Delanghe J R, Louagie H K, De Buyzere M L, Leroux-Roels G G
Central Laboratory, University Hospital, Gent, Belgium.
Clin Chim Acta. 1994 Jan 14;224(1):33-44. doi: 10.1016/0009-8981(94)90118-x.
Various methods for serum creatinine determination were compared and validity of the Cockroft-Gault algorithm for calculating creatinine clearance was tested in adult icteric patients. Using conventional Jaffé assays, negative interference is proportional to the serum bilirubin content. Pretreatment of the serum with bilirubin oxidase was more efficient in eliminating bilirubin than pretreatment with potassium ferricyanide. Due to a continued creatine-poor diet and liver dysfunction, erythrocyte creatine levels and creatinine output rate were decreased. Median effect (creatinine equivalent) of non-specific chromogens in the unmodified Jaffé assay was 21 mumol/l (range: 1-108 mumol/l), vs. 19 mumol/l (range: 16-26 mumol/l) for the reference population. In the absence of multi-organ failure, the Cockroft-Gault algorithm could be used for estimating glomerular filtration rate. In patients with multiple organ failure however, we recommend correction for both bilirubin and non-specific chromogens for measuring the serum creatinine concentration.
比较了多种血清肌酐测定方法，并在成年黄疸患者中测试了Cockroft-Gault算法计算肌酐清除率的有效性。使用传统的Jaffe法，负干扰与血清胆红素含量成正比。用胆红素氧化酶预处理血清比用铁氰化钾预处理更有效地消除胆红素。由于持续的低肌酸饮食和肝功能障碍，红细胞肌酸水平和肌酐输出率降低。未改良的Jaffe法中非特异性色原的中位效应（肌酐当量）为21μmol/L（范围：1-108μmol/L），而参考人群为19μmol/L（范围：16-26μmol/L）。在没有多器官功能衰竭的情况下，Cockroft-Gault算法可用于估计肾小球滤过率。然而，在多器官功能衰竭患者中，我们建议在测量血清肌酐浓度时对胆红素和非特异性色原进行校正。
