3种样本管血液葡萄糖测定的稳定性比较

目的比较3种样本管血液葡萄糖测定结果的稳定性。方法将同一份患者标本分别置于普通真空采血管、草酸钾-氟化钠真空采血管、带促凝剂分离胶真空采血管内,分别在2、4、6、8、24、48、72、96h测定血液葡萄糖,观察血液葡萄糖在3种不同采血管中及不同时间内的稳定性。结果普通采血管血清葡萄糖明显低于氟化钠抗凝血浆、带促凝剂分离胶血清葡萄糖。普通真空采血管血清葡萄糖在4h内有降低趋势,但差异无统计学意义（P〉0．05）,在6、8、24、48h的血清葡萄糖逐渐降低,且差异有统计学意义（P〈0．01）。氟化钠抗凝血浆放置72h内葡萄糖浓度没有明显变化,但在96h后葡萄糖浓度降低,且差异有统计学意义（P〈0．01）。分离胶血清放置96h葡萄糖浓度没有明显变化。结论普通真空采血管血清葡萄糖浓度可稳定4h,氟化钠真空采血管血浆葡萄糖浓度可稳定72h,分离胶采血管中血清葡萄糖浓度在室温下至少可稳定96h,建议实验室使用带促凝剂分离胶采血管。     

氟化钠抗凝管与分离胶真空采血管在血糖中的应用评价

目的 探讨氟化钠抗凝管与分离胶真空采血管对保存标本血糖检测的稳定性.方法 同一体检者分别抽取氟化钠抗凝管与分离胶真空采血管静脉血各1支,连续测定即时及24、48、72、96、120、144 h血糖浓度,观察两种采血管保存标本不同时间段血糖浓度的变化.结果 检测即时及24、48、72、96、120、144 h氟化钠抗凝管与分离胶真空采血管中血糖浓度,两种采血管之间结果差异无统计学意义(P>0.05);同时分别对两种采血管即时与144 h血糖浓度进行比较,结果显示两者差异无统计学意义(P>0.05).结论 以氟化钠抗凝管与分离胶真空采血管保存的血液标本血糖浓度具有较好的稳定性.     

草酸钠-氟化钠采血管中血样离心前放置时间对血浆葡萄糖测定的影响

目的探讨草酸钠-氟化钠采血管中血样在离心前放置的时间对血浆葡萄糖测定结果产生的影响。方法收集102例志愿者的血样,将同一患者标本分别置于4管草酸钠-氟化钠采血管和4管带促凝剂分离胶采血管内,草酸钠-氟化钠采血管血样在放置0、30、60、120min后离心,带促凝剂分离胶采血管血样凝固后离心,分别放置0、30、60、120min后和草酸钠-氟化钠采血管一同测定葡萄糖浓度。结果草酸钠-氟化钠采血管中血样的血浆葡萄糖浓度随离心前放置时间增加而降低,带促凝剂分离胶采血管中样本葡萄糖浓度变化不具有统计学意义。结论草酸钠-氟化钠采血管中血样离心前放置时间对血浆葡萄糖测定结果有影响,放置时间增加会导致测定值降低。     

使用添加剂处理标本对离子选择电极法测定血锂浓度的影响

目的　探讨使用肝素钠抗凝剂、促凝剂、分离胶等添加剂处理的标本是否适合锂盐(Li+ )浓度的监测。方法　选择临床服用碳酸锂治疗达稳态的住院患者,使用真空采血系统分别采集普通管血液标本和分别含有肝素钠抗凝剂、促凝剂、分离胶等添加剂的标本,在IMS 972电解质分析仪上测定Li+浓度,比较结果的差异。结果　(1)不同方式处理的标本间Li+浓度差异有显著性(P<0. 001),其中普通血清、肝素钠抗凝血浆、促凝剂处理的血清之间Li+浓度差异均无显著性(P>0. 05),分离胶处理的标本与普通血清、促凝剂和肝素钠处理的标本之间Li+浓度差异均有显著性(P<0. 001); (2)肝素钠抗凝剂和促凝剂处理的标本与普通血清Li+浓度之间呈高度线性相关(r=0. 988~0. 993, P<0. 001),分离胶处理的标本与普通血清、肝素钠抗凝剂、促凝剂处理标本的Li+浓度线性相关均无显著性(r=0. 203~0. 288,P>0. 05); (3)肝素钠抗凝剂、促凝剂、分离胶等添加剂处理标本和普通血液标本,不分离血凝块室温放置8h,Li+浓度较放置前增高(P<0. 05~0. 001)。结论　促凝剂和肝素处理标本适合用于锂盐的快速测定,而分离胶处理的标本不适合用于离子选择电极法测定Li+浓度,也不适于储存和标本运输;使用肝素钠抗凝剂和促凝剂处理的标本,不能及时测定时应分离血浆或血     

