Rosenthal P, Keefe M T, Henton D, Cheng M, Lee C R, Hall R L, Newton M K
Department of Pediatrics, Children's Hospital of Los Angeles, University of Southern California School of Medicine.
Clin Chem. 1990 May;36(5):788-91.
This study compares total and direct-reacting bilirubin values in 40 serum samples from patients with various diagnoses, as measured by automated methods (Beckman Synchron CX-5, Beckman Astra 8, Kodak Ektachem 700) and HPLC and by a manual method for delta bilirubin. For total bilirubin, within-run CVs were less than 6%. The Ektachem 700 method underestimated bilirubin with serum samples from patients with Crigler-Najjar syndrome and from newborns in whom unconjugated bilirubin concentrations were increased but conjugated bilirubins were not present or were present only in small amounts. The Astra 8 and Synchron CX-5 methods were inaccurate with cholestatic serum samples, in which conjugated bilirubin concentrations were increased and other compounds such as bile acids could be expected to interfere. We conclude that each automated method examined provides reasonable estimates for total and direct-reacting bilirubin values for routine clinical use. The need for each laboratory to select the appropriate bilirubin method for its particular situation is obvious.
本研究比较了40份来自不同诊断患者的血清样本中的总胆红素和直接反应胆红素值，这些值通过自动化方法（贝克曼同步CX-5、贝克曼阿斯特拉8、柯达Ektachem 700）、高效液相色谱法以及一种测定δ胆红素的手工方法进行测量。对于总胆红素，批内变异系数小于6%。Ektachem 700方法低估了患有克里格勒-纳贾尔综合征患者以及未结合胆红素浓度升高但结合胆红素不存在或仅少量存在的新生儿的血清样本中的胆红素。阿斯特拉8和同步CX-5方法对于胆汁淤积性血清样本不准确，在这类样本中结合胆红素浓度升高，并且预计其他化合物如胆汁酸会产生干扰。我们得出结论，所检测的每种自动化方法对于常规临床使用的总胆红素和直接反应胆红素值都能提供合理的估计。每个实验室根据其特定情况选择合适的胆红素检测方法的必要性是显而易见的。
