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造影剂如何影响心脏标志物和凝血试验?实验研究。

How Do Contrast Agents Affect Cardiac Markers and Coagulation Tests? Experimental Study.

作者信息

Tascanov Mustafa Begenc, Gönel Ataman

机构信息

Department of Cardiology, Harran University, Sanliurfa, Turkey.

Department of Medical Biochemistry, Harran University, Sanliurfa, Turkey.

出版信息

Comb Chem High Throughput Screen. 2019 Aug 8;22(5):355-360. doi: 10.2174/1386207322666190603170438.

Abstract

BACKGROUND

The discovery that biotin interferes with results of troponin and Nt-proBNP led some commercial firms to update their measurement methods. In particular, the clinical incompatibility of cardiac test results may affect the risk of morbidity and mortality.

OBJECTIVE

The aim of this study is to investigate the interference effects of 7 different contrast agents on cardiac markers (Troponin-I, Nt-proBNP, Mass CK-MB, CK, AST, LDH) and in coagulation tests (PT, APTT).

METHODS

Seven different contrast media were added into control materials by using interference protocol. The concentrations of PT, APTT, CK, AST, LDH, Mass CK-MB, Troponin-I, and Nt-proBNP were measured by Sysmex CS-2100, Abbott c16000, Siemens Centaur XP and AFİAS-6 analyzer. The number of deviations from target values was calculated.

RESULTS

The 7 different contrast media caused negative interference in troponin levels between 57.43% and 62.87%. It was found that different contrast media produced false negativity in the Nt-proBNP test, ranging from 6.11% to 96.01%. Enzymes and coagulation tests were less affected.

CONCLUSION

Different contrast media may cause false negatives in cTnI and Nt-proBNP. The contrast medium that causes the least interference should be preferred. The results of samples taken in the first hour after contrast imaging should be interpreted with care.

摘要

背景

生物素干扰肌钙蛋白和N末端脑钠肽前体(Nt-proBNP)检测结果这一发现,促使一些商业公司更新其检测方法。特别是心脏检测结果的临床不兼容性可能会影响发病和死亡风险。

目的

本研究旨在调查7种不同造影剂对心脏标志物(肌钙蛋白I、Nt-proBNP、质量法肌酸激酶同工酶MB、肌酸激酶、天门冬氨酸氨基转移酶、乳酸脱氢酶)及凝血检测(凝血酶原时间、活化部分凝血活酶时间)的干扰作用。

方法

采用干扰方案将7种不同造影剂添加到对照材料中。使用Sysmex CS-2100、雅培c16000、西门子Centaur XP和AFİAS-6分析仪检测凝血酶原时间、活化部分凝血活酶时间、肌酸激酶、天门冬氨酸氨基转移酶、乳酸脱氢酶、质量法肌酸激酶同工酶MB、肌钙蛋白I和Nt-proBNP的浓度。计算与目标值的偏差数量。

结果

7种不同造影剂导致肌钙蛋白水平出现57.43%至62.87%的负干扰。发现不同造影剂在Nt-proBNP检测中产生的假阴性率为6.11%至96.01%。酶和凝血检测受影响较小。

结论

不同造影剂可能导致心肌肌钙蛋白I(cTnI)和Nt-proBNP出现假阴性。应首选干扰最小的造影剂。造影成像后第一小时采集的样本结果应谨慎解读。

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