Clinical usefulness of alkaline phosphatase isoenzyme determinations.

1. We report on the clinical usefulness of alkaline phosphatase isoenzyme determinations using a combined chemical inhibition method on 731 patient serum specimens exhibiting elevated (greater than 350 U/L) alkaline phosphatase (AP) activity. 2. The relative percentages of the organ-specific alkaline phosphatase activities were computed on the basis of three independent assays: total activity, activity in the presence of 10 mMl-phenylalanine, and activity in the presence of 3.1 M urea. 3. Gamma-glutamyl transferase (GGT) activity assays were also performed on the same specimens. Using an upper reference limit of 30 U/L for GGT and comparing the GGT results with the percent liver AP, we found that the GGT results were 91% sensitive and 60% specific. 4. We conclude that AP isoenzyme determinations are very useful in identifying the organ source(s) responsible for elevated AP values. 5. The reference ranges for several age groups in relation to the adult population and their significance are presented.     

High-molecular-mass alkaline phosphatase: simplified and highly sensitive determination by liquid chromatography

This simplified HPLC method for measurement of high-molecular-mass alkaline phosphatase (high-Mr AP; EC 3.1.3.1) in serum and bile is rapid (time for column preparation and separation 30 min), reproducible (CV 4.2%), and highly sensitive (detects high-Mr AP in healthy controls at 1-3% of total AP activity in serum), and is suitable for processing small batches of sample. We characterized high-Mr AP in serum and bile by incubating samples with L-phenylalanine, neuraminidase, 1-butanol, or wheat-germ lectin, and by determining stability to heat. High-Mr AP activity was determined in sera of patients with various liver diseases (4-32% of total AP serum activity) and results were compared with those by electrophoresis on agarose.     

Serum alkaline phosphatase isoenzyme patterns in disease

Serum alkaline phosphatase isoenzyme patterns have been obtained using starch gel electrophoresis. The intestinal isoenzyme was detected in about one-third of over 300 serum samples examined. The incidence was high in cirrhosis and chronic renal failure but low in gastrointestinal disease. In serum from some patients the intestinal isoenzyme was the only isoenzyme present. Isoenzymes of unusual electrophoretic mobility were found in the serum of eight patients.     

Unusually high alkaline phosphatase due to intestinal isoenzyme in a healthy adult.

Intestinal alkaline phosphatase (ALP) is more prevalent in individuals of blood group O or B, and increases after a meal, especially on a high-fat diet. We did not realize that clinicians could underestimate the importance of fasting for ALP measurement until one healthy adult showed a huge difference in ALP levels before and after a meal. We report a case of transient hyperphosphatasemia resulting in unnecessary workup due to intestinal ALP in a healthy adult of blood group O.     

高效液相色谱法测定人血清甜菜碱方法的建立

目的 采用柱前衍生高效液相色谱法-紫外检测法建立一种测定人血清甜菜碱浓度的方法.方法 以对溴苯乙酰溴和18-冠醚-6溶于乙腈制成衍生液,将其与甜菜碱反应形成的衍生物用Supelcosil LC-SCX色谱柱进行分离.流动相为乙腈∶水体积比90∶10,含16 mmol/L的氯化胆碱,等度洗脱,流速为0.8 ml/min,检测波长为259 nm,利用甜菜碱标准品绘制标准曲线,外标法定量检测20名健康大学生志愿者血清甜菜碱.结果 甜菜碱的测定线性范围为6.25～200.00 μmol/L,回归方程Y=1 568.1X-2 747.5,R2=0.999 8.最低检测限为3.0 μmol/L.批内不精密度为1.88%～3.79%(平均3.24%),批间不精密度为3.14%～6.76%(平均4.39%).方法 回收率为95.89%～102.86%(平均99.16%).结论 成功建立一种检测人血清甜菜碱浓度的方法,适用于实验室及临床常规检测.     

Bone isoenzyme of serum alkaline phosphatase in acromegaly.

In 37 patients with active acromegaly and in 15 patients with inactive acromegaly, activity of bone isoenzyme of serum alkaline phosphatase correlated (P less than 0.001) with serum concentration of immunoreactive growth hormone. By using stepwise regression analysis, the predication of serum growth hormone values based on serum levels of bone isoenzyme of serum alkaline phosphatase, gamma-glutamyl transferase and calcium in these patients with acromegaly was within 1 S.D. range in 37 patients and in only 2 patients was it out of 2 S.D. range. By using discriminant analysis, based on bone and liver isoenzymes of serum alaline phosphatase and urinary hydroxyproline excretion, 87%, 60% and 97% of the classification of patients with active and inactive acromegaly and healthy adults, respectively, was correct. The multivariate approach offers a quantitative appraisal of the biochemical parameters of peripheral growth hormone action used as an indicator of growth hormone concentration in patients with acromegaly.     

