Rasburicase體外活性嚴重影響尿酸檢驗結果

In Vitro Activity of Rasburicase Significantly Affects Uric Acid Test Results

Rasburicase為強效的降尿酸藥物，臨床上用於治療腫瘤溶解症候群(Tumor lysis syndrome, TLS)所引發的高尿酸血症(Hyperuricemia)，治療過程須監控病患血中尿酸濃度，而在Rasburicase藥物治療時期，檢體送檢過程所花費的時間及保存溫度，均會影響尿酸的檢驗數據，曾經發生患者接受Rasburicase藥物治療，檢體於常溫送檢，當日測得尿酸濃度為8.3mg/dL，兩天後取同一檢體重測，尿酸濃度低於儀器可分析範圍(＜0.5mg/dL)。為闡明尿酸濃度降解的原因，本研究取該名病患之血清檢體，外部添加至不同尿酸濃度檢體，發現原尿酸濃度因此下降，直接證明存在該患者檢體中的Rasburicase藥物仍具有活性，在人體外仍具有持續分解尿酸的作用。另一組實驗則收集兩種尿酸濃度檢體，加入Rasburicase後於冰水浴及室溫環境中保存，結果顯示冰水浴組能明顯減緩Rasburicase降解尿酸的速度，證明Rasburicase的藥物活性可受溫度影響。

Rasburicase is an effective uric acid degradation drug, used to treat hyperuricemia caused by tumor lysis syndrome, the patient’s blood uric acid concentration must be monitored during the drug treatment. Whereas specimens delivery time and the storage temperature will affect the blood test of uric acid. The previous case showed that the patient was treated with Rasburicase and the specimen was tested after being transported at room temperature, the uric acid concentration is 8.3 mg/dL that day, but two days later, the same sample was taken to re-determine the uric acid concentration, and the result showed that it was below the analyzable range of the instrument (＜0.5 mg/dL). Trying to understand the cause of uric acid concentration degradation, we took this patient’s serum sample and add it to the other samples with different uric acid concentrations, and then we found that the concentration of uric acid decreased as a result, therefore, it’s proved that Rasburicase in the patient’s specimen still retains activity and has the effect of degrading uric acid in vitro. Another experiment is to collect two samples of uric acid concentration, and store in ice bath and room temperature environment after adding Rasburicase, the results showed that the ice bath group can significantly slow down the degradation of uric acid, so we proved that the activity of Rasburicase can be affected by temperature.