Potter J L, Timmons G D, Kofron W G
Department of Pathology and Laboratory Medicine, The Children's Hospital Medical Center of Akron, OH, USA.
Clin Chim Acta. 1999 Mar;281(1-2):71-6. doi: 10.1016/s0009-8981(98)00207-1.
Screening tests for genetic metabolic diseases remain extremely useful due to their rapidity, ease of interpretation and substantial reduction of cost. However, interferences in these tests are still a source of concern in laboratory medicine. Cost considerations have so compressed the duration of the medical work-up that the administration of radiologic contrast may often antedate the collection of body fluids for genetic-metabolic testing. It has been found that under these circumstances, certain contrast media may interfere with the urinary studies of amino acids, organic acids, and tests involving ultraviolet absorption such as those concerned with purines, pyrimidines, and related compounds. The consequences of interference may be misdiagnosis, repeated testing, extensive and expensive work-ups, and unnecessary delay and anxiety for the family. As in all testing, it is prudent to avoid medications and atypical diets, if possible. In the case of contrast media, it is a simple matter to collect samples for analysis prior to the administration of radiocontrast so as to avoid the pitfalls and yet not delay the diagnostic work-up.
由于其快速性、易于解读以及成本大幅降低，遗传性代谢疾病的筛查测试仍然极为有用。然而，这些测试中的干扰因素仍是检验医学中令人担忧的一个问题。出于成本考虑，医疗检查的时间被大幅压缩，以至于放射造影剂的使用往往早于用于遗传性代谢测试的体液采集。已经发现，在这些情况下，某些造影剂可能会干扰氨基酸、有机酸的尿液研究，以及涉及紫外线吸收的测试，如与嘌呤、嘧啶及相关化合物有关的测试。干扰的后果可能是误诊、重复检测、广泛且昂贵的检查，以及给家庭带来不必要的延误和焦虑。与所有检测一样，如有可能，谨慎的做法是避免使用药物和采用非典型饮食。就造影剂而言，在使用放射造影剂之前采集样本进行分析是一件简单的事情，这样既能避免陷阱，又不会延误诊断检查。
