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使用底物1,2 - O - 二月桂酰 - 消旋甘油戊二酸 -(6' - 甲基试卤灵)酯的脂肪酶测定法在犬急性胰腺炎诊断中的验证及诊断效能

Validation and diagnostic efficacy of a lipase assay using the substrate 1,2-o-dilauryl-rac-glycero glutaric acid-(6' methyl resorufin)-ester for the diagnosis of acute pancreatitis in dogs.

作者信息

Graca Roberta, Messick Joanne, McCullough Sheila, Barger Anne, Hoffmann Walter

机构信息

Department of Veterinary Pathobiology, University of Illinois-Champagne, Urbana, IL, USA.

出版信息

Vet Clin Pathol. 2005;34(1):39-43. doi: 10.1111/j.1939-165x.2005.tb00007.x.

Abstract

BACKGROUND

Increased serum lipase activity has been used historically to support the diagnosis of acute pancreatitis, a common disease in dogs. Most of the lipase assays that are currently in use lack optimum sensitivity and specificity.

OBJECTIVE

The objectives of this study were to 1) validate the 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6'-methylresorufin) ester (DGGR) assay for determination of lipase activity in canine serum and 2) compare results, reference intervals, sensitivity, and specificity of the DGGR assay with a standard 1,2-diglyceride (1,2 DiG) assay for diagnosing acute pancreatitis in dogs.

METHODS

Precision, linearity, and interference studies were performed for method validation on a Hitachi 911 analyzer. Lipase results from the DGGR and 1,2 DiG assays were compared by linear regression analysis. Sensitivity, specificity, and diagnostic efficacy were determined for both assays on a population of 30 dogs, 15 of which had acute pancreatitis based on history, clinical signs, and ultrasound findings.

RESULTS

Within-run and within-day coefficients of variation (CVs) were low (<3%), with higher day-to-day CVs (< or =14 %). The assay was linear between 8 and 2792 U/L. No significant interference by hemolysis and lipemia was found. Poor correlation was found between the assays (r(s)=0.84). The lipase reference interval was 8-120 U/L for the DGGR assay and 30-699 U/L for the 1,2 DiG assay. Sensitivity and specificity for the diagnosis of pancreatitis were 93% and 53%, respectively, for the DGGR assay and 60% and 73% for the 1,2 DiG assay. Receiver operating characteristic curve analysis showed similar areas under the curve.

CONCLUSIONS

On the basis of this study, the DGGR method is considered adequate for assaying serum lipase activity in dogs. The high sensitivity of the DGGR assay suggests it may be a useful screening test for canine pancreatitis.

摘要

背景

血清脂肪酶活性升高一直被用于辅助诊断急性胰腺炎,这是犬类的一种常见疾病。目前使用的大多数脂肪酶检测方法缺乏最佳的敏感性和特异性。

目的

本研究的目的是:1)验证1,2 - o - 二月桂酰 - rac - 甘油 - 3 - 戊二酸 -(6'-甲基试卤灵)酯(DGGR)检测法用于测定犬血清中脂肪酶活性的有效性;2)比较DGGR检测法与标准的1,2 - 甘油二酯(1,2 DiG)检测法在诊断犬急性胰腺炎时的结果、参考区间、敏感性和特异性。

方法

在日立911分析仪上进行精密度、线性和干扰研究以验证方法。通过线性回归分析比较DGGR检测法和1,2 DiG检测法的脂肪酶结果。对30只犬进行检测,其中15只根据病史、临床症状和超声检查结果诊断为急性胰腺炎,测定两种检测法的敏感性、特异性和诊断效能。

结果

批内和日内变异系数(CV)较低(<3%),日间CV较高(≤14%)。该检测法在8至2792 U/L之间呈线性。未发现溶血和脂血有明显干扰。两种检测法之间相关性较差(r(s)=0.84)。DGGR检测法的脂肪酶参考区间为8 - 120 U/L,1,2 DiG检测法为30 - 699 U/L。DGGR检测法诊断胰腺炎的敏感性和特异性分别为93%和53%,1,2 DiG检测法为60%和73%。受试者操作特征曲线分析显示曲线下面积相似。

结论

基于本研究,DGGR方法被认为适用于检测犬血清中的脂肪酶活性。DGGR检测法的高敏感性表明它可能是犬胰腺炎的一种有用的筛查试验。

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