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頁籤選單縮合
題名 | 高濃度葡萄糖對判讀肌酸酐測定時之影響 |
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作者 | 陳振文; 吳綉春; 黃東波; | 書刊名 | 中華民國腎臟醫學會雜誌 |
卷期 | 8:1 1994.03[民83.03] |
頁次 | 頁32-37 |
分類號 | 415.74 |
關鍵詞 | 肌酸酐; 葡萄糖; 腹膜平衡試驗; 肌酸酐修正係數; Creatinine; Glucose; Peritoneal equilibration test; Corrected creatinine coefficient; |
語文 | 中文(Chinese) |
中文摘要 | 葡萄糖 (glucose) 可以干擾肌酸酐 (creatinine) 之測定並造成假陽性肌酐軒的現象。在一般生理情況下低濃度葡萄糖所產生的干擾效果有限,臨床上通常都忽略不計。即使在一些糖尿病患所產生的高血糖併發症,例如高血糖性高滲透壓非自同性糖尿病昏迷 (hyperglycernic hyperosmolar ElordEetonic diabetic coma,HHNK) 也不需要特別去修正此一干擾效果。但是在尿毒症病忠接受連續性移動性腹膜透析 (continous ambulatory peritoneal dialysis,CAPD) 之透析方式必需使用高濃度葡萄糖的透析液。通常使用 1.5% 葡萄槍透析液,有時為了超過濾的關係亦使用到 425% 葡萄糖透析液。在這種情況下就必需評估茍苟糖對肌酸酐的影響,以保證所測定肌酸軒的正確性。本研究的目的首先比較三種測定葡萄糖濃度的方法,並在不同稀釋倍數下對於假陽性肌酸酐的影響。三種方法分別為 A:hexokinase 法、 B :oxygen rate 法、 C :O-toluidine 反應法。結果顯示在未曾使用的透析液中所測出之假陽性肌酸軒如下:1.5% 葡萄槍透析液為 0.23 ±0.05mg% 、 2.5% 葡萄槍透析液為 0.47 ± 0.05mg% 、 425% 葡萄糖逢析波 為 0.83 ± 0.05mg% 。肌酸酐修正係數 (corrected creatinine coefficient) 分別如下:1.5% 葡茍糖透析液為 0.OOO154 ± 0.OOOOO7,2.5% 葡萄糖透析波為 0.OOO192 ± 0.OOOOO2,4.25% 葡萄糖透析液為 0.OOO206 土 0.OOOOOl。對於最佳葡萄糖測定法及稀釋倍數如下:1.5% 葡萄糖透析液以 O-toluidine 反應法赫釋 20 倍為 1491.7± 68.1mg%,2.5% 葡萄糖透析液以 hexokinase 反應法稀釋 5 倍為 2442.5 ± 34.5mg%,4.25% 葡萄槍透析液 則以 hexokinase 反應,法稀釋 10 倍為 4025.O ± 38.6mg% 為最接近理論值。此外肌酸軒修正係數和透析浪葡萄糖的濃度亦呈正相闋的線性相關(r=0.67,p<0.001) 。 |
英文摘要 | Glucose can interfere with the reading of creatinine analysis and make false positive results. Usually, this effect is neglected due to low glucose concentration. Yet in uremic patients treated with CAPD(continuous ambulatory peritoneal dialysis), dialysate with high glucose levels (1.5%, 2.5%, & 4.25%) may significantly interfere with the reading of creatinine analysis. This study, by comparing three methods of glucose analysis, aims to observe the degree of false positive value in creatinine reading and to find the corrected creatinine coefficient. We used (A) colorimetric hexokinase method, (B) oxygen rate method, and (C) 0-toluidine reactive method to analyze samples of dialysate 1.5%, 2.5% and 4.25%, after having them diluted according to their reading ranges. The false positive val- ues of creatinine in dialysates were 0.23 -40.05 mg% for 1.5% glucose concentration, 0.47±0.05mg% for 2.5% glucose and 0.83± 0.05 mg% for 4.25% glucose. The corrected creatinine coefficients in 1.5% glucose was 0.000154±0.000007, in 2.5% was 0.000192 ± 0.000002, and in 4.25% was 0.000206 ±0. 000001. The accuracy of glucose analysis is determined by the method used and -the times of dilution. The best result can be obtained by using 0-toluidine method with twenty times of dilution for 1.5% of dialysates; colorimetric hexokinase method with five times of dilution for 2.5% of dialysate, and with ten times dilution for 4.25% of dialysate. There is a positive correlation (r=0.67,' p<0.00) between the corrected creatinine coefficient and the concentration of glucose in dialysate. |
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