三种真空采血管对临床生化检测结果的影响

目的 了解常用真空采血管对33项临床化学检验项目结果的影响。方法 选一国产的含促凝剂、分离胶、氟化钠/草酸钾真空采血管分别与普通干试管采集的血清进行33项临床化学项目结果比较。结果 促凝剂真空管各项生化项目结果与普通干试管生化结果比较,均无显著性差别(P>0.05);分离胶真空管除CK-MB、LDH(P<0.01)外,其它生化项目结果均与普通干试管的比较一致(P>0.05);氟化钠/草酸钾真空管应用血糖检测效果最佳,但部分生化项目的结果与干试管的比较有显著性差异(P<0.01)。结论 氟化钠/草酸钾真空管仅用于血糖检测,促凝剂真空管可用于全部常规生化项目,分离胶真空管适用于大部分的生化项目。建议各实验室依据自身实验室的条件和所检测的项目,选用适当的真空采血管。     

使用添加剂处理标本对离子选择电极法测定血锂浓度的影响

目的 探讨使用肝素钠抗凝剂、促凝剂、分离胶等添加剂处理的标本是否适合锂盐(Li+)浓度的监测.方法 选择临床服用碳酸锂治疗达稳态的住院患者,使用真空采血系统分别采集普通管血液标本和分别含有肝素钠抗凝剂、促凝剂、分离胶等添加剂的标本,在IMS-972电解质分析仪上测定Li+浓度,比较结果 的差异.结果 (1)不同方式处理的标本间Li+浓度差异有显著性(P＜0.001),其中普通血清、肝素钠抗凝血浆、促凝剂处理的血清之间Li+浓度差异均无显著性(P＞0.05),分离胶处理的标本与普通血清、促凝剂和肝素钠处理的标本之间Li+浓度差异均有显著性(P＜0.001);(2)肝素钠抗凝剂和促凝剂处理的标本与普通血清Li+浓度之间呈高度线性相关(r=0.988～0.993,P＜0.001),分离胶处理的标本与普通血清、肝素钠抗凝剂、促凝剂处理标本的Li+浓度线性相关均无显著性(r=0.203～0.288,P＞0.05);(3)肝素钠抗凝剂、促凝剂、分离胶等添加剂处理标本和普通血液标本,不分离血凝块室温放置8 h,Li+浓度较放置前增高(P＜0.05～0.001).结论 促凝剂和肝素处理标本适合用于锂盐的快速测定,而分离胶处理的标本不适合用于离子选择电极法测定Li+浓度,也不适于储存和标本运输;使用肝素钠抗凝剂和促凝剂处理的标本,不能及时测定时应分离血浆或血清.     

