Alberti K G, Hockaday T D
Br Med J. 1972 Jun 3;2(5813):565-8. doi: 10.1136/bmj.2.5813.565.
Different methods of assessing ketone body concentrations in blood and plasma of ketoacidotic patients have been compared. We confirmed that Ketostix reacts strongly with acetoacetate, giving a useful range of 0 to 10 mM for plasma acetoacetate, that acetone reacts weakly, and that 3-hydroxybutyrate does not react at all. Plasma Ketostix readings correlated only moderately well with enzymatically determined whole-blood acetoacetate. All samples giving a + + + reaction contained more than 1.6 mM acetoacetate while only 4 out of 21 samples showing 0 contained more than 0.4 mM. Comparison of Ketostix readings with total blood ketone body content showed poor correlation. One reason for this was the large variation in the ratio of 3-hydroxybutyrate to acetoacetate in ketoacidosis; another was that often Ketostix had been stored in such a way that they had become damp, which impairs their reliability. If the Ketostix reading and estimation of the blood pH show a discrepancy we suggest that an enzymatic assay should be used to determine the ketone bodies and lactate.
已对评估酮症酸中毒患者血液和血浆中酮体浓度的不同方法进行了比较。我们证实，酮体试纸与乙酰乙酸反应强烈，对于血浆乙酰乙酸，给出的有用范围为0至10 mM，丙酮反应较弱，而3-羟基丁酸根本不反应。血浆酮体试纸读数与酶法测定的全血乙酰乙酸仅中度相关。所有给出 +++ 反应的样本乙酰乙酸含量均超过1.6 mM，而21个显示为0的样本中只有4个超过0.4 mM。酮体试纸读数与全血酮体含量的比较显示相关性较差。原因之一是酮症酸中毒中3-羟基丁酸与乙酰乙酸的比例变化很大；另一个原因是酮体试纸常常因储存方式不当而受潮，这会损害其可靠性。如果酮体试纸读数与血液pH值估计存在差异，我们建议采用酶法测定酮体和乳酸。
