单克隆荧光偏振免疫法、多克隆荧光偏振免疫法和高效液相色谱法分别测定环孢素A血药浓度结果的相关性探讨

 目的本实验定量比较当前通行的3种CsA(环孢素A)测定方法,考察方法间相关性,建立普遍适用的测定结果换算方法。方法分别采用高效液相色谱法、单克隆和多克隆荧光免疫法测定样品,测定结果采用Levene和Tamhane's T2进行方差分析,用Spearman进行相关性比较。结果经过统计分析得到3组方法结果互换方程式,Y_mFPIA=0.967 1X_HPLC+45.761; Y_pFPIA=1.493 7X_HPLC+205.94;Y_pFPIA=1.563X_mFPIA+129.72。结论高效液相色谱法、单克隆和多克隆荧光偏振免疫法三者间具有良好的相关性,通过方程式可将各自测定结果方便准确的互算。     

LC-MS/MS法和mFPIA法测定全血环孢素A浓度的相关性比较

目的:对高效液相色谱电喷雾串联质谱(LC-MS/MS)法和单克隆荧光偏振免疫(mFPIA)法测定肾移植术后稳定期患者不同时间点的全血环孢素A(CsA)浓度进行相关性比较。方法:分别采用LC-MS/MS法和mFPIA法测定患者全血CsA浓度,对测定结果进行双侧配对t检验比较差异性,用Passing-Bablok回归分析法比较不同采血时间点2种方法测定结果的相关性。结果:2种方法测定值之间具有显著性差异;服药后0、3.0、4.0h时2法测定值的相关性最好,0.5、0.75、12.0h相关性最差。结论:对CsA血药浓度监测结果的分析需考虑监测方法以及不同采血时间点的影响。     

HPLC—MS法和mFPIA法测定全血环孢霉素A及其代谢物的比较

目的:对测定全血环孢霉素 A 的 HPLC-MS 法和单克隆荧光偏振免疫分析法(mFPIA 法)进行评价。方法:建立HPLC-MS 测定全血环孢霉素 A 及其代谢物的方法,采用多元线性回归对 HPLC-MS 法和 mFPIA 法测定的结果进行比较。结果:当患者肝、肾功能异常时,mFPIA 法测定结果同环孢霉素 A 及主要代谢物浓度呈线性相关,易导致检测结果偏高。结论:当患者肝、肾功能异常时,mFPIA 法不适宜作为环孢霉素 A 的临床监测方法。     

Comparison of cyclosporine concentrations in renal transplant recipients using ACMIA and mFPIA methods

OBJECTIVE: This study investigated the performance and data comparability of a new, relatively specific immunoassay method, affinity column mediated immunoassay (ACMIA) run on the Dimension Xpand-HM, and the established less specific monoclonal fluorescence polarization immunoassay (mFPIA) method on the TDx analyzer (mFPIA/TDx) in determining cyclosporine (CsA) concentrations. METHODS: Accuracy and within and between-run precision were tested. Then we measured CsA concentrations of 216 samples obtained from 51 patients and divided the 113 samples from 21 patients with renal transplants into two groups based on sampling time. RESULTS: Accuracy relative to the four weighed-in concentrations ranged from 99% to 104% and from 106% to 117% for ACMIA and mFPIA/TDx, respectively. The mean within-run precision (CV%) for the ACMIA and mFPIA/TDx methods was 4.31% and 2.57%, respectively. The mean recovery for ACMIA and mFPIA/TDx in the between-run study was 104.50% and 111.12%, respectively. The mFPIA/ACMIA ratio (the ratio of the concentration measured by mFPIA/TDx to that measured by ACMIA) of C2-3 (concentrations measured 2-3 h after oral administration) was 118.85%, which was significantly smaller than that (139.12%) of C8-12 (those measured more than 8 h after the administration) at each mean concentration. CONCLUSIONS: These results indicate that ACMIA is more accurate than mFPIA/TDx, and the difference in the mFPIA/ACMIA ratio between C2-3 and C8-12 was due to the difference in the relative cross-reactivity with CsA metabolites. Although mFPIA/TDx had an apparent calibration error, both methods had a clinically acceptable within and between-run precision.