不同样本管中血液葡萄糖的稳定性比较

[目的]了解不同样本管血液葡萄糖结果随放置时间的影响。[方法]我们对35例受检者在全自动生化仪上分别测定其真空血清管及真空草酸钾-氟化钠抗凝管、带分离胶真空管及一次性塑料管在放置不同时间后的葡萄糖浓度。[结果]一次性塑料管的葡萄糖浓度随时间延长下降最明显，真空血清管的葡萄糖浓度随时间延长下降较明显，带分离胶真空管的葡萄糖浓度及真空草酸钾-氟化钠抗凝管的葡萄糖浓度在6h内测定值与草酸钾-氟化钠真空抗凝管的血糖即刻测定值比较无显著性差异。[结论]如果标本有血液葡萄糖检测项目，最好采用带分离胶真空管或草酸钾-氟化钠真空抗凝管。     

高原地区干燥环境下血液标本离心后室温放置时间对血糖结果的影响

目的探讨使用带分离胶的真空采血管采集的血液标本,离心后室温放置时间对血糖检测结果的影响。方法收集20例新鲜血液标本,即刻离心(0h),采用Roche Modular P全自动生化分析仪检测血糖水平,分别于室温下放置1、2、4、6、8h后,再次检测血糖水平,比较不同放置时间后血糖检测结果与0h检测结果的差异。结果标本在室温下放置1、2h后,血糖检测结果与0h血糖水平比较,差异无统计学意义(P0.05);标本在室温下放置4、6、8h后,血糖检测结果较0h血糖水平明显升高,差异有统计学意义(P0.05)。结论使用含分离胶的真空采血管采集血糖检测标本,促凝效果良好,有效阻止了血液离体后红细胞的糖酵解过程;另一方面,高原地区的干燥环境引起的水分蒸发对血糖检测结果造成一定影响。     

标本存放条件对血糖检测的影响及措施

目的分析标本存放条件对血糖检测的影响,以及探讨实验室如何采取合适的措施来避免这些因素的干扰。方法随机抽取10例患者连续2 d早晨空腹采血共20份标本。第1天每份标本分装入3支无添加剂管中,组成3组,30 min后分别进行离心,并对室温组标本检测,作为即时检测,其余两组分别放置冰箱和水浴箱保存。于2.5 h、5 h后分别对3组标本进行检测。第2天,每份标本分为两管,分别置入氟化钠草酸钾抗凝管和分离胶促凝剂管中,离心后分别于30 min(即时)2、.5 h、5 h后检测。结果无添加剂真空管中的血糖标本置室温和水浴箱2.5 h和5 h后血糖检测结果与即时检测结果相比差异均有统计学意义(P<0.01)。而冰箱存放标本2.5 h后与即时检测血糖值相比差异无统计学意义(P>0.05),但5 h后差异有统计学意义(P<0.05)。即时检测的两种真空管中的标本比较,差异无统计学意义(P>0.05)。2.5 h和5 h后血糖检测值与即时检测组同类试管比较差异均无统计学意义(P>0.05)。结论标本在不同条件下,由于糖酵解等因素会影响血糖的检测,而采用氟化钠草酸钾抗凝管和分离胶促凝剂真空采血管可以有效避免这些因素的影响。     

肝素锂抗凝血浆分离管用于血氨检测的可行性研究及评价

目的探讨肝素锂抗凝血浆分离管用于血氨检测的可行性及应用价值。方法首先选择20例健康成年人静脉血,分别将1.5 mL血液注入到肝素锂抗凝血浆分离管、EDTA-K2抗凝管、惰性分离胶管以及肝素抗凝管四种不同的真空采血管中,离心分离后将所得的血清或血浆用干化学法进行血氨即刻测定,然后研究它们在25 oC(室温)的保存条件下,随着时间的延长血氨检测结果的变化情况。另外,再选20例健康成人静脉血标本,用同样的方法探究相同血液标本即刻检测及标本常温放置1 h后再进行离心检测,分析四种不同真空采血管的血氨检测结果的差异。结果①肝素抗凝管与肝素锂抗凝血浆分离管的血氨检测即刻结果较为接近(P>0.05),且略低于EDTA-K2抗凝管及惰性分离胶管内的血氨检测结果,但四种采血管即刻检测结果间两两比较差异并不显著,无统计学意义(P>0.05)。②离心分离后常温保存时,EDTA-K2抗凝管的血氨检测结果不断升高,放置1 h即有显著变化。而肝素抗凝管、分离胶管组以及肝素锂抗凝血浆分离管组的检测结果较为接近,常温放置1 h开始升高,2 h有显著变化(P<0.05)。③肝素管与肝素锂抗凝血浆分离管的标本未离心分离常温放置1 h后的血氨检测结果略微升高,但差异无统计学意义。而EDTA-K2抗凝管和惰性分离胶管的1 h检测结果则与即刻检测结果有显著差异。结论肝素锂抗凝血浆分离管在血氨检测的实际应用中兼具肝素抗凝管与惰性分离胶管的优点,是临床血氨标本采集的优良选择。     

