类风湿因子引起免疫比浊法测定肌钙蛋白Ⅰ假阳性的分析与对策

Investigation on rheumatoid factors immune turbidimetric method for troponin Ⅰ produced false-positive interference and countermeasures

目的探讨类风湿因子对免疫比浊法测定肌钙蛋白Ⅰ产生的干扰性假阳性及对策。方法选取类风湿因子在0～55IU/ml、56-109IU/ml、110IU/ml以上的患者标本各20例,且都无慢性支气管炎、肺心病、冠心病等器质性疾病,CK、CK-MB、AST、肌红蛋白(MYO)均正常、无黄胆及高脂血症的患者标本,用免疫比浊法测定肌钙蛋白I和电化学发光法测定肌钙蛋白T,分析类风湿因子对测定的干扰作用。结果类风湿因子在0～55IU/ml时对肌钙蛋白Ⅰ未造成干扰,在56～109IU/ml时可造成轻度干扰,在超过110IU/ml时可造成明显干扰。结论明显增高的类风湿因子会引起免疫比浊法测定肌钙蛋白Ⅰ出现假阳性,通过联合和连续监测CK、CK-MB、AST、肌红蛋白(MYO)以及分析临床资料,可以识别这种假阳性,以避免对临床诊治造成干扰。

Objective To investigate the rheumatoid factor immune turbidimetric method, to determine troponin I produced false-positive interference and countermeasures. Methods Selected rheu- matoid factors in 0-551U/mL ,56-109IU /mL, 110IU/mL with more than 20 cases specimens of patients, and no chronic bronchitis, Cot pulmonale, coronary artery heart disease and other organic diseases. CK, CK-MB, AST, myoglobin （MYO） were normal, no jaundice and Hyperlipidemia in patients with specimens with immunoturbidimetric determination of troponin I and electro chemiluminescence determination of troponin T, analysis of rheumatoid factor on the determination of the interference effect. Results When the results of rheumatoid factor in the 0-55 IU/mL for Troponin I, no interference,in 56-109IU/mL caused mild interference, more than 110IU/mL caused significant interference. Conclusions Significantly higher rheumatoid factor causes the immune turbidimetric method false positive troponin I, and continuous monitoring by the Joint CK, CK-MB, AST, myoglobin （MYO）, and analysis of clinical data can identify the false positive, clinical diagnosis and treatment in order to avoid causing interference.