基于微型光谱仪战地急救生化试剂的实验研究
详细信息    本馆镜像全文|  推荐本文 |  |   获取CNKI官网全文
摘要
目的:
     为适应高科技局部战争条件下对战地伤员(休克、出血、感染、多器官衰竭等重伤比例相应的增加)的救治保障需要,满足野战环境下急救设备便携、机动的需求,拟研制一种基于低电压启动的微型光谱仪进行检测,并可在野战条件下使用的生化检测仪器及配套试剂。其检测的指标包括血红蛋白、葡萄糖及血钾、钠、氯、二氧化碳,并将这几项指标组合在一起,形成急救生化的功能检测单元,通过一次检测获得6项检测结果。本研究重点在于对上述6种检测试剂进行方法改良与改进,使之能适用于微型光谱仪的检测要求,同时对其同步检测的可行性进行探讨,为简化操作、缩短报告时间、适应野外检测创造条件,也为提高战地急救能力提供技术支持。
     方法:
     1、为每项检测指标在微型光谱仪的检测波长范围内(360nm~780nm)选择一种合适的方法及试剂;
     2、分别将选定的各项指标液体检测试剂制备为干试剂:对试剂干燥方式进行选择,同时对改善试剂外观及性能的添加剂种类和浓度进行筛选;
     3.将制备好的干试剂通过调整试剂样品稀释比、检测时间以及对显色剂进行调整替换,进行干试剂成分及测定方法的改进;
     4、初步观察各项指标检测试剂的性能:对干试剂的准确性、重复性、稳定性进行初步评价。
     5、将六项指标检测试剂同步冻干于自制检测杯中,在微型光谱仪上进行整体检测的初步应用,同时对检测试剂性能进行再评价,对测定结果采用SPSS 11.0软件进行统计学分析处理。
     6、对仪器的温控系统及磁力混匀系统进行使用评价。
     主要结果:
     1、血红蛋白检测试剂由高铁氰化钾,氰化钾,离子表面活化剂等成分配置而成,并直接进行冻干。制备后的干试剂具有良好的溶解性能,降低试剂样品稀释度为125:1,使冻干后试剂具有良好溶解性能,同时获得较好的线性范围。试剂准确性实验偏倚系数为5.76%、试剂批内变异系数为2.22%,批间变异系数均值为3.37%,试剂在3个月内稳定性能良好。
     2、葡萄糖检测试剂由酶试剂、0.5%的自制色原TBHBA、以及10g/L的添加剂白蛋白制备而成,增加试剂样品稀释倍数为200:1,使试剂缩短检测时间为10min,且试剂准确性实验偏倚系数为3.28%,试剂批内变异系数为2.15%,批间变异系数均值为3.76%,试剂在3个月内稳定性能良好。
     3、钾离子检测试剂由四苯硼锂、蛋白水解酶、氢氧化钠以及20g/L的添加剂木糖醇组成,制备好的干试剂保持了较好的溶解性能及反应性能。试剂准确性实验偏倚系数为4.13%,试剂批内变异系数为2.98%,批间变异系数均值为4.06%,试剂在3个月内稳定性能良好。
     4、钠离子检测试剂由β-半乳糖苷酶、O-硝基酚半乳糖苷、缓冲液等组成,分两步进行冻干。制备好的干试剂溶解性能良好,且试剂准确性实验偏倚系数为2.79%,试剂批内变异系数为2.10%,批间变异系数均值为4.34%,试剂在3个月内稳定性能良好。
     5、氯离子检测试剂由硫氰酸汞、硝酸铁、硝酸汞等以及40g/L的添加剂右旋糖酐组成,将制备好的干试剂稀释倍数调整为100:1,获得了较好的检测性能。试剂准确性实验偏倚系数为3.05%,试剂批内变异系数为2.10%,批间变异系数均值为3.15%,试剂在3个月内稳定性能良好。
     6、二氧化碳检测试剂由碳酸酐酶、指示剂及20g/L的添加剂聚乙二醇组成,制备好的干试剂准确性实验偏倚系数为3.27%,试剂批内变异系数为3.57%,批间变异系数均值为5.41%,试剂在3个月内稳定性能良好。
     7、按照六项指标检测试剂的冻干方式,直接冻干于自制检测杯中,使用统一的稀释液,加样后自动进行磁力混匀及加热,孵育后由系统在指定波长下进行检测,通过电脑微处理快速输出报告。由检测结果显示,各指标检测试剂偏倚系数均在10%以内,除二氧化碳检测试剂批间重复性(CV%)超出5%外,其余各项指标检测试剂批内及批间重复性(CV%)均小于5%,且测定结果与干化学分析仪VITRO S-250相关性r≥0.97。
     8、微型光谱仪空气孵育系统在3min内能够达到试剂孵育所需的37℃,同时混匀系统92%的磁力搅拌子混匀状态良好。
     结论:
     1、通过对血红蛋白、葡萄糖及钾、钠、氯、二氧化碳,六种急救生化检测试剂方法、成分的改进与改良,研制出了适用于微型光谱仪的检测干试剂。该试剂在三个月内稳定性能良好,测定结果准确、可靠,能够基本满足临床测定的要求,试剂便于保存和携带。
     2、多项目急救生化指标组合式检测所形成的功能检测单元,能够通过一次检测即可获得6项测定结果,可为伤员的现场救治提供必要的检验数据,同时缩短了报告时间,为及时救治提供了保证。
     3、低电压启动的微型光谱仪,采用干电池作动力,无需交流电能完成自动孵育及混匀,整套装置具有良好的便携性和机动性,能够满足战场急救、现场快速检验的需要。
     4、微型离心机的配套研制,可为检测标本提供快速、有效的分离,同时仪器运行使用干电池,实现了不受环境限制、进行快速现场检测的目的。
     综上所述,由实验研究证实战地急救生化试剂的性能是可靠的,其基于微型光谱仪进行的同步检测方法是可行的。整套检测系统适于野战环境,能够满足便携、机动的战地检测需求,实现为战地急救提供快速、可靠检测数据的目的。
Objective:
