-
血清淀粉样蛋白A(serum amyloid A protein,SAA)是一种急性时相蛋白质,是组织淀粉样蛋白A的前体物质。SAA主要有4个基因型,分别表达SAA 1型至4型。人类和小鼠的SAA均由4个外显子和3个内含子组成,分型依据其空间构型和N末端蛋白序列等[1-2]。SAA在感染性疾病[3-4]、肿瘤检测[5]、脑卒中预后[6]、慢阻肺[7]、细胞凋亡[8]等方面均有一定的临床价值,目前SAA检测平台或检测方法有多种,本文着重比较免疫散射比浊法和免疫荧光层析2种测定法之间的异同点,现作报道。
-
观察组血清用2种方法检测的SAA水平均高于对照组(P < 0.01);观察组免疫速率散射比浊法所测SAA值高于免疫荧光层析测定法(P < 0.01),而对照组采用两种方法所测SAA值差异无统计学意义(P>0.05)(见表 1)。按厂家说明书所示:免疫速率散射比浊法SAA < 10 mg/L判读正常,≥10 mg/L判读阳性;免疫荧光层析 < 8 mg/L判读正常,≥8 mg/L判读阳性。对所有研究对象的SAA水平进行检测,结果显示,2种方法的敏感度和特异性差异均无统计学意义(P>0.05)(见表 2)。
分组 n 免疫速率散射比浊法 免疫荧光层析测定法 t P 观察组 100 95.31±16.99 63.37±7.85 19.89 < 0.01 对照组 100 5.80±0.87 8.25±1.27 0.62 > 0.05 t — 52.62 69.31 — — P — < 0.01 < 0.01 — — 表 1 两种方法所测SAA水平的比较(x±s;mg/L)
分组 n 敏感度/% 特异度/% 免疫速率散射比浊法 200 53.00 92.00 免疫荧光层析测定法 200 57.00 93.00 χ2 — 0.32 0.07 P — > 0.05 > 0.05 表 2 两种方法检测SAA敏感度及特异度的比较
-
免疫荧光层析测定法对健康体检者所测SAA的下限概率为83.00%(83/100),高于免疫速率散射比浊法的42.00%(42/100)(χ2=35.86,P < 0.01),免疫荧光层析测定法检测低值时候更稳定。
两种检测系统检测血清淀粉样蛋白A的结果比较
Effect comparison of two methods in the detection of serum amyloid A protein
-
摘要:
目的比较免疫速率散射比浊法和免疫荧光层析法检测血清淀粉样蛋白A(serum amyloid A protein,SAA)的结果。 方法收集住院病人(观察组)和健康体检者(对照组)血清,均分别采用全自动特定蛋白检测仪(采用免疫速率散射比浊法)和荧光免疫定量分析仪(免疫荧光层析法)检测SAA水平,比较2种检测系统上的分析结果。 结果观察组血清用2种方法检测的SAA水平均高于对照组(P < 0.01);观察组免疫速率散射比浊法所测SAA值高于免疫荧光层析法(P < 0.01),而对照组采用2种方法所测SAA值差异无统计学意义(P>0.05)。免疫速率散射比浊法和免疫荧光层析法检测的敏感度分别为53.00%和57.00%,特异度分别为92.00%和93.00%,差异均无统计学意义(P>0.05)。荧光免疫层析法对健康体检者所测SAA的下限概率为83.00%(83/100),高于免疫速率散射比浊法的42.00%(42/100)(χ2=35.86,P < 0.01),荧光免疫层析法检测低值时候更稳定。 结论免疫速率散射比浊法和免疫荧光层析均能用于临床检测,后者的稳定性更好。 Abstract:ObjectiveTo compare the effects between immunovelocity nephelometry and immunofluorescence chromatography in the detection of serum amyloid protein A(SAA). MethodsThe serum levels of SAA of inhospital patients(observation group) and healthy physical examinees(control group) were detected using the full-automatic specific protein detector(immunovelocity nephelometry) and fluorescence immunoquantitative analyzer (immunofluorescence chromatography), and the detection results were compared between two methods. ResultsThe serum levels of SAA deetcted by two methods in observation grop were higher than those in control group(P < 0.01).The serum level of SAA in observation group detected by immunovelocity nephelometry was higher than that of immunofluorescence chromatography(P < 0.01), while the difference of the serum level of SAA in control group was not statistically significant between two detection methods(P>0.05).The sensitivities and specificities of immunovelocity nephelometry and immunofluorescence chromatography were 53.00% & 57.00% and 92.00% & 