Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
BMC Med Res Methodol. 2012 Mar 31;12:40. doi: 10.1186/1471-2288-12-40.
Chronic obstructive pulmonary disease (COPD) is an inflammatory pulmonary disorder with systemic inflammatory manifestations that are mediated by circulating acute-phase reactants. This study compared an enzyme-linked immunosorbent assay (ELISA) to a nephelometric technique for the measurement of serum C-reactive protein (CRP) and serum amyloid A (SAA) and investigated how the choice of assay influenced the estimation of inflammation in patients with stable COPD.
CRP and SAA concentrations measured by ELISA and nephelometry in 88 patients with COPD and 45 control subjects were used to evaluate the performance of these methods in a clinical setting.
With both assays, the concentrations of CRP and SAA were higher in COPD patients than in controls after adjustment for age and sex. There was a moderate correlation between the values measured by ELISA and those measured by nephelometry (logCRP: r = 0.55, p < 0.001; logSAA: r = 0.40, p < 0.001). However, the concentrations of biomarkers determined by nephelometry were significantly higher than those obtained with ELISA for CRP (mean difference = 2.7 (9.4) mg/L) and SAA (mean difference = 0.31 (14.3) mg/L).
Although the serum CRP and SAA concentrations measured by ELISA and nephelometry correlated well in COPD patients, the ELISA values tended to be lower for CRP and SAA when compared with nephelometric measurements. International standardization of commercial kits is required before the predictive validity of inflammatory markers for patients with COPD can be effectively assessed in clinical practice.
慢性阻塞性肺疾病（COPD）是一种具有全身炎症表现的炎症性肺部疾病，这些表现由循环中的急性期反应物介导。本研究比较了酶联免疫吸附测定（ELISA）和散射比浊法测量血清 C 反应蛋白（CRP）和血清淀粉样蛋白 A（SAA）的效果，并研究了选择哪种检测方法会影响对稳定期 COPD 患者炎症的评估。
使用 ELISA 和散射比浊法测量 88 例 COPD 患者和 45 例对照者的 CRP 和 SAA 浓度，以评估这些方法在临床环境中的性能。
两种检测方法均显示，调整年龄和性别后，COPD 患者的 CRP 和 SAA 浓度均高于对照组。ELISA 和散射比浊法测量的 CRP 和 SAA 值之间存在中度相关性（logCRP：r=0.55，p＜0.001；logSAA：r=0.40，p＜0.001）。然而，散射比浊法确定的生物标志物浓度明显高于 ELISA 法测量的 CRP（平均差值=2.7（9.4）mg/L）和 SAA（平均差值=0.31（14.3）mg/L）。
尽管 COPD 患者的血清 CRP 和 SAA 浓度用 ELISA 和散射比浊法测量时相关性良好，但与散射比浊法测量值相比，ELISA 法测量的 CRP 和 SAA 值往往更低。在临床实践中有效评估 COPD 患者炎症标志物的预测有效性之前，需要对商业试剂盒进行国际标准化。