     To meet the first aid needs of battlefield wounded persons (corresponding rate increment of serious injuries like shock, bleeding, infection, multiple organ failure and so on) in the high-technology partial war, and meet the requirements of convenience and automation of first-aid equipments in field war, we plan to develop biochemical detection equipments and matched reagents, which is based on low-voltage-start miniature optic spectrometers and can be used in field war. Detection indexes include hemoglobin, glucose and kalium, sodium, chloridion, carbon dioxide combining power. Combination of these six indexes will form an examining unit for first-aid biochemical functions, and one test gives six results. This research focuses on how to improve the six detection reagents and how to make them meet the requirements of miniature optic spectrometers. And it discusses the feasibility of simultaneous detection, and creates conditions to simplify operation, and cuts report time to fit in field detection, and provides technical support to enhance battlefield first-aid ability.
     Methods:
     1. Select a suitable method and reagent for each examining index in the wave length of miniature optic spectrometer (380nm~720nm).
     2. Make each selected index’s liquid detection reagent into dry reagent respectively: select the dry method, and filter the additive categories and concentration for the improvement of reagent appearance and performance.
     3. Adjust the dried reagent dilution ratio and examining time and adjust and substitute the chromogenic agent, and then improve the element and examining method for the dried reagent.
     4. Observe the all examining indexes initially and test the performance of dried reagent: make a primary comment on the accuracy, repeatability and stability of the dried reagent.
     5. Freeze-dry all examining reagents of the six indexes in self-made detection cup synchronously for the primary application by micro spectrometers, and at the same time evaluate examining reagent performanceperformances, and statistically analyze and deal with the detection results by the software of SPSS 11.0.
     6. Utilize and evaluate the equipment temperature control system and magnetic mixing system.
     Results:
     1. Hemoglobin examining reagent is made up of ferrate potassium cyanide, potassium cyanide, ionic surfactant and so on, and can be freeze-dry directly. Dried reagent has good solvability. When the dilution decreased to 125:1, the dried reagent not only has good solvability, but also gets better linearity range. Coefficient of variation in group of the reagent is 2.22%, and the average interassay variation coefficient is within 3.37%,. The reagent is stable in 3 months.