Cell membrane handling of sodium in lymphocytes during salt restriction in normotensives

Lymphocyte sodium content and sodium efflux were studied in 9 healthy normotensive males without history of essential hypertension before, during and after 5 weeks of severe sodium depletion. Sodium depletion caused a significant increase in sodium content and a slight but non-significant decrease in potassium content. Total and ouabain-sensitive sodium efflux rate constants decreased significantly during sodium depletion, while absolute sodium efflux, derived from cellular sodium concentration and the corresponding sodium efflux rate constants, remained unchanged. A significant reduction in arterial mean and diastolic blood pressure, measured by ambulatory as well as by home readings, was observed during salt restriction. Prolonged severe sodium depletion of normotensive subjects leads to changes in lymphocytic sodium homeostasis, probably due to a primary inhibition of the sodium pump and a secondary intralymphocytic sodium accumulation. The mechanism underlying these changes remains unclarified.     

Cefoperazone sodium/sulbactam sodium vs piperacillin sodium/tazobactam sodium for treatment of respiratory tract infection in elderly patients

BACKGROUNDRespiratory tract infections in the elderly are difficult to cure and can easily recur, thereby posing a great threat to patient prognosis and quality of life.AIMTo investigate the therapeutic effects of different antibiotics in elderly patients with respiratory tract infection. METHODSSeventy-four elderly patients with respiratory tract infection were randomly allocated to a study (n = 37; treated with cefoperazone sodium/sulbactam sodium) or control (n = 37; treated with piperacillin sodium/tazobactam sodium on the basis of routine symptomatic support) group. Both groups were treated for 7 d. Time to symptom relief (leukocyte recovery; body temperature recovery; cough and sputum disappearance; and rale disappearance time), treatment effect, and laboratory indexes [procalcitonin (PCT), C-reactive protein (CRP), white blood cell count (WBC), and neutrophil percentage (NE)] before and 7 d after treatment and the incidence of adverse reactions were assessed.RESULTSIn the study group, the time to WBC normalization (6.79 ± 2.09 d), time to body temperature normalization (4.15 ± 1.08 d), time to disappearance of cough and sputum (6.19 ± 1.56 d), and time to disappearance of rales (6.68 ± 1.43 d) were shorter than those of the control group (8.89 ± 2.32 d, 5.81 ± 1.33 d, 8.77 ± 2.11 d, and 8.69 ± 2.12 d, respectively; P = 0.000). Total effective rate was higher in the study group (94.59% vs 75.68%, P = 0.022). Serum PCT (12.89 ± 3.96 μg/L), CRP (19.62 ± 6.44 mg/L), WBC (20.61 ± 6.38 × 10⁹/L), and NE (86.14 ± 7.21%) levels of the study group before treatment were similar to those of the control group (14.05 ± 4.11 μg/L, 18.79 ± 5.96 mg/L, 21.21 ± 5.59 × 10⁹/L, and 84.39 ± 6.95%, respectively) with no significant differences (P = 0.220, 0.567, 0.668, and 0.291, respectively). After 7 d of treatment, serum PCT, CRP, WBC, and NE levels in the two groups were lower than those before treatment. Serum PCT (2.01 ± 0.56 μg/L), CRP (3.11 ± 1.02 mg/L), WBC (5.10 ± 1.83 × 10⁹/L), and NE (56.35 ± 7.17%) levels were lower in the study group than in the control group (3.29 ± 0.64 μg/L, 5.67 ± 1.23 mg/L, 8.13 ± 3.01 × 10⁹/L, and 64.22 ± 8.08%, respectively; P = 0.000). There was no significant difference in the incidence of adverse reactions between the groups (7.50% vs 12.50%, P = 0.708).CONCLUSIONPiperacillin sodium/tazobactam sodium is superior to cefoperazone sodium/ sulbactam sodium in the treatment of elderly patients with respiratory tract infection with a similar safety profile.     

