目的：探讨湿化学酶法检测华氏巨球蛋白血症患者肌酐假性增高的原因及解决方法。方法以2010～2012年中国人民解放军白求恩国际和平医院收治的5例华氏巨球蛋白血症患者为研究对象，采用离心超滤管将采集的患者血清中大分子蛋白滤去，分别用湿化学酶法、苦味酸法、干化学酶法检测超滤前后患者血清肌酐水平并进行比较分析。结果超滤前其中2例华氏巨球蛋白血症患者用湿化学酶法测得血清肌酐水平与苦味酸法、干化学酶法比较有明显差异，而5例患者后2种方法测得的肌酐水平差异不明显。而以离心超滤管滤去大分子蛋白后，3种方法测得的血清肌酐水平无明显差异。结论采用湿化学酶法检测华氏巨球蛋白血症患者血清肌酐时，应去除大分子蛋白以防止所测血清肌酐水平异常增高，或用干化学酶法或苦味酸法测定以确定检测的准确性，为临床提供真实可靠的检验结果。%Objective To explore causes and solutions of false estimates of elevated serum creatinine in patients with Walden‐strom′s macroglobulinemia throug wet chemical enzymatic method .Methods 5 cases of patients hospitalized in the Bethune Inter‐national Peace Hospital were enrolled as subjects from 2010 to 2012 .The large molecular proteins were removal from serum sam‐ples collected from patients with Waldenstrom′s macroglobulinemia by using centrifugal ultrafiltration tube .The serum creatinine levels were detected through using the wet chemical enzymatic method ,wet chemical picric acid method and dry chemical enzymatic method before and after ultrafiltration ,and data were compared .Results Before ultrafiltration ,the levels of serum creatinine of 2 cases of patients with Waldenstrom′s macroglobulinemia detected by using wet chemical enzymatic method differed with those de‐tected by using wet chemical picric acid method and dry chemical enzymatic method .While there were no obvious differences be‐tween levels of serum creatinine detected by wet chemical picric acid method and dry chemical enzymatic method .While ,after ultra‐filtration ,no obvious differences were founded in levels of serum creatinine detected by the thress methods .Conclusion The large molecular proteins should be eliminated when using the wet chemical enzymatic method in the detection of serum creatinine levels , in order to avoid abnormal increase .And the wet chemical picric acid method and dry chemical enzymatic method could also be uti‐lized to determine the accuracy ,and provide reliable determination results .
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