     2. Glucose examining reagent is made up of enzyme agent, self-made chromogen TBHBA of 0.5%, and albumin addictive of 10g/L. Increase the dilution multiple of the reagent to 200:1, and cut the reagent examining time to 10min. Coefficient of variation in groupof the reagent accuracy experiment is 2.15%, and the average interassay variation coefficient is within 3.76%. The reagent is stable in 3 months.
     3. Potassium ion examining reagent is made up of lithium tetraphenylborate proteolytic enzyme, sodium hydroxide, and xylitol addictive of 20g/L. Finished dried reagent has good solubility and reactivity. Coefficient of variation in group of the reagentof the reagent is 2.98%, and the average interassay variation coefficient is within 4.06%. The reagent is stable in 3 months.
     4. Sodium ion examining reagent is made up ofβ-galactosidase, 0-nitrophenol-galactoside, buffer solution and so on. Finished dried reagent has good solubility. Coefficient of variation in group of the reagentof the reagent is 2.10%, and the average interassay variation coefficientis within 4.34%. The reagent is stable in 3 months.
     5. Chloride examining reagent is made up of mercury thiocyanate, ferric nitrate, mercury nitrate, and dextran addictive of 40g/L. Adjust the dilution multiple of the reagent to 100:1, and get better examining performanceperformance. Coefficient of variation in group of the reagent of the reagent is 2.10%, and the average interassay variation coefficient is within 3.15%. The reagent is stable in 3 months.
     6. Examining reagent of carbon dioxide is made up of carbonic anhydrase, indicator, and addictive of polyethylene glycol of 20g/L. The accuracy experiment’s bias coefficient the finished dried reagent is 3.27%, and the coefficient of variation in group of the reagent is 3.57%, and average interassay variation coefficient 5.41%. has good solubility and repeatability. The reagent is stable in 3 months.
     7. According to the freeze-drying method for examining reagents of the six indexes, freeze-dry them in the self-made cup directly, and use uniform diluent, and mix magnetically and heat automatically after loading, and test in designated wave length by the system after incubating, and output the report quickly by computer microprocessing. Examine results show that bias coefficient of each reagent is within 10%, within-batch and inter-batch repeatability (CV%) of each index reagent is less than 5%, except the reagent of carbon dioxide combining power more than 5%. All reagents are stable in 3 months. Relevance between the examining results and dry chemistry analyzer VITRO S-250 is more than 0.97.
     8. Air incubation system of miniature optic spectrometers can reach 37℃in 3min for reagent incubation, at the same time 92% of mixing system has good mixing status.
     Conclusions:
     1. By the improvement of the method and composition of the six first-aid biochemical detection of hexokinase, glucose and kalium, sodium, chloridion, carbon dioxide combining power, we developed the examining dry reagent for miniature optic spectrometers. The reagent is stable within 3 months with accurate and reliable results which can meet basic requirements in clinical examination. The reagent is easy for storage and carrying.
     2. Performance examining unit formed by the composite examination of multi-project first-aid biochemical indexes, can gain 6 examining results from one examination. It can provide necessary data for the on-site first aid of the wounded, and cut the reporting time which ensures the timely treatment.
     3. Low-voltage-start miniature optic spectrometers use dry batteries for energy, and can finish automate incubation and mixing without alternating current. The overall equipments have good portability and automation, which can meet the needs of battlefield first aid and on-site quick examination.
     4. The development of matched miniature centrifuges can separate examining samples quickly and effectively. The equipments run by dry batteries, which breaks the environmental limitation and realized the purpose of on-site quick examination.
     In conclusion, the experimental research proves that the biochemical reagent performance for the battlefield first aid is reliable, and the simultaneous examining method is feasible on the basis of miniature optic spectrometers. The overall examining system is suitable for battlefield and can meet the portable and automate needs in battlefield examination, and realizes the purpose to provide quick and reliable information for battlefield first aid.
引文
1.王政,伍瑞昌,军队卫生装备研究现状与发展,中国医学装备,2005,2(5):1-4
    2.蒲晓允.军事检验医学概论.重庆:重庆出版社, 2006.
