Cheng Jenny Yeuk Ki, Ranganatha Subramaniam Shreenidhi, Yu Stephanie C Y, Lois Choy L Y, Kwok Jeffrey Sung Shing
Department of Chemical Pathology, Prince of Wales Hospital, Hospital Authority, Hong Kong.
Department of Chemical Pathology, The Chinese University of Hong Kong, Hong Kong.
Pract Lab Med. 2024 May 15;40:e00399. doi: 10.1016/j.plabm.2024.e00399. eCollection 2024 May.
Dopamine is known to cause negative interference on enzymatic creatinine measurement. However, its effect on the Jaffe reaction, and its concentration required to interfere with enzymatic reactions, remain uncertain. This study was designed to study the interference of stable dopamine infusion on Jaffe and enzymatic creatinine assays, as well as the effect of dopamine infusion drip arm contamination on both creatinine assays.
For the first part of the study, dopamine was spiked into pooled plasma samples at different concentrations to mimic the scenario of patients on dopamine infusion at an infusion rate between 2 and 20 μg/kg/min. For the second part, dopamine preparation of 2 g/L (same as the preparation used clinically) was mixed with pooled plasma samples at different proportions to mimic drip arm contamination. Creatinine concentrations were measured using Jaffe and enzymatic reactions.
The first part showed that creatinine measurements were not interfered by dopamine infusion at an infusion rate between 2 and 20 μg/kg/min. The second part showed that dopamine could negatively interfere with enzymatic creatinine assays, even with minute drip arm contamination. The effect on the Jaffe reaction was less significant.
Creatinine concentration could be reliably measured by Jaffe or enzymatic reactions if samples are from venous access sites other than the site of dopamine infusion. When dopamine interference on enzymatic creatinine assays is suspected, using the Jaffe reaction to cross-check may provide additional useful information.
A目的：已知多巴胺会对肌酐酶法测定产生负干扰。然而，其对Jaffe反应的影响以及干扰酶促反应所需的浓度仍不确定。本研究旨在探讨稳定输注多巴胺对Jaffe法和酶法肌酐测定的干扰，以及多巴胺输注滴注臂污染对两种肌酐测定方法的影响。
B设计与方法：在研究的第一部分，将不同浓度的多巴胺加入混合血浆样本中，以模拟多巴胺输注速率为2至20μg/kg/min的患者情况。在第二部分，将2g/L的多巴胺制剂（与临床使用的制剂相同）与混合血浆样本按不同比例混合，以模拟滴注臂污染。使用Jaffe法和酶促反应测定肌酐浓度。
C结果：第一部分表明，多巴胺输注速率为2至20μg/kg/min时，肌酐测定不受干扰。第二部分表明，即使滴注臂有微量污染，多巴胺也会对酶法肌酐测定产生负干扰。对Jaffe反应的影响较小。
D讨论：如果样本来自多巴胺输注部位以外的静脉通路部位，则可通过Jaffe法或酶促反应可靠地测定肌酐浓度。当怀疑多巴胺对酶法肌酐测定有干扰时，使用Jaffe反应进行交叉核对可能会提供额外的有用信息。
