Porter W H, Yao H H, Karounos D G
Department of Pathology and Laboratory Medicine, University of Kentucky Medical Center, Lexington 40536-0084, USA.
Am J Clin Pathol. 1997 Mar;107(3):353-8. doi: 10.1093/ajcp/107.3.353.
We have performed a two-part evaluation of assays for beta-hydroxybutyrate (beta HB). In Part I, we evaluated the analytical acceptability of a dry film, self-contained analyzer for beta HB measurement (KetoSite; GDS Diagnostics, Elkhart, Ind). The assay response is linear and between-day imprecision is acceptable. Acetoacetate (AcAc) interferes severely with this assay. This interference could be minimized by dilution of serum before the assay. With this predilution protocol, KetoSite beta HB results compare favorably with an automated Sigma (St. Louis, Mo) beta HB assay. In Part II, we compared the clinical utility of beta HB measurements (Sigma) with the qualitative measurement of ketones using the nitroprusside test (Acetest; Bayer, Elkhart, Ind) for the diagnosis and management of diabetic ketoacidosis (DKA). Test results for both assays were abnormal for all patients with DKA on admission. However, frequent monitoring with either test during the management of uncomplicated DKA added little if any additional clinical information over routine measurements of serum glucose and total carbon dioxide.
我们对β-羟基丁酸（βHB）检测方法进行了两部分评估。在第一部分中，我们评估了一种用于βHB测量的干片式独立分析仪（KetoSite；GDS Diagnostics，印第安纳州埃尔克哈特）的分析可接受性。该检测方法的反应呈线性，日间不精密度可接受。乙酰乙酸（AcAc）对该检测方法有严重干扰。这种干扰可通过在检测前稀释血清来最小化。采用这种预稀释方案时，KetoSite的βHB结果与Sigma（密苏里州圣路易斯）的自动化βHB检测方法相比具有优势。在第二部分中，我们比较了βHB测量（Sigma）与使用硝普钠试验（Acetest；拜耳，印第安纳州埃尔克哈特）定性检测酮体在糖尿病酮症酸中毒（DKA）诊断和管理中的临床效用。所有DKA患者入院时两种检测方法的结果均异常。然而，在单纯性DKA治疗期间，使用任何一种检测方法进行频繁监测，相较于常规测量血清葡萄糖和总二氧化碳，几乎没有增加额外的临床信息。