    3.吴俊琪,徐瑞龙,杜忠明等.VITRO S-250干式生化分析仪测定结果的比对校正.检验医学,2006,21(3):285-287
    4.陆奎英,黄国平,周爱国等.V250全自动干化学急诊生化分析仪使用评价.医疗卫生装备,2004,9:173-174
    5.袁丁,赵兰;AFT-400型快速电解质分析仪的应用体会;右江民族医学院学报;2003,25(2):243
    6. Hiroaki Suzuki, Yasuaki Matsugi. Integrated microfluidic system for the simultaneous determination of ammonia, creatinine, and urea. Sensors and Actuators B: Chemical, 2005,108(22): 700-707
    7. I. Grabowska, D. Stadnik, M. Chudy, et al. Architecture and method of fabrication PDMS system for uric acid determination. Sensors and Actuators B: Chemical, 2007,121(20): 445-451
    8.林元峰,干式法测定钾钠氯及其评价,上海医学检验杂志,1999,14(5):311
    9.王前,郑磊,张鹏.战地快速检验的现状和发展趋势.人民军医,2005,48(2):118-119
    10. B.J. Dascombe,P.R.J.Reaburn, A.C. Sirotic, et al. The reliability of the i-STAT clinical portable analyzer.Journal of Science and Medicine in Sport, 2007, 10( 3) :135-140
    11. Watts P, Haswell SJ. Microfluidic combinatorial chemistry. Curr Opin Chem Biol, 2003, 7(3):380-387
    12.潘德刚.基层部队半自动生化分析仪使用现状及建议.医疗卫生装备,2006,27(1):76
    13.管文军,便携式医学检测仪器的设计;中国医疗器械杂志;2002,26(5):323-328
    14.周小棉,林炳承.诊断实验仪器的小型化与家庭化.广东医学,2004, 25(3):333-335
    15.重庆大学.微型生化光谱分析仪器.温志渝,陈刚.中国专利.发明,ZL200310111186.X,2004-11-17
    16.陈水泳,临床检验仪器的发展趋势。医疗装备,2008(4):5-6
    17.叶应妩,王毓三.全国临床检验操作规程.第二版.南京:东南大学出版社,1997:125
    18.周细国,雷兰芳,杨伟平.间接离子选择电极法测定血清总二氧化碳的实验评价及临床应用.南华大学学报医学版,2003,31(1):100-101
    19.高强黄繁嫱韩猛,血清总二氧化碳酶法全自动分析评价,江西医学检验,2001,19(1):24-25
    20.桑胜云,胡荣芬,酶标仪微量酸碱法测定献血员血红蛋白,临床输血与检验;2009,2(3)
    21.王克强,赵辉,刘瑞锁等,低渗氯化钠法测定血红蛋白;泰山医学院学报,2004,25(3)
    22.张鹏,微孔板速率法在丙氨酸氨基转移酶检测中的应用,现代检验医学杂志,2007,22(6):60-61
    23.吴斌,崔云龙.应用酶标生化仪微量测试血清葡萄糖的评价.医疗装备,2002,12: 5-6
    24.刘录春,遇婷.丙氨酸氨基转移酶的微量检测法.预防医学情报杂志, 2005,21(3):372-373
    25. Michael D. Frenchik,Steve J. McFaul.A microplate assay for the determination of hemoglobin concentration.Clinica Chimica Acta,2004,339:199
    26. Naoto Ohgami, Sanjay Upadhyay, Ayumi Kabata, et al. Determination of the activities of glutamic oxaloacetic transaminase and glutamic pyruvic transaminase in a microfluidic system. Biosensors and Bioelectronics, 2007, 22(7): 1330-1336
    27.许敦复,郑效东·冷冻干燥技术与冻干机·北京:化学工业出版社,2005
    28.刘嘉,刘汉清,冻干技术及其在中药冻干制剂中应用的研究进展.中国医药技术经济与管理,2007, 1(5):34-42
    29.赵鹤皋·冷冻干燥技术与设备·武汉:华中科技大学出版社,2005
    30.姜崴,张春丽,王雪丰等,冻千干扰素保护剂(稳定剂)的筛选。微生物学免疫学进展, 2002, 30( 4):40-43
    31. Abira Pyne, Rahul Surana, Raj Suryanarayanan. Crystalli-zation of mannitol below Tduring freeze-drying in binary and ternary aqueous[J]. Pharm. Res., 2002,19(6):901~908.