Dietary sodium intake is associated with long-term risk of new-onset atrial fibrillation

Abstract

Background: The association between dietary salt intake and hypertension has been well documented. We evaluated the association between dietary sodium intake and the incidence of new-onset atrial fibrillation (AF) during a mean follow-up of 19 years among 716 subjects from the Oulu Project Elucidating Risk of Atherosclerosis (OPERA) cohort.

Material and methods: Dietary sodium intake was evaluated from a seven-day food record. The diagnosis of AF (atrial flutter included) was made if ICD-10 code I48 was listed in the hospital discharge records during follow-up.

Results: In the Kaplan-Meier curves, when quartiles of sodium consumption were considered, the cumulative proportional probabilities for AF events were higher in the highest (4th) quartile (16.8%) than in the lower quartiles (1st 6.7%, 2nd 7.3% and 3rd 10.6%) (p?=?.003). In the Cox regression analysis, sodium consumption (g/1000?kcal) as a continuous variable was independently associated with AF events (Hazard Ratio?=?2.1 (95% CI, 1.2 to 3.7) p?=.015) when age, body mass index, smoking (pack-years), office systolic blood pressure, left atrium diameter, left ventricular mass index and the use of any antihypertensive therapy were added as covariates.

Conclusions: These findings indicate that sodium intake is associated with the long-term risk of new-onset AF. Further confirmatory studies are needed.

• Key messages

• Sodium consumption correlated positively with CV risk factors: age, smoking, SBP, BMI and LDL-cholesterol.

• When quartiles of sodium consumption were considered, the AF incidence was higher in the highest quartile compared to lower quartiles.

• Sodium consumption as a continuous variable was independently associated with AF events when age, BMI, smoking, SBP, LAD, LVMI and the use of any antihypertensive therapy were considered.

     

The effect of spironolactone on sweat and urinary sodium excretion during exercise in humans

This study examined the effect of spironolactone on urinary ([Na⁺]_urine) and sweat sodium concentration ([Na⁺]_sweat) when controlling for sweat rate. Fifteen healthy subjects were required to complete two 90‐min exercise bouts (three 30‐min ordered exercise bouts at 60%, 70%, and 80% of the subjects’ age‐predicted maximum heart rate) in a 35°C and 40% relative humidity environmental chamber, once after administration of 300 mg spironolactone, and once after administration of 300 mg placebo. Both the drug and placebo were taken over an 18 h period, with the second 100 mg dose taken 6 h prior to exercise, and the first 200 mg dose taken 12 h prior to the second dose. Sweat rate was measured during each of the three exercise bouts using a Macroduct® sweat collector affixed to the flexor surface of the forearm. Urine sodium excretion rate was calculated for the three hour period immediately prior to each exercise bout. Urinary and sweat sodium concentrations were analyzed via flame photometry. Spironolactone had no effect on [Na⁺]_sweat at the different sweat rates. However, the urinary sodium excretion rate was significantly higher with spironolactone use (P<0·05). These results demonstrate that spironolactone caused the expected natriuresis, but greater sodium excretion was not observed in the sweat gland. Since the mineralocorticoid receptors (MR) in the sweat gland were not antagonized by spironolactone in the same manner as those in the kidney, this suggests that different isoforms of the MR exist in the kidney and the sweat gland of humans.     

