Férard G, Lessinger J M
Laboratoire de Biochimie Appliquée, UFR des Sciences Pharmaceutiques, Université Louis Pasteur de Strasbourg, Illkirch, France.
Clin Chim Acta. 1998 Dec;278(2):151-62. doi: 10.1016/s0009-8981(98)00141-7.
Standardisation in clinical enzymology needs not only reference methods but also reference materials. While single-enzyme reference enzymes have been developed, a multienzyme certified reference material (MECRM) available in high amount remains to be produced. To transfer trueness from the value of the reference system to patients' results, validated enzyme calibrators (EC) are also needed. Both the MECRM and the ECs must exhibit the same catalytic properties as the corresponding enzymes in human plasma. Moreover, commutability of these materials with patients' samples must be experimentally tested for one or a set of methods defined by an analytical specificity equal to that of the reference method. Various experimental studies have shown that the commutability of an enzyme material depends on the source of enzyme and its purification process, the matrix (including cofactors, effectors, additives, stabilisers... ) and the mode of processing of the final material. To promote intermethod calibration in clinical enzymology, a collaborative programme between the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC), Institute for Reference Materials and Measurements (IRMM, Geel, Belgium) and IFCC corporate members is in progress for the development of a MECRM containing amylase, ALT, AST, ALP, CK, GGT, LDH, and lipase and exhibiting a wide and defined commutability.
临床酶学标准化不仅需要参考方法,还需要参考物质。虽然已经开发出单酶参考酶,但仍有待生产大量可用的多酶认证参考物质(MECRM)。为了将参考系统的值的准确性传递给患者的检测结果,还需要经过验证的酶校准品(EC)。MECRM和EC都必须表现出与人类血浆中相应酶相同的催化特性。此外,这些物质与患者样本的互换性必须针对由与参考方法相同的分析特异性定义的一种或一组方法进行实验测试。各种实验研究表明,酶物质的互换性取决于酶的来源及其纯化过程、基质(包括辅因子、效应物、添加剂、稳定剂等)以及最终物质的加工方式。为了促进临床酶学中的方法间校准,国际临床化学和检验医学联合会(IFCC)、参考物质和测量研究所(IRMM,比利时海尔)以及IFCC企业成员之间正在开展一项合作计划,以开发一种包含淀粉酶、谷丙转氨酶、谷草转氨酶、碱性磷酸酶、肌酸激酶、γ-谷氨酰转移酶、乳酸脱氢酶和脂肪酶且具有广泛且明确互换性的MECRM。