Errico Giorgia, Giordano Alessia, Paltrinieri Saverio
Veterinary Clinic Centro Veterinario Nuovo (CVN), Naples, Italy.
Vet Clin Pathol. 2012 Dec;41(4):529-40. doi: 10.1111/j.1939-165X.2012.00462.x. Epub 2012 Sep 7.
Electrophoretic analysis of plasma may provide inaccurate results unless plasma is defibrinated with ethanol.
The aim of this study, conducted following the Standards for Reporting of Diagnostic Accuracy (STARD), was to determine whether cellulose acetate (CAE), agarose gel (AGE), and capillary zone (CZE) electrophoresis of native plasma (NP) and defibrinated plasma (DP) provided the same information as serum electrophoretograms.
Serum, NP, and DP electrophoretograms obtained using the 3 methods were examined visually by 3 observers to identify changes in globulin fractions and provide diagnostic interpretations. Using serum analysis as the reference method, sensitivity, specificity, and positive likelihood ratio of NP and DP electrophoretograms to identify abnormal globulin profiles were calculated.
Specimens from 46 dogs were analyzed. Albumin and α(1) - and γ-globulin fractions were lower and β(2) -globulin fractions higher in NP than in serum and DP. Interpretations of NP electrophoretograms were the same as for serum in 54.8% (CAE), 51.2% (AGE), and 51.6% (CZE), revealed an increased β-globulin fraction in 32.3-41.5%, and resulted in misinterpretation, especially for CZE analysis, in 4.7-16.1% of the dogs; all dogs with abnormal serum electrophoretograms were identified correctly using NP. Analysis of DP was similar to serum analysis in about 2/3 of the dogs. In the others, defibrination did not resolve spurious plasma findings or induced additional changes. Up to 75 and 27% of NP and DP electrophoretograms, respectively, were abnormal in dogs with normal serum electrophoretograms. Sensitivity for NP and DP analysis was high, but specificity for NP was poor.
Analysis of NP provides the same information as serum analysis in > 50% of cases, and, despite low specificity, could preliminarily exclude the presence of abnormalities when only plasma is available. If electrophoretograms are not normalized by defibrination, electrophoretic abnormalities are likely present, and electrophoresis should be repeated using serum.
除非用乙醇去除血浆纤维蛋白，否则血浆的电泳分析可能会得出不准确的结果。
本研究按照诊断准确性报告标准（STARD）进行，旨在确定天然血浆（NP）和去纤维蛋白血浆（DP）的醋酸纤维素（CAE）、琼脂糖凝胶（AGE）和毛细管区（CZE）电泳是否能提供与血清电泳图相同的信息。
3名观察者对使用这3种方法获得的血清、NP和DP电泳图进行目视检查，以识别球蛋白组分的变化并提供诊断解释。以血清分析作为参考方法，计算NP和DP电泳图识别异常球蛋白谱的敏感性、特异性和阳性似然比。
分析了46只犬的样本。NP中的白蛋白、α(1) -和γ-球蛋白组分低于血清和DP，而β(2) -球蛋白组分高于血清和DP。NP电泳图的解释在54.8%（CAE）、51.2%（AGE）和51.6%（CZE）的情况下与血清相同，在32.3 - 41.5%的犬中显示β-球蛋白组分增加，并且在4.7 - 16.1%的犬中导致错误解释，尤其是CZE分析；所有血清电泳图异常的犬使用NP均能正确识别。约2/3的犬中DP分析与血清分析相似。在其他犬中，去纤维蛋白未能解决血浆的假性结果或引发其他变化。血清电泳图正常的犬中，分别有高达75%和27%的NP和DP电泳图异常。NP和DP分析的敏感性较高，但NP的特异性较差。
在超过50%的病例中，NP分析提供的信息与血清分析相同，并且尽管特异性较低，但在仅有血浆可用时可初步排除异常情况的存在。如果电泳图未通过去纤维蛋白进行标准化，可能存在电泳异常，应使用血清重复进行电泳。