93.00%, respectively, and the differences of those were not statistically significant between two methods(P>0.05).The lower limit probability of SAA detected by fluorescence immunochromatography in control group(83.00%, 83/100) was higher that of immunovelocity nephelometry(42.00%, 42/100) (χ2=35.86, P < 0.01).The fluorescence immunochromatography in the detection of low value was more stable. ConclusionsThe immunovelocity nephelometry and immunofluorescence chromatography can be used for clinical detection, the latter has better stability. -
表 1 两种方法所测SAA水平的比较(x±s;mg/L)
分组 n 免疫速率散射比浊法 免疫荧光层析测定法 t P 观察组 100 95.31±16.99 63.37±7.85 19.89 < 0.01 对照组 100 5.80±0.87 8.25±1.27 0.62 > 0.05 t — 52.62 69.31 — — P — < 0.01 < 0.01 — — 表 2 两种方法检测SAA敏感度及特异度的比较
分组 n 敏感度/% 特异度/% 免疫速率散射比浊法 200 53.00 92.00 免疫荧光层析测定法 200 57.00 93.00 χ2 — 0.32 0.07 P — > 0.05 > 0.05 -
[1] SACK GH JR.Serum amyloid A-a review[J].Mol Med, 2018, 24(1):46. [2] BEACH CM, DE BEER MC, SIPEI JD, et al.Human serum amyloid A protein.Complete amino acid sequence of a new variant[J].Biochem J, 1992, 282(Pt2):615. [3] 李留花.小儿感染性疾病鉴别诊断中SAA和CRP联合检测的临床价值[J/CD].临床检验杂志(电子版), 2018, 7(1):113. [4] 吴金斌, 邹德学, 周逵, 等.降钙素原与淀粉样蛋白A检测在学龄前儿童早期细菌感染中的诊断价值[J].国际检验医学杂志, 2016, 37(15):2126. [5] 廖贵莉, 张月霞, 许秀军.血清淀粉样蛋白A联合肿瘤标志物检测在肺癌中的应用[J].国际检验医学杂志, 2016, 37(24):3500. [6] 孙增强, 王璐璐, 王雁.急性后循环缺血性脑卒中患者血清淀粉样蛋白A和C反应蛋白浓度变化[J].中国老年学杂志, 2018, 38(14):3368. [7] 高淑平, 温旺荣, 谭艳玲.慢性阻塞性肺疾病急性加重期伴肺炎患者血清IL-6、HPT、SAA的检测价值分析[J].国际检验医学杂志, 2018, 39(12):1479. [8] 张倩璐, 邓珊, 江青山, 等.SAA蛋白与BCL-2、Caspase-3及NF-κB关系的研究[J].东南大学学报(医学版), 2015, 34(2):191. [9] SIEGMUND SV, SCHLOSSER M, SCHILDBERG FA, et al.Serum amyloid A induces inflammation, proliferation and cell death in activated hepatic stellate cells[J].PLoS One, 2016, 11(3):e0150893. [10] VALLEJO A, CHAMI B, DENNIS JM, et al.NFkappaB inhibition mitigates serum amyloid a-induced pro-atherogenic responses in endothelial cells and leukocyte adhesion and adverse changes to endothelium function in isolated aorta[J].Int J Mol Sci, 2018, 20(1):E105. [11] JO SH, YUN J, KIM JM, et al.Serum amyloid A induces WISH cell apoptosis[J].Acta Pharmacol Sin, 2007, 28(1):73. [12] MIWATA H, YAMADA T, OKADA M, et al.Serum amyloid A protein in acute viral infections[J].Arch Dis Child, 1993, 68(2):210. [13] 梁毅珊.CD64、降钙素原、血清淀粉样蛋白A及C反应蛋白在急性感染性疾病中的诊断价值[J/CD].临床医药文献电子杂志, 2018, 5(6):138. [14] 龚桓卉, 张峥嵘, 赵秋华.血清淀粉样蛋白A方法评价及其在儿童感染性疾病诊断中的应用[J].当代医学, 2019, 25(4):59. [15] KURET T, LAKOTA K, MALI P, et al.Naturally occurring antibodies against serum amyloid A reduce IL-6 release from peripheral blood mononuclear cells[J].PLoS One, 2018, 13(4):e0195346.