Luna-Záizar Hilda, Virgen-Montelongo María, Cortez-Álvarez Cesar R, Ruiz-Quezada Sandra L, Escutia-Gutiérrez Raymundo, García-Lemus Cuauhtémoc R, Mendizabal-Ruiz Adriana P
CUCEI/Centro Universitario de Ciencias Exactas e Ingenierías, Universidad de Guadalajara, Blvd. Marcelino García Barragán 1421, C.P. 44430 Guadalajara, Jalisco, Mexico.
CUCEI/Centro Universitario de Ciencias Exactas e Ingenierías, Universidad de Guadalajara, Blvd. Marcelino García Barragán 1421, C.P. 44430 Guadalajara, Jalisco, Mexico.
Clin Biochem. 2015 May;48(7-8):538-41. doi: 10.1016/j.clinbiochem.2015.01.007. Epub 2015 Jan 22.
Here we aimed to investigate the in vitro effects of three analgesic-antipyretic drugs frequently used in clinical practice in Mexico - acetaminophen (AAP), aspirin (ASA) and metamizole (MMZ) - on serum measurements of glucose, urea, and creatinine.
Each analyte was measured in a base-serum pool spiked with the drugs at subtherapeutic, therapeutic, and toxic doses. Serum glucose and urea were measured using the hexokinase/G-6PDH and urease/GLDH kinetic assays, respectively. Serum creatinine (SCr) was measured with a Jaffe procedure based on the alkaline-picrate reaction and with an enzymatic dry-chemistry system. Measurements were carried out in IL-Monarch and Vitros DT60-II analyzers, respectively. Data were analyzed by the difference-paired interference test and by ANOVA.
By the kinetic Jaffe/Monarch procedure, we found positive interference by the drugs on the SCr measurements and by only ASA for urea measurement. For creatinine measurements, the total errors (TEs) were 22-51%, 18-105%, and 15-26% for AAP, ASA, and MMZ respectively, while for urea measurement the TE was 16-21% for ASA. A negative interference by MMZ on SCr (TE=-47%), but no-interference for AAP or ASA, were found via the enzymatic/DT60-II system.
In vitro positive interference induced by AAP, ASA, and MMZ (via the alkaline-picrate reaction), or negative interference by MMZ (via a dry-chemistry system), on the SCr measurements highlights the importance of investigating all possible sources of variation that may alter the accuracy of the laboratory tests, in order to provide useful results for making medical decisions for optimal patient care.
本研究旨在探究墨西哥临床实践中常用的三种解热镇痛药——对乙酰氨基酚（AAP）、阿司匹林（ASA）和安乃近（MMZ）——对血清葡萄糖、尿素和肌酐检测结果的体外影响。
在基础血清样本中分别加入亚治疗剂量、治疗剂量和中毒剂量的上述药物，然后对每种分析物进行检测。血清葡萄糖和尿素分别采用己糖激酶/G-6PDH和脲酶/GLDH动力学分析法进行检测。血清肌酐（SCr）采用基于碱性苦味酸盐反应的Jaffe法以及酶促干化学系统进行检测。分别在IL-Monarch和Vitros DT60-II分析仪上进行测量。数据通过配对差异干扰试验和方差分析进行分析。
通过动力学Jaffe/Monarch法，我们发现这些药物对SCr测量存在正干扰，对尿素测量仅有ASA存在正干扰。对于肌酐测量，AAP、ASA和MMZ的总误差（TE）分别为22 - 51%、18 - 105%和15 - 26%，而对于尿素测量，ASA的TE为16 - 21%。通过酶促/DT60-II系统发现MMZ对SCr存在负干扰（TE = -47%），但对AAP或ASA无干扰。
AAP、ASA和MMZ（通过碱性苦味酸盐反应）引起的体外正干扰，或MMZ（通过干化学系统）引起的负干扰，对SCr测量结果的影响突出了调查所有可能改变实验室检测准确性的变异来源的重要性，以便为优化患者护理的医疗决策提供有用结果。
