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一种高灵敏度C反应蛋白免疫测定法的开发及其与商用试剂盒的比较。

Development of a high sensitivity C-reactive protein immunoassay and comparison with a commercial kit.

作者信息

Naz Saima, Ghafoor Farkhanda, Iqbal Imran Akhtar, Saqlan Naqvi S M

机构信息

a National Health Research Complex , Shaikh Zayed Hospital , Lahore , Pakistan.

b Department of Cardiology , Shaikh Zayed Hospital , Lahore , Pakistan.

出版信息

J Immunoassay Immunochem. 2017;38(1):10-20. doi: 10.1080/15321819.2016.1206565. Epub 2016 Jul 1.

Abstract

C-reactive protein (CRP) is intricately sensitive marker of inflammation, infection, and tissue damage. Role in the prognosis of heart diseases has been recently discovered. This study aimed to develop a cost-effective and high-sensitivity CRP immunoassay for use in cardiac risk assessment. Assay was optimized for coating, blocking of capturing antibody, dilution, and reaction time of the conjugate and sample volume. For normal reference range, CRP was determined in serum samples from apparently healthy volunteers. For clinical validation, CRP was determined in samples of acute coronary syndrome patients by in-house and commercial assays. The lower detection limit of in-house assay was 0.16 µg/L. Intra and inter assay imprecision was 4.39%, 4.6% and 8.6%, 9.3%, respectively. The correlation between the CRP levels by the two assays was r = 0.861. Sensitivity, specificity, predictive value for a positive test, and a negative test of in-house assay was 95.3%, 92.8%, 95.3%, and 92.8%, respectively. At lower-end CRP levels of both kits correlated very well but showed variation at upper end. In-house assay showed high sensitivity and reliability at lower end and it is hoped that will help to evaluate cardiac risk assessment (after improvement at upper end) in clinically poor settings.

摘要

C反应蛋白(CRP)是炎症、感染和组织损伤的一种极其敏感的标志物。最近发现了其在心脏病预后中的作用。本研究旨在开发一种用于心脏风险评估的具有成本效益且高灵敏度的CRP免疫测定法。对包被、捕获抗体封闭、稀释、结合物反应时间和样本体积进行了测定优化。对于正常参考范围,在看似健康的志愿者的血清样本中测定CRP。为进行临床验证,通过内部测定法和商业测定法在急性冠状动脉综合征患者的样本中测定CRP。内部测定法的最低检测限为0.16µg/L。批内和批间不精密度分别为4.39%、4.6%和8.6%、9.3%。两种测定法测得的CRP水平之间的相关性为r = 0.861。内部测定法的灵敏度、特异性、阳性预测值和阴性预测值分别为95.3%、92.8%、95.3%和92.8%。两种试剂盒在较低CRP水平时相关性很好,但在较高水平时存在差异。内部测定法在较低水平显示出高灵敏度和可靠性,希望在临床条件较差的情况下(在较高水平改进后)有助于评估心脏风险评估。

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