化学发光分析法测定血管紧张素 I、血管紧张素 II、醛固酮和肾素的分析干扰。
Analytical Interference in Chemiluminescence Assay-Measured Angiotensin I, Angiotensin II, Aldosterone, and Renin.
机构信息
Department of Clinical Laboratory, The 909th Hospital, School of Medicine, Xiamen University, Zhangzhou, Fujian, China.
出版信息
J Clin Lab Anal. 2024 May;38(10):e25045. doi: 10.1002/jcla.25045. Epub 2024 Jun 1.
BACKGROUND
The interference can be a significant source of laboratory errors with the potential to cause immunoassay results to drift. Therefore, we evaluated the interference in various endogenous and exogenous substances on immunoassay for angiotensin I (Ang I), angiotensin II (Ang II), aldosterone, and renin in vitro.
METHODS
Ten endogenous and eight exogenous substances were evaluated at supraphysiologic or supratherapeutic plasma levels using the screening study to identify potential interfering substances. Subsequently, potential interfering substances were further tested within maximum pathological or therapeutic plasma concentration ranges using the dose-response study to determine whether the interference has a significant bias. According to preset acceptance criteria, the interference in potential interfering substances for Ang I, Ang II, and renin and aldosterone assays was determined.
RESULTS
Six potential interfering substances for Ang I immunoassays were identified, namely valsartan, nifedipine, spironolactone, cholesterol, hemoglobin, and triglyceride. Meanwhile, ethanol, nifedipine, spironolactone, heparin sodium, warfarin, hemoglobin, uric acid, cholesterol, and triglyceride appeared to have potential interference in the Ang II assay. Three identified as possible interferents for aldosterone immunoassays were glucose, valsartan, and spironolactone. Moreover, warfarin, valsartan, spironolactone, uric acid, cholesterol, bilirubin unconjugated, triglyceride, and hemoglobin were potential interfering substances for renin immunoassays. However, only spironolactone of these potential interfering substances exceeded preset mean bias limits (less than ±10.0%) in aldosterone immunoassays.
CONCLUSION
Exogenous spironolactone caused clinically significant interference in aldosterone immunoassays. Moreover, the interference in other substances was acceptable in Ang I, Ang II, and renin and aldosterone immunoassays.
背景
干扰可能是实验室误差的一个重要来源，有可能导致免疫测定结果发生漂移。因此，我们评估了各种内源性和外源性物质对血管紧张素 I（Ang I）、血管紧张素 II（Ang II）、醛固酮和肾素免疫测定的体外干扰。
方法
使用筛选研究评估了十种内源性和八种外源性物质在超生理或超治疗血浆水平下对免疫测定的潜在干扰物质。随后，使用剂量反应研究在最大病理或治疗血浆浓度范围内进一步测试潜在的干扰物质，以确定干扰是否存在显著偏差。根据预设的接受标准，确定了 Ang I、Ang II 和肾素及醛固酮测定中潜在干扰物质的干扰情况。
结果
鉴定出 Ang I 免疫测定的六种潜在干扰物质，即缬沙坦、硝苯地平、螺内酯、胆固醇、血红蛋白和甘油三酯。同时，乙醇、硝苯地平、螺内酯、肝素钠、华法林、血红蛋白、尿酸、胆固醇和甘油三酯似乎对 Ang II 测定有潜在干扰。三种被鉴定为醛固酮免疫测定可能干扰物的物质为葡萄糖、缬沙坦和螺内酯。此外，华法林、缬沙坦、螺内酯、尿酸、胆固醇、未结合胆红素、甘油三酯和血红蛋白是肾素免疫测定的潜在干扰物质。然而，在醛固酮免疫测定中，只有这些潜在干扰物质中的螺内酯超过预设的平均偏差限制（小于±10.0%）。
结论
外源性螺内酯在醛固酮免疫测定中引起了临床显著的干扰。此外，在 Ang I、Ang II 和肾素及醛固酮免疫测定中，其他物质的干扰是可以接受的。
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