National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, PR China.
Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, PR China.
Clin Chem Lab Med. 2020 Jul 12;59(1):139-145. doi: 10.1515/cclm-2020-0424.
Drug-laboratory test interactions (DLTIs) are one of the major sources of laboratory errors. Calcium dobesilate (CaD) interference on serum creatinine testing is a widespread problem that has long been ignored in China. A national EQA-based survey was launched to investigate the current status of CaD interference on creatinine routine methods used in China and enhance the education of CaD interference in clinical laboratories.
A descriptive survey was developed to characterize the status quo of Chinese laboratory professionals' cognition to CaD interference. Four of survey samples which were spiked with/without interference additive were shipped to 175 participant laboratories. The target reference values from a reference measurement procedure were compared against the results from participating laboratories to evaluate the CaD interference on serum creatinine measurements using enzymatic method or Jaffé method.
The lack of knowledge of DLTIs and the barriers to collect information from pharmacological and laboratory data systems had become the main problems on implementing DLTIs education in China. A significant negative influence of CaD on enzymatic method was observed regardless of measurement platforms. Jaffé method was generally free from interaction with CaD but showed poor precision and accuracy at low creatinine concentrations.
More efforts should be made to enhance the education of DLTIs in clinical laboratories in China.
药物-实验室检验相互作用（DLTIs）是实验室检验误差的主要来源之一。在我国，过去很长一段时间里，一直忽视了羟苯磺酸钙（CaD）对血清肌酐检测的干扰问题。本研究开展了一项基于全国室间质量评价（EQA）的调查，旨在了解我国目前 CaD 对常规肌酐检测方法的干扰情况，加强临床实验室对 CaD 干扰的认识。
设计了一项描述性调查，以了解中国实验室专业人员对 CaD 干扰的认知现状。将 4 个含有/不含有干扰添加剂的样本分发给 175 家参与实验室。将参考测量程序的靶值与参与实验室的结果进行比较，以评估酶法或 Jaffé 法检测血清肌酐时 CaD 对检测的干扰。
缺乏药物-实验室检验相互作用的相关知识，以及从药理学和实验室数据系统获取信息的障碍，已成为我国实施药物-实验室检验相互作用教育的主要问题。无论检测平台如何，CaD 对酶法均有显著的负性影响。Jaffé 法一般不受 CaD 干扰，但在肌酐浓度较低时精密度和准确度较差。
应加强我国临床实验室药物-实验室检验相互作用教育。
