[基于生物传感器技术的血液和血浆中乳酸测量评估：方法比较]

[Evaluation of lactate measurement in blood and plasma with biosensor technology: a comparison of methods].

作者信息

Biedler A, Risch A, Mertzlufft F

机构信息

Klinik für Anaesthesiologie und Intensivmedizin, Universitätskliniken des Saarlandes.

出版信息

Anaesthesist. 1998 Dec;47(12):968-74. doi: 10.1007/s001010050653.

DOI:10.1007/s001010050653

PMID:9893889

Abstract

UNLABELLED

The introduction of biosensor technology for near bedside measurement of plasma lactate concentrations has been a promising step for critical care profiling. However, methodological drawbacks and relevant inaccuracy have been reported. With the advent of a new biosensor (Chiron Diagnostics) and a revised NOVA Biomedical device, accuracy was expected to be improved. The goal of the present investigation was to evaluate the accuracy of both methods.

METHODS

Two devices (System 860, Chiron Diagnostics; StatProfile 9, NOVA Biomedical) were simultaneously analysed using 9 biosensors in both fresh frozen plasma and citrated whole blood. The results were compared with an established photometric method (Lactat PAP, Analyticon). Measurements were performed as duplicates (n = 1120) before and after the addition of 1 molar sodium lactate solution (2-24 mmol/L). For the estimation of between-day precision commercially available aqueous and serum-based quality controls were analysed daily over a period of 60 days.

RESULTS

Reproducibility in blood was 2.6 +/- 2.8% (Chiron), 4.1 +/- 4.0% (NOVA) and 1.5 +/- 2.1% (Analyticon), in plasma respectively 2.1 +/- 2.4%, 2.1 +/- 2.9% and 1.0 +/- 1.1%. Mean inaccuracy in plasma presented to be -0.2 +/- 16.4% (plasma) and +7.2 +/- 13.1% (blood) for Chiron, +9.4 +/- 18.4% and +18.7 +/- 16.7% for NOVA, and -37.8 +/- 18.2% and -27.5 +/- 17.6% for Analyticon. Calculated between-day-precision (variation coefficients mean values) was 11.5 +/- 4.9% (Chiron) and 14.0 +/- 5.9% (NOVA).

CONCLUSION

Although accuracy of lactate concentrations obtained with biosensor technology has improved (mean 0-18%), the variability of the results still poses a problem (mean 13-18%). Therefore, from the methodological point of view, interpretation of a single lactate value requires caution when applying to the critically ill, particularly with view to threshold values, and should be considered vis-à-vis other options.

摘要

未标注

用于床旁测量血浆乳酸浓度的生物传感器技术的引入，是危重症病情分析中很有前景的一步。然而，已有报道指出该方法存在缺陷和相关不准确之处。随着新型生物传感器（Chiron诊断公司）和经修订的诺华生物医学设备的出现，预计准确性会有所提高。本研究的目的是评估这两种方法的准确性。

方法

使用9个生物传感器，在新鲜冷冻血浆和枸橼酸盐抗凝全血中同时分析两种设备（860系统，Chiron诊断公司；StatProfile 9，诺华生物医学）。将结果与既定的光度法（Lactat PAP，Analyticon）进行比较。在添加1摩尔乳酸钠溶液（2 - 24 mmol/L）之前和之后，测量重复进行（n = 1120）。为评估日间精密度，在60天内每天分析市售的水性和血清基质质量控制品。

结果

血液中的重现性分别为2.6 ± 2.8%（Chiron）、4.1 ± 4.0%（诺华）和1.5 ± 2.1%（Analyticon），血浆中分别为2.1 ± 2.4%、2.1 ± 2.9%和1.0 ± 1.1%。Chiron在血浆中的平均误差为 -0.2 ± 16.4%（血浆）和 +7.2 ± 13.1%（血液），诺华为 +9.4 ± 18.4%和 +18.7 ± 16.7%，Analyticon为 -37.8 ± 18.2%和 -27.5 ± 17.6%。计算得出的日间精密度（变异系数平均值）为11.5 ± 4.9%（Chiron）和14.0 ± 5.9%（诺华）。