LC-MS/MS法和EMIT法测定人血清中丙戊酸浓度的对比研究

摘要

目的:比较液相色谱-串联质谱(LC-MS/MS)法与酶放大免疫(EMIT)法测定人血清中丙戊酸(VPA)浓度的差异,为临床治疗药物监测提供参考.方法:分别采用LC-MS/MS法和EMIT法对144份住院或门诊患者血清样品中的VPA浓度进行检测,采用配对t检验、Pearson相关性分析和Bland-Altman偏差图等方法对其检测结果的差异进行评价.结果:LC-MS/MS法和EMIT法的检测结果呈正相关(r=0.924,P＜0.05);两者的回归方程为cEMIT=0.920 7cLC-MS/MS-1.114 4(r=0.924);LC-MS/MS法和EMIT法测得的VPA平均血药浓度分别为(49.9±21.2)、(54.9±21.3) μg/mL,组间比较差异有统计学意义(P＜0.05);EMIT法检测结果比LC-MS/MS法偏高8.3 μg/mL,95％置信区间为(-13.6,18.7).结论:LC-MS/MS法和EMIT法测定人血清中VPA的浓度相关性良好,但检测结果有一定的差异,建议同一患者长期监测应选用同一种方法.%OBJECTIVE:To compare the difference in the concentration determination of valproie acid (VPA) in human serum by LC-MS/MS and EMIT.METHODS:Both LC-MS/MS and EMIT methods were applied to determine the serum concentration of VPA in 144 inpatients or outpatients.The paired t-test,Pearson correlation analysis,Bland-Altman deviation chart and other methods were used to evaluate the difference in the results of concentration determination.RESULTS:The results of LC-MS/MS method was pos itively correlated with that of EMIT method (r=0.924,P＜0.05);the regression equation of them was cEMIT=0.920 7cLC.MS/MS-1.114 4 (r=0.924).Average serum concentrations of VPA determined by LC-MS/MS and EMIT were (49.9 ± 21.2) and (54.9 ± 21.3) μg/mL,with statistical significance (P＜0.05).The serum concentration of VPA determined by EMIT was higher than that by LC-MS/MS 8.3 μg/mL,95％ confidence interval was (-13.6,18.7).CONCLUSIONS:The serum concentration of VPA determined by LC-MS/MS and EMIT have high correlation.But the determination results still have certain difference,it is suggested to use same method for long term monitering.