巨碱性磷酸酶在肝癌诊断中的临床应用

寻求比较敏感可靠的检测肝癌的方法。方法采用巨碱性磷酸酶（ＨＭＡＰ）免疫测定对２４３例肝癌患者血清中ＨＭＡＰ含量进行分析，并与ＡＦＰ免疫测定相对照。与健康人群做比较。结果ＨＭＡＰ检测对转移性肝癌，原发性小肝癌及老年原发性肝癌诊断阳性率显著高于ＡＦＰ检测。结论ＨＭＡＰ弥补了ＡＦＰ测定的不足，可做为临床上肝癌检测的一项新方法。     

高效液相色谱法测定血浆同型半胱氨酸

目的 建立测定血浆同型半胱氨酸的高效液相色谱（ＨＰＬＣ）方法。方法 血浆同型半胱氨酸经巯基乙醇还原后用碘乙酸封闭巯基,。再与邻苯二甲醛（ＯＰＡ）反应完成衍生化,以磺在同型半胱氨酸为内标,经Ｃ１８反相柱进行色谱分离,荧光检测器测定结果。结果测定线性范围达１５０μｍｏｌ／Ｌ,最低检测限为１．０μｍｏｌ／Ｌ日内不精密度３．７－４．２％,日间不精密度３．８－４．３％;方法回收率９３－１０２％。结论本方法     

Particulate (high-molecular-mass) and soluble alkaline phosphatase in urine determined by high-performance liquid chromatography

We detected in urine by HPLC two enzyme fractions of alkaline phosphatase (AP, EC 3.1.3.1), soluble and particulate, analogous to those in serum. The second fraction was eluted with high-salt-content eluent at the same elution time as high-molecular-mass, or particulate, AP in serum. AP characterization in urine from a patient with acute rejection crisis showed a greater sensitivity of the particulate form to treatment with L-phenylalanine, which suggests a higher content of intestinal-type AP in the particulate form. The soluble fraction showed a more liver-type AP behavior. Changes in the chromatograms after the sample was treated with 1-butanol and Triton X-100 support a membrane origin of the particulate AP. Urinalyses from patients with acute renal disease showed increased activity of soluble and particulate AP, with a relatively greater increase of particulate AP.     

Placental alkaline phosphatase isoenzyme in quality control materials may be a source of variability in alkaline phosphatase activity

ObjectivesTo determine the cause of discrepancies in the alkaline phosphatase (ALP) activities of quality control (QC) materials in two different analyzers using IFCC method.Design and methodsALP activities of patients' samples and QC materials (QC1 and QC2 from Bio-Rad) measured using TBA-200FR and Synchron LX-20 analyzers were compared and isoenzyme electrophoresis was done. Fractional mixing of bone or liver ALP with placental ALP was performed. ALP activities of QC materials were measured in TBA-200FR with pH-modified reagents.ResultsALP activities of QC materials were significantly lower in TBA-200FR than in LX-20. Placental ALP comprised 57% of QC1 and 95% of QC2. Higher placental ALP proportion in the mixture with bone or liver ALP resulted in lower ALP activities in TBA-200FR. The discrepancy in ALPs of QC materials decreased when measured with pH-modified reagents.ConclusionPlacental ALP in QC materials and differences in reagents' pH caused the discrepancy in ALP activities.     

高效液相色谱法测定血清葡萄糖

摘要：目的:建立一种测定血清葡萄糖（glucose,Glu）的高效液相色谱法（HPLC）,探讨其能否作为血清Glu测定的参考方法。 方法:以D-半乳糖（D-galactose）为内标物,用无水乙醇沉淀、去除血清中的蛋白质,在pH 9.1条件下与1-苯基-3-甲基-5-吡唑啉酮（PMP）反应,用HPLC测定血清Glu衍生产物、D-半乳糖衍生产物,用标准曲线法定量;对建立的方法进行方法学评价。 结果:本法测定血清Glu的批内变异系数（CV）为0.33%～0.67%,平均0.51%;批间CV为0.02%～0.85%,平均0.38%;总CV为0.47%～1.03%,平均0.68%。回收率为98.22%～101.96%。分析Glu的参考物质SRM 965a,测定结果与认定值的偏差为-0.928%～0.347%,平均偏差为-0.072%。 结论:初步建立了测定血清Glu的HPLC法;该法准确、精密,有望作为血清Glu测定的候选参考方法。