头孢哌酮钠促溶方法对比研究

目的 探讨头孢哌酮钠的促溶方法。方法 采用36支(1g/支)注射用头孢哌酮钠进行试验，将每支分为三等分后分别纳入加温促溶组、机械振荡组、碳酸氢钠促溶组进行溶解试验，比较各组溶解情况。结果 从溶解速度来看，机械振荡组最快，碳酸氢钠促溶组其次，加温促溶组最慢，其中仅碳酸氢钠促溶组未出现再凝。结论 碳酸氢钠促溶是可行的方法。     

头孢哌酮钠舒巴坦钠的临床应用效果研究

目的：探讨头孢哌酮钠舒巴坦钠的临床应用效果。方法：选取2017.03～2018.03来我院就诊的108例需抗感染治疗的患者为研究对象,随机分为观察组和对照组,每组54例,观察组给予头孢哌酮钠舒巴坦钠滴注,对照组给予头孢他啶滴注,比较两组患者的临床疗效和不良反应发生情况。结果：观察组患者的临床有效率为94.44%(51/54),显著高于对照组的68.82%(37/54),差异有统计学意义,P＜0.05;观察组患者不良反应发生率为37.03%(20/54),显著高于对照组的16.67%(9/54),差异有统计学意义,P＜0.05。结论：头孢哌酮钠舒巴坦钠用于治疗感染疗效显著,但不良反应发生率较高,在临床应用过程中,需根据患者状况,谨慎给药。     

Naproxen sodium in the treatment of migraine

Seventy patients with classical or common migraine were treated during their attacks with either naproxen sodium or placebo in a randomised, double-blind parallel group study. The initial dose of naproxen sodium was 825 mg followed one hour later by a further 550 mg, if symptoms were the same or had improved. If the migraine symptoms had worsened, patients were offered an escape analgesic combination of 1000 mg paracetamol and 10 mg metoclopramide. Patients were assessed at monthly intervals for changes in the severity and duration of headache, premonitory symptoms (mainly visual disturbances) and photophobia, nausea and vomiting associated with migraine attacks that had occurred since the previous visit. Patients were studied for a maximum of ten attacks and significant improvement was observed in the severity and duration of headache when the patients were on naproxen sodium. Also the premonitory symptoms and photophobia improved significantly on naproxen sodium and significantly less rescue analgesics were required. Patients suffering from common migraine had less severe headaches and photophobia when taking naproxen sodium than when taking placebo and the headaches were shorter in duration and patients took less rescue analgesic. No significant difference was observed between the treatment groups in patients with classical migraine. Ten patients in the placebo group and six in the naproxen sodium group reported side-effects but these were possibly related to the use of rescue medication. Naproxen sodium proved safe and effective in common migraine attacks, but in this study efficacy was not established for classical migraine.     

普德欣与邦来立欣之间存在配伍禁忌

病例介绍患者,女,38岁,乳腺癌术后第1天。查体:T38.9℃,P76次/min,R19次/min,BP120/80mmHg。一般情况可,右乳缺如,术后给予抗炎及支持治疗,静脉输注生理盐水250ml 普德欣3g,接输邦来立欣约2min发现输液管中出现白色浑浊立即停止输入,更换其它液体,患者未发生输液不良反应。对此现象我们进行了实验观察,按照临床配置方法,将普得欣3g溶入生理盐水250ml缓慢滴入邦来立欣溶液,两药交界处迅速变成乳白色,静置2～3min后,变成白色混浊液,出现絮状物。按上述方法重复多次,均出现相同反应。讨论普德欣为第三代头孢菌素类抗生素,邦来立欣属氟喹诺酮…     

含香清洗消毒剂的研究

次氯酸钠、十二烷基磺酸钠与香精组成的含香清洗消毒剂,用含250mg/L有效氯的稀释液作用3分钟,可杀灭布片上细菌繁殖体99.98％;浸泡2分钟,对瓷碗上大肠杆菌杀灭率为100％。用含500mg/L有效氯的稀释液作用5或10分钟,可分别灭活纯化HBsAg和含10％血清的HBsAg。含1000mg/L有效氯的稀释液,浸泡15分钟,可杀灭布片上的枯草杆菌黑色变种芽胞99.99％;以其擦拭3遍,可消除物体表面自然菌99.98％。随有效氯浓度增大,作用时间延长,温度升高,溶液pH值降低,有机物含量减少,杀菌效果增强。