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葡萄糖-6-磷酸脱氢酶缺乏症的定量和定性检测比较。

Comparison of quantitative and qualitative tests for glucose-6-phosphate dehydrogenase deficiency.

出版信息

Am J Trop Med Hyg. 2014 Oct;91(4):854-861. doi: 10.4269/ajtmh.14-0194. Epub 2014 Jul 28.

Abstract

A barrier to eliminating Plasmodium vivax malaria is inadequate treatment of infected patients. 8-Aminoquinoline-based drugs clear the parasite; however, people with glucose-6-phosphate dehydrogenase (G6PD) deficiency are at risk for hemolysis from these drugs. Understanding the performance of G6PD deficiency tests is critical for patient safety. Two quantitative assays and two qualitative tests were evaluated. The comparison of quantitative assays gave a Pearson correlation coefficient of 0.7585 with significant difference in mean G6PD activity, highlighting the need to adhere to a single reference assay. Both qualitative tests had high sensitivity and negative predictive value at a cutoff G6PD value of 40% of normal activity if interpreted conservatively and performed under laboratory conditions. The performance of both tests dropped at a cutoff level of 45%. Cytochemical staining of specimens confirmed that heterozygous females with > 50% G6PD-deficient cells can seem normal by phenotypic tests.

摘要

消除间日疟原虫疟疾的一个障碍是对感染患者的治疗不充分。基于 8-氨基喹啉的药物可清除寄生虫;然而,葡萄糖-6-磷酸脱氢酶(G6PD)缺乏的人会因这些药物而面临溶血的风险。了解 G6PD 缺乏症检测的性能对患者安全至关重要。评估了两种定量检测和两种定性检测。定量检测的比较给出了 Pearson 相关系数为 0.7585,平均 G6PD 活性有显著差异,突出了需要坚持使用单一参考检测的必要性。如果保守解释并在实验室条件下进行,两种定性检测在截定点 G6PD 值为正常活性的 40%时均具有高灵敏度和阴性预测值。在截定点为 45%时,两种检测的性能均下降。对标本的细胞化学染色证实,杂合子女性中 > 50% 的 G6PD 缺乏细胞可以通过表型检测看起来正常。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db9b/4183416/ec42cc676ec8/tropmed-91-854-g001.jpg

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