アデニル酸キナーゼ活性がJSCC勧告法のクレアチンキナーゼ(CK)測定に与える影響

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  • アデニルサン キナーゼ カッセイ ガ JSCC カンコクホウ ノ クレアチンキナーゼ(CK)ソクテイ ニ アタエル エイキョウ

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Most laboratories in Japan measure creatine kinase using the method recommended by the Japan Society of Clinical Chemistry(JSCC). As high activity of adenylate kinase(AK), an enzyme widely distributed across organs, causes positive errors in CK values, the JSCC recommends the use of AK inhibitors and dual kinetic assay in the measurement of CK activity. Here we investigated the effect of AK activity on the CK value in blood samples.We found that seven of 27,767 samples showed relatively high AK activity in the first reaction(Abs/min ≥ 0.01). All seven of those patients died within 1 to 36 hours of sample collection. Six samples showed higher AK activity in the first reaction than in the second reaction. Negative errors during CK assay of the seven samples ranged from －27 to 0 U/L, and atypical CK activity that showed negative values(－21 U/L) was observed. The negative error was improved by sample dilution, probably due to a decrease in AK activity in the samples. An inhibition study using AMP and Ap5A, and an electrophoretic analysis suggested that in the seven samples with high levels of AK activity, five had high levels of AK3 activity and two had high levels of AK2 activity.The high levels of AK activity caused negative errors when assaying CK. The error may be avoided by calculating CK activity with dual kinetic assay after reducing AK activity through sample dilution.

収録刊行物

  • 臨床病理

    臨床病理 67 (1), 17-23, 2019-01-25

    日本臨床検査医学会

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