    32. Andrea Hawe, Wolfgang Frie?. Physico-chemical lyophilization behavior of mannitol, human serum albumin formulations. European Journal of Pharmaceutical Sciences, 2006, 28( 3): 224-232
    33. Ying Han, Guo Bo Quan, Xiu Zhen Liu, et al. Improved preservation of human red blood cells by lyophilization. Cryobiology, 2005, 51:152–164
    34.刘琳琳,王华忠,蒲晓允.以TBHBA为色原的唾液葡萄糖全自动分析法的建立及应用.重庆医学,2006,35(17):1552-1553
    35. Ken-ichi Izutsu, Shigeo Kojima. freeze-concentration separates protein and polymer excipients into different amorphous phase[J]. Pharm. Res., 2000, 17(10):1316~1322.
    36. Izutsu K, Kojima S. Excipient crystallinity and its protein-structure-stabilizing effect druing freeze-drying. Journal of Pharm. Pharmacol. 2002, 54:1033–1039
    37.应武林,顾国耀.主编.分析化学.第五版.辽宁青岛:中国海洋大学出版社,2003:194-195
    38. Paul Trinder, David Webster. Determination of HDL-cholesterol using 2,4,6-tribromo-3-hydroxybenzoic acid with a commercial CHOD-PAP reagent. Ann Clin Biochem, 1984, 21: 430-436
    39.张海涛,王玉萍,郭晋,酶法和离子选择电极法测定血清钾、钠的比较;检验医学,2007,32(2):216-218;
    40.席云,肖刚,冉烈;离子选择电极间接法与酶法测定血清钾、钠的比较[J],现代医学仪器与应用,2004,16(2):5-6
    41.张春旭,王伟祥,高峰.酶法、化学发与电极法测定血清电解质的方法学对比与评估[J].检验医学,2004,19(3):256
    42. Felix Franks,Freeze-drying of bioproducts: putting principles into practice,European Journal of Pharmaceutics and Biopharmaceutics,1998,45(3): 221-229
    43. Marion G. Anhorn, Hanns-Christian Mahler, Klaus Langer, Freeze drying of human serum albumin (HSA) nanoparticles with different excipients,International Journal of Pharmaceutics, 2008,363(1-2): 162-169
    44. Wassim Abdelwahed, Ghania Degobert, Hatem Fessi , Investigation of nanocapsules stabilization by amorphous excipients during freeze-drying andstorage,European Journal of Pharmaceutics and Biopharmaceutics, 2006,63(2): 87-94
    45. Felix Franks,Freeze-Drying/Lyophilisation of Pharmaceutical and Biological Products,Cryobiology, 2000,40(4): 381-382
    46.陈麟凤,刘景汉,常用细胞冻干保护剂的特性、作用机制及应用进展。中国输血杂志,2006 , 19 (6 )500-502
    47.谭涛,刘景俊,如何减少冻干粉针制品中的萎缩不良品。齐鲁药事2005;24(8):489-490
    48.陈会海,郝万鹏;酶法与原子吸收法测定血清钾、钠对比实验研究;现代检验医学杂志,2008,23(4):14-15
    49.张孝山,何庆,帅真;硫氰酸汞法测定氯化物单点与两点定标的对比研究,天津医药,2002,30(10):612-614
    50.池胜英,陈筱菲,袁谦;硫氰酸汞法测定血清(体液)氯定标方法的探讨,温州医学院学报,1999,129(3):224-225
    51.郭江华,黄胜起,非直线定标方法测定血清氯含量;现代预防医学,2004,31(2):181-183
    52.罗梅,朱晓玲,张迎玖.液体试剂与干粉试剂酶法测定血清总二氧化碳的实验对比[J].检验医学,2004,19(6):511
    53.李和楼,刘瑞锁,曹洪林等,双试剂酚红比色法测定血清碳酸氢根,2002,20(5):285-286
