic acid（VPA）, methotrexate（MTX） and cyclosporine A（CsA） concentrations in human plasma, and to evaluate the correlation of concentrations determined by EMIT and FPIA. METHODS Plasma samples were collected from patients. Both EMIT and FPIA method were employed to determine the concentrations of VPA, MTX and CsA. Regression analyses were performed （EMIT results as dependant, FPIA as independent variable） for the evaluation of correlation. RESULTS The regression equation of the results determined by FPIA （X） and EMIT （Y） were YVPA=--1.894 1＋1.190 3X, r=0.983; YMTX=0.099 24＋1.136X, r=0.992; Ycsg=-1.146 5＋0.846 1X, r=0.971. VPA concentration determined by EMIT was 11.2 μg.mL^-1 higher than FPIA. MTX concentration determined by EMIT was 0.22 μmol.L^-1 higher than FPIA. CsA concentration determined by EMIT was 20.6 ng.mL^-1 lower than FPIA（P〈0.05）. CONCLUSION Attentions should be paid to the differences ofVPA, MTX and CsA concentration determined by EMIT and FPIA methods in dosage modification.