Long Heather, Nelson Lewis S, Hoffman Robert S
Department of Emergency Medicine, St. Peter's Hospital, Albany, NY, USA.
Acad Emerg Med. 2008 Jul;15(7):688-90. doi: 10.1111/j.1553-2712.2008.00150.x.
Many hospitals must send out ethylene glycol (EG) samples to a reference laboratory, and delays in diagnosis and treatment may occur. A qualitative colorimetric test (ethylene glycol test [EGT] kit), already in use by veterinarians, gives results in 30 minutes with little expertise or cost. The EGT reliably detects the presence of EG in spiked human serum samples. The objective of this study was to prospectively assess the sensitivity and specificity of the EGT kit in actual clinical samples submitted for EG testing by the criterion standard gas chromatography (GC).
Blood samples from patients with suspected toxic alcohol poisoning submitted to a reference laboratory were tested by GC. An investigator blinded to the GC results tested the same sample with the EGT kit following the manufacturer's instructions and using the internal control. Three physicians also blinded to the GC results categorized the sample as positive for EG, negative, or inconclusive. Interrater reliability was assessed with a kappa statistic (kappa). Results of the EGT kit testing were then compared to those from GC testing.
Data are reported on 24 samples submitted. By GC, 15 samples were confirmed for EG (range 27-281 mg/dL), 5 were confirmed for methanol (ME; range 64-101 mg/dL), and 4 were negative for both alcohols. The EGT was unanimously positive in all confirmed EG samples and negative in all ME samples. In one of the negative samples, an ambiguous result occurred and was counted as a false-positive. Interobserver agreement with the EGT was high (kappa = 0.909; 95% confidence interval [CI] = 0.735 to 1.0). Sensitivity and specificity were 100% (95% CI = 70% to 100%) and 88.8% (95% CI = 52% to 100%), respectively.
The EGT appears to be a reliable qualitative test in cases of suspected human EG poisoning.
许多医院必须将乙二醇（EG）样本送往参考实验室，这可能会导致诊断和治疗的延迟。一种定性比色试验（乙二醇试验[EGT]试剂盒）已被兽医使用，该试验在30分钟内即可得出结果，所需专业知识和成本都很低。EGT能可靠地检测出加样后的人血清样本中EG的存在。本研究的目的是通过标准气相色谱法（GC）对提交进行EG检测的实际临床样本，前瞻性地评估EGT试剂盒的敏感性和特异性。
将疑似有毒酒精中毒患者的血样送至参考实验室，采用GC进行检测。一名对GC结果不知情的研究人员按照制造商的说明并使用内部对照，用EGT试剂盒对同一样本进行检测。另外三名同样对GC结果不知情的医生将样本分类为EG阳性、阴性或不确定。用kappa统计量（kappa）评估评分者间的可靠性。然后将EGT试剂盒检测结果与GC检测结果进行比较。
报告了提交的24个样本的数据。通过GC检测，15个样本被确认为EG阳性（范围为27 - 281mg/dL），5个样本被确认为甲醇（ME；范围为64 - 101mg/dL），4个样本两种醇类均为阴性。所有确诊的EG样本中EGT均呈阳性，所有ME样本中EGT均呈阴性。在一个阴性样本中出现了模棱两可的结果，被计为假阳性。观察者间对EGT的一致性较高（kappa = 0.909；95%置信区间[CI] = 0.735至1.0）。敏感性和特异性分别为100%（95% CI = 70%至100%）和88.8%（95% CI = 52%至100%）。
在疑似人类EG中毒的病例中，EGT似乎是一种可靠的定性检测方法。
