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[碳水化合物缺乏转铁蛋白测定的个人经验]

[Personal experience with determination of carbohydrate-deficient transferrin].

作者信息

Stejskal D, Vavrousková J, Franková M, Jedelský L, Horalík D, Pastorková R

机构信息

Oddĕlení laboratorní medicíny Nemocnice, Sternberk.

出版信息

Vnitr Lek. 1999 Jun;45(6):347-52.

Abstract

Assessment of carbohydrate-deficient serum transferrin CDT) is considered a very useful indicator of alcohol abuse. There is a number of methods for assessment of CDT. In clinical practice most frequently assessment of the percentage ratio of CDT in transferrin is used. In our hospital we assessed CDT by the method of homogeneous immunoanalysis (Boehringer Mannheim (CDT-BM). Because we obtained a relatively high percentage of false results and because we found in the literature reference to a new method of homogeneous immunoanalysis (The Sanqui BioTech-CD-SB) with a different cut-off, we decided to compare the results of the estimations by the two methods and assess the percentage of false results. We examined a group of 49 patients incl. 16 who admitted alcohol abuse (> 60 g alcohol more than four times per week). As anticipated, we found that the %CDT assessed by the CDT-BM method was significantly higher than the percentage CDT-SB. After classification of the group into sub-groups with regard to alcohol intake the two sub-groups differed significantly only in values of CDT-SB and CDT-BM. In the group of patients with alcohol abuse we found relations between CDT-MB and indicators of hepatic lesions. In CDT-SB we found only an association with AST. This finding could suggest a greater specificity of CDT-SB. We confirmed data in the literature that GMT is independent on CDT and the mean corpuscular volume is independent on CDT in subjects with alcohol abuse. In abstainers who negated alcohol intake we found also when assessing CDT-SB a significant gender differentiation which is described in the literature (the reason is probably the fact that the CDT-SB method analyzes, contrary to CDT-BM, only asialo,-monosialo and disialylic isoforms of transferrin and women have higher levels of monosialylic forms). In our group the examination of %CDT by the new method, the Sanqui Biotech for alcohol abuse, had an almost absolute specificity and sensitivity. Contrary to the older Boehringer-Mannheim method we did not record any false increase in any patient with signs of hepatopathy nor any false negative results). We assume that the described methodical innovation of the analysis could facilitate the differential diagnosis of various diseases in different medical disciplines (internal medicine, neurology, psychiatry, assessment of work capacity).

摘要

对缺糖血清转铁蛋白(CDT)的评估被认为是酒精滥用的一项非常有用的指标。有多种评估CDT的方法。在临床实践中,最常使用的是评估转铁蛋白中CDT的百分比。在我们医院,我们采用均相免疫分析法(勃林格殷格翰(CDT-BM))评估CDT。由于我们获得了相对较高比例的假结果,并且在文献中发现了一种具有不同临界值的均相免疫分析新方法(三奇生物科技-CD-SB),我们决定比较两种方法的评估结果,并评估假结果的比例。我们检查了一组49名患者,其中包括16名承认有酒精滥用情况的患者(每周饮酒超过60克,超过四次)。正如预期的那样,我们发现通过CDT-BM方法评估的%CDT显著高于CDT-SB的百分比。在根据酒精摄入量将该组患者分为亚组后,两个亚组仅在CDT-SB和CDT-BM的值上存在显著差异。在酒精滥用患者组中,我们发现CDT-MB与肝脏病变指标之间存在关联。在CDT-SB中,我们仅发现与谷草转氨酶(AST)有关联。这一发现可能表明CDT-SB具有更高的特异性。我们证实了文献中的数据,即在酒精滥用患者中,γ-谷氨酰转移酶(GMT)与CDT无关,平均红细胞体积也与CDT无关。在否认饮酒的戒酒者中,我们在评估CDT-SB时也发现了文献中所描述的显著性别差异(原因可能是与CDT-BM相反,CDT-SB方法仅分析转铁蛋白的去唾液酸、单唾液酸和双唾液酸异构体,而女性的单唾液酸形式水平较高)。在我们的研究组中,采用三奇生物科技的新方法检测酒精滥用患者的%CDT具有几乎绝对的特异性和敏感性。与较旧的勃林格殷格翰方法不同,我们没有记录到任何有肝病迹象的患者出现假阳性增加的情况,也没有记录到任何假阴性结果。我们认为,所描述的分析方法创新可能有助于不同医学学科(内科、神经科、精神科、工作能力评估)中各种疾病的鉴别诊断。

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