免疫透射比浊法和免疫散射比浊法检测特定蛋白的抗干扰能力比较

Comparison on the anti-interference abilities of immune turbidimetry and immune nephelometry for detecting specific proteins

目的比较免疫透射比浊法和免疫散射比浊法检测特定蛋白[免疫球蛋白G(IgG)、免疫球蛋白M(IgM)和C反应蛋白(CRP)]时对游离胆红素(FBil)、结合胆红素(CBil)、血红蛋白(Hb)和乳糜(CH)的抗干扰能力。方法收集血清样本,分别制备高、低2种浓度(IgG:8～12 g/L、>16 g/L;IgM:1.0～1.5 g/L、>2.0 g/L;CRP:4～10 mg/L、>100 mg/L)的特定蛋白混合血清6管,按1∶5、2∶5、3∶5、4∶5、5∶5将4种干扰物分别配成5种不同浓度(FBil:656、1 312、1 968、2 624、3 280μmol/L;CBil:688、1 376、2 064、2 752、3440μmol/L;Hb:9.9、19.8、29.8、39.7、49.6μmol/L;CH:3 000、6 000、9 000、12 000、15 000 FTU)添加于混合血清中,用免疫透射比浊法和免疫散射比浊法分别检测相应的特定蛋白浓度,计算干扰率,按美国临床实验室标准化协会(CLSI)EP7-A文件评价2种方法的抗干扰能力。添加不同浓度干扰物之后的特定蛋白测定均值超过同一浓度下的空白对照管的±5%为产生了干扰作用。结果免疫散射比浊法检测高浓度IgM、低浓度CRP分别在Hb浓度为9.9、29.8和9.9、29.8、39.7μmol/L时有干扰作用;免疫散射比浊法测定高、低浓度IgM分别在CH浓度为9 000、12 000、15 000和6 000、9 000、12 000、15 000 FTU时有干扰作用;而4种干扰物对免疫透射比浊法检测IgG、IgM和CRP均无干扰作用。结论免疫透射比浊法对临床常见的4种干扰物(FBil、CBil、Hb和CH)的抗干扰能力优于免疫散射比浊法。免疫透射比浊法对于干扰物颗粒较大的脂血、溶血样本具有更高的准确性。

Objective To compare the anti-interference abilities of immune turbidimetry and immune nephelometry for detecting specific proteins [immunoglobulin G（IgG）,immunoglobulin M（IgM） and C reactive protein（CRP）]through the interferers of free bilirubin（FBil）,conjugated bilirubin（CBil）,hemoglobin（Hb） and chyle（CH）. Methods A total of 6 mixed serum samples were prepared under 2 levels（high/low） of specific proteins（IgG：8-12 g/L,〉16 g/L;IgM：1.0-1.5 g/L,〉2.0 g/L;CRP：4-10 mg/L,〉100mg/L）. The 4 interferers were prepared into 5 different concentrations（FBil：656,1 312,1 968,2 624 and 3 280 μmol/L;CBil：688,1 376,2 064,2 752 and 3 440 μmol/L;Hb：9.9,19.8,29.8,39.7 and 49.6 μmol/L;CH：3 000,6 000,9 000,12 000 and 15 000 FTU） by rules（1∶5,2∶5,3∶5,4∶5 and 5∶5）,and the interferers were added to the mixed serum. The concentration of the specific proteins was detected by immune turbidimetry and immune nephelometry respectively,and the interference rate was calculated. The anti-interference abilities of the 2 methods were calculated according to Clinical and Laboratory Standards Institute（CLSI） EP7-A standard. The average concentration of the specific proteins with different interferers ±5% of the control tubes at the same concentration was considered to have interference. Results By the immune nephelometry,the values to detect IgM（high level ）and CRP（ low level） with the interferer of Hb（9.9 and 29.8 μmol/L）and Hb（9.9,29.8 and 39.7 μmol/L） respectively,also the values to detect IgM（high level and low level ） with the interferer of CH（9 000,12 000 and 15 000 FTU）and CH（6 000,9 000,12 000 and 15 000 FTU） were all considered to have interference. However,by the immune turbidimetry,the values to detect IgG,IgM and CRP with the 4 interferers were considered to have no interference. Conclusions To 4 interferers（FBil,CBil,Hb and CH）,the anti-interference ability of immune turbidimetry is better than that of immune nephelometry. The immune turbidimetry shows better accuracy to detect specimens with the interferers of lipidemia and haemolysis as large particles in the clinical application.