Van Lente F, Suit P
Department of Biochemistry, Cleveland Clinic Foundation, OH 44195.
Clin Chem. 1989 Dec;35(12):2326-30.
We compared creatinine concentrations in serum and urine and creatinine clearances determined by two Jaffé (Beckman's "Astra," Boehringer Mannheim Diagnostics) and two enzymatic (Kodak, Boehringer Mannheim Diagnostics) methods. Serum creatinine and creatinine clearances determined by each method were also compared with the glomerular filtration rate as measured with use of sodium [125I]iothalamate in patients with a wide range of renal function. Results between methods correlated excellently, but we saw clear method-dependent biases of up to 2.9 mg/L for serum. The highest serum creatinine values and the lowest creatinine clearances were obtained with Boehringer Mannheim Diagnostics' Jaffé method. The reciprocal of the serum creatinine and the creatinine clearance also correlated well with the glomerular filtration rate, but all methods over-estimated the glomerular filtration rates to varying degrees. Appropriate standardization of methods appears to be as important as method principle for establishing an accurate relationship between creatinine determinations and glomerular filtration rate.
我们比较了血清和尿液中的肌酐浓度，以及通过两种杰氏法（贝克曼公司的“Astra”、勃林格殷格翰诊断公司的产品）和两种酶法（柯达公司、勃林格殷格翰诊断公司的产品）测定的肌酐清除率。还将每种方法测定的血清肌酐和肌酐清除率与使用[125I]碘肽酸钠测量的肾小球滤过率进行了比较，这些患者的肾功能范围广泛。各方法之间的结果相关性极佳，但我们发现血清存在高达2.9mg/L的明显方法依赖性偏差。勃林格殷格翰诊断公司的杰氏法得出的血清肌酐值最高，肌酐清除率最低。血清肌酐的倒数和肌酐清除率与肾小球滤过率也具有良好的相关性，但所有方法均不同程度地高估了肾小球滤过率。对于在肌酐测定和肾小球滤过率之间建立准确关系而言，方法的适当标准化似乎与方法原理同样重要。