    54.李顺君,临床生化实验室试剂性能评价指标探讨,现代检验医学杂志,2005,20(1):46-47
    55.叶解明,基质效应及定标方式对氯电极测定的影响,上海医学检验杂志,2002,17(1):16-18
    56.柯军,王以立,二氧化碳酶法测定不稳定的因素,临床检验杂志,1996,14(6):300
    57.李桂云.标本溶血对15项生化检验结果的影响及分析[J].检验医学与临床,2006,3(4):164-165
    58.李淼,高丽萍,王春晖等.试剂温度对半自动生化分析仪酶学测定的影响.实用诊断与治疗杂志, 2004, 18(5):417
    1. Wax DB,Reich DL.Changes,in utilization of intraoperative laboratory testing associated with the introduction of point-of-care testing device in an academic department .Anesth Analg.2007;105(6):1713-2711
    2. Catherine A. Hammett-Stabler, James H. Nichols, Point-of-Care Testing, a Critical Component of Laboratory Medicine . Clinical Biochemistry, 2009, 42( 3):135
    3.冯亚英,冯亚军,刘改凤。医学检验的发展。中国实用医药,2008,3(1):146-147
    4.陈晓东,周旭一,POCT-检验医学发展的趋势之一。放射免疫学杂志,2008,23(4):335-337
    5. Freedman DB.Clinical governance:implications for point-of-care testing[J].Ann Clin Biochem,2002,39(Pt 5):421-42
    6.干化学技术与应用。医学检验与临床,2008,19(1):1-5
    7.张克坚,生物传感器及其应用研究进展。齐鲁医学检验,2004,15(2)
    8.白莉,郭学青,生物芯片技术及其在检验医学中的应用,中外健康文摘医药学刊,2008,5(2):165
    9.王前,郑磊,张鹏.战地快速检验的现状和发展趋势.人民军医,2005,48(2):118-119
    10.丁红香,张维策,徐晓杰,即时检验血糖监测仪的应用评价。医学研究杂志,2006,35(5):85-86
    11. Jack J. Chavez, Jeffrey S. Weatherall, Stephen M. et al. Evaluation of a Point-of-Care coagulation analyzer on patients undergoing cardiopulmonary bypass surgery, Journal of Clinical Anesthesia, 2004,16(1):7-10
    12. L.V. Rao, Bj?rn A. Ekberg, Diane Connor, et al. Evaluation of a new point of care automated complete blood count (CBC) analyzer in various clinical settings, Clinica Chimica Acta, 2008, 389(1-2): 120-125
    13.陈水泳,临床检验仪器的发展趋势。医疗装备,2008(4):5-6
    14.韩志钧,黄志锋,卢业成等.主编.临床化学常用项目自动分析法.第三版.辽宁:辽宁科学技术出版社,2005.488-495
    15.张东军.作战条件下医学检验工作的设置和开展.空军总医院学报,2001,21(3):164-165
    16.李锋,吴一辉,赵华兵,等.用于微型生化分析的光探测系统.光谱学与光谱分析,2005,25(4):633-636
    17. WEN Z Y, CHEN G, HUANG S I, et al. A Novel Micro Fiber Spectrometer.SPIE’s Micromachining and Microfabrication,2003,1:4983—18.
    18.重庆大学.微型生化光谱分析仪器.温志渝,陈刚.中国专利.发明,ZL 200310111186.X,2004-11-17
    19.蒋夏林,温志渝,基于触膜屏的便携式生化仪人机接口设计。电测与仪表,2008,45(1):27-29
    20.董明国,石应元,胡家培,POCT即时检验仪器的应用与质量控制。现代检验医学杂志,2008,23(1):113-115
    21.施俊,严壮志,潘志浩,面向基层医疗卫生的POCT和数字助理的开发。中国医疗器械杂志,2008,32(1):40-46
    22.蒲晓允.主编.军事检验医学概论.重庆:重庆出版社, 2006. 115-119

© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号

地址:北京市海淀区学院路29号 邮编:100083

电话:办公室:(+86 10)66554848;文献借阅、咨询服务、科技查新:66554700