Evaluation of the Test-mate ChE (Cholinesterase) Field Kit in Acute Organophosphorus Poisoning
Evaluation of the Test-mate ChE (Cholinesterase) Field Kit in Acute Organophosphorus Poisoning
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DOI：
10.1016/j.annemergmed.2011.07.014
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发表时间：
2011-12-01
影响因子：
6.2
通讯作者：
Buckley, Nicholas A.
中科院分区：
文献类型：
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作者：
Rajapakse, Bishan N.;Thiermann, Horst;Buckley, Nicholas A.
研究目的：乙酰胆碱酯酶（AChE）的测量被推荐用于有机磷中毒的管理，这导致全世界每年有20万人死亡。Test-mate ChE 400是一种便携式现场工具包，用于检测职业性有机磷暴露，可在4分钟内测量RBC AChE和血浆胆碱酯酶（PChE）。我们评估Test-mate对急性有机磷自身中毒患者的参考实验室检测：方法：这是一个横断面的比较研究，2007年5月至2008年6月之间的14例急性有机磷中毒。红细胞乙酰胆碱酯酶和PChE分别测定96和91个样本，与测试伴侣胆碱酯酶现场试剂盒和与参考实验室进行比较，使用一致性方法（Bland和Altman），kappa统计，和斯皮尔曼的相关系数的限制。平均差异（供试品-参比品）为-0.62 U/g血红蛋白，95%一致性限值为-10.84至9.59 U/g血红蛋白。在轻度、中度和重度RBC AChE抑制类别之间也观察到良好的一致性（加权kappa 0.85; 95%置信区间[Cl] 0.83至0.87）。PChE的测量结果也显示出良好的一致性，平均差异（供试品-参比品）为+0.06 U/mL血液，95%一致性限值为-0.41至0.53 U/mL血液。RBC AChE和PChE的斯皮尔曼相关系数分别为0.87（95%CI 0.81 ~ 0.91）和0.76（95%CI 0.66 ~ 0.84）。受试者内相关性分析的受试者并没有改变的限制agreement.Conclusion：Test-mate胆碱酯酶现场试剂盒可靠地提供了快速测量红细胞乙酰胆碱酯酶在急性有机磷中毒。[Ann 2011;58：559-564.]
Study objective: Measurement of acetylcholinesterase (AChE) is recommended in the management of organophosphorus poisoning, which results in 200,000 deaths worldwide annually. The Test-mate ChE 400 is a portable field kit designed for detecting occupational organophosphorus exposure that measures RBC AChE and plasma cholinesterase (PChE) within 4 minutes. We evaluate Test-mate against a reference laboratory test in patients with acute organophosphorus self-poisoning.Methods: This was a cross-sectional comparison study of 14 patients with acute organophosphorus poisoning between May 2007 and June 2008. RBC AChE and PChE were measured in 96 and 91 samples, respectively, with the Test-mate ChE field kit and compared with a reference laboratory, using the limits of agreement method (Bland and Altman), kappa statistics, and Spearman's correlation coefficients.Results: There was good agreement between the Test-mate ChE and the reference laboratory for RBC AChE. The mean difference (Test-mate reference) was -0.62 U/g hemoglobin, 95% limits of agreement -10.84 to 9.59 U/g hemoglobin. Good agreement was also observed between the categories of mild, moderate, and severe RBC AChE inhibition (weighted kappa 0.85; 95% confidence interval [Cl] 0.83 to 0.87). Measurement of PChE also showed good agreement, with a mean difference (Test-mate reference) of +0.06 U/mL blood, 95% limits of agreement -0.41 to 0.53 U/mL blood. Spearman's correlation coefficients were 0.87 (95% Cl 0.81 to 0.91) for RBC AChE and 0.76 (95% Cl 0.66 to 0.84) for PChE. Analysis for within-subject correlation of subjects did not change the limits of agreement.Conclusion: The Test-mate ChE field kit reliably provides rapid measurement of RBC AChE in acute organophosphorus poisoning. [Ann Emerg Med. 2011;58:559-564.]