Wilke T J
Clin Chem. 1984 Nov;30(11):1742-5.
I examined the effect of albumin deficiency, as might occur in pregnancy and nonthyroidal illness, on four analog-based assays for free thyroxin (Amersham's Amerlex, Diagnostic Products Corporation's Coat-A-Count "one-step," Clinical Assays' Gammacoat "one-step," and Corning's Immophase "single-step"). In subjects with albumin deficiency per se, Amerlex and Coat-A-Count results for free thyroxin were not significantly different from normal, whereas free thyroxin values by Gammacoat and Immophase assays were lower than that of the control. Furthermore, in the albumin-deficient group, the mean amount of thyroxin associated with antisera in each assay was significantly higher than that of the control and correlated well with the degree of decrease in free thyroxin. I conclude that subnormal results for thyroxin by analog assays, in euthyroid patients with albumin deficiency, is a function of the specific assays and is not a characteristic of analog assays per se. In addition, the study suggests that albumin deficiency alters the distribution between thyroxin and its binders in all four analog assays, but only in the Gammacoat and Immophase methods is this alteration sufficiently large as to distort assay results.
我研究了孕期及非甲状腺疾病中可能出现的白蛋白缺乏对四种游离甲状腺素的模拟法检测（即安迈盛公司的Amerlex、诊断产品公司的一步法Coat - A - Count、临床检验公司的一步法Gammacoat以及康宁公司的单步法Immophase）的影响。在单纯白蛋白缺乏的受试者中，Amerlex和Coat - A - Count检测的游离甲状腺素结果与正常结果无显著差异，而Gammacoat和Immophase检测的游离甲状腺素值低于对照组。此外，在白蛋白缺乏组中，各检测方法中与抗血清结合的甲状腺素平均量显著高于对照组，且与游离甲状腺素的降低程度密切相关。我得出结论，在甲状腺功能正常但白蛋白缺乏的患者中，模拟法检测甲状腺素结果异常是特定检测方法的作用，而非模拟法本身的特性。此外，该研究表明，白蛋白缺乏会改变所有四种模拟法检测中甲状腺素与其结合物之间的分布，但只有在Gammacoat和Immophase方法中，这种改变足够大以至于会扭曲检测结果。
