各种胆红素对氧化酶法测定血清尿酸浓度的影响

目的　通过分析不同胆红素对尿酸(UA)氧化酶方法的干扰,探讨各种胆红素对过氧化物酶偶联Trinder反应的UA氧化酶测定方法的影响。方法　我们制备了24种含有不同浓度UA的血清,每种血清含有不同浓度的未结合胆红素(Bu)、结合胆红素(Bc)、δ胆红素(δBil),使用美国EKTACHE750XRCanalyzer生化分析仪测定各种胆红素浓度,使用日本7170全自动生化分析仪测定血清中的UA浓度。结果　来自Bc的干扰最大,当浓度为400μmol/L时,回收率只有56.4%;Bu的干扰较小,当浓度400μmol/L时,回收率仍达87.4%;δBil的干扰最小,随着血清中δBil浓度的提高,对UA测定基本无影响,回收率保持在93.4%以上。结论　Bu、Bc、δBil对UA氧化酶测定方法影响程度不同,在实际工作中应予以重视。     

化学氧化法测定胆红素对尿酸测定的影响

我们发现用化学氧化法测定总胆红素之后再测定尿酸,尿酸的测定结果明显偏高。通过实验观测,发现是胆红素试剂的干扰所致。报道如下。     

胆红素氧化酶法测定血清结合胆红素

介绍使用国产胆红素氧化酶和二牛磺酸胆红素校准物建立血清结合胆红素测定方法。测定缓冲液为０．１ｍｏｌ／Ｌ柠檬酸盐缓冲液（ｐＨ＝５．０），胆红素氧化酶浓度５００Ｕ／Ｌ，反应（终点）时间１５分钟。本法线性范围可达２４０μｍｏｌ／Ｌ，批内不精密度＜１０％，回收率为９８．３％～１０７．１％，与重氮方法比较，回归方程为Ｙ（酶法）＝０．９５６Ｘ（重氮法）－０．５１３。本法测定人血清结合胆红素参考值２．５７±２．５６μｍｏｌ／Ｌ（ｎ＝９５）。     

胆红素氧化酶法测定血清结合胆红素

介绍使用国产胆红素氧化酶和二牛磺酸胆红素校准物建立血清结合胆红素测定方法。测定缓冲液为０．１ｍｏｌ／Ｌ柠檬酸盐缓冲液（ｐＨ＝５．０），胆红素氧化酶浓度５００Ｕ／Ｌ，反应（终点）时间１５分钟。本法线性范围可达２４０μｍｏｌ／Ｌ，批向不精密度＜１０％，回收率为９８．３％～１０７．１％，与重氮方法比较，回归方程为Ｙ（酶法）＝０９５６Ｘ（重氮法）－０．５１３。本法测定人血清结合胆红素参考值２．５７±２．５     

血清胆红素和尿酸水平与冠心病的关系

目的探讨血清胆红素(Bil)和尿酸(UA)水平与冠心病(CHD)的关系。方法符合条件并经冠状动脉造影确诊的100例CHD患者为CHD组,经体检证实为健康者60名为对照组,采用全自动生化分析仪检测空腹血清总Bil(TBil)、直接Bil(DBil)和血UA浓度并计算间接Bil(IBil)。再将CHD组分为单支病变组和多支病变组与对照组进行比较,并根据冠状动脉病变积分进行统计学分析。结果CHD组血清TBil、DBil、IBil、UA与健康对照组之间的差异有统计学意义(P<0.01)。对照组、单支病变组与多支病变组之间血清Bil和UA的差异有统计学意义(P<0.05、P<0.01)。血清TBil浓度与冠状动脉病变程度呈显著负相关,而血UA与冠状动脉病变程度呈显著正相关。结论低血清Bil水平可能是CHD的危险因素之一。高UA水平可能是导致CHD的重要因素。血清Bil和UA水平与冠状动脉病变的严重程度有一定的关系,可通过血清Bil、血UA等生化指标的综合测定来间接评估患者冠状动脉病变的严重程度。     

血清胆红素和尿酸水平与冠心病的关系

目的探讨血清胆红素（Bil）和尿酸（UA）水平与冠心病（CHD）的关系。方法符合条件并经冠状动脉造影确诊的100例CHD患者为CHD组,经体检证实为健康者60名为对照组,采用全自动生化分析仪检测空腹血清总Bil（TBil）、直接Bil（DBil）和血UA浓度并计算间接Bil（IBil）。再将CHD组分为单支病变组和多支病变组与对照组进行比较,并根据冠状动脉病变积分进行统计学分析。结果CHD组血清TBil、DBil、IBil、UA与健康对照组之间的差异有统计学意义（P〈0.01）。对照组、单支病变组与多支病变组之间血清Bil和UA的差异有统计学意义（P〈0.05、P〈0.01）。血清TBil浓度与冠状动脉病变程度呈显著负相关,而血UA与冠状动脉病变程度呈显著正相关。结论低血清Bil水平可能是CHD的危险因素之一。高UA水平可能是导致CHD的重要因素。血清Bil和UA水平与冠状动脉病变的严重程度有一定的关系,可通过血清Bil、血UA等生化指标的综合测定来间接评估患者冠状动脉病变的严重程度。     

冠心病患者血清胆红素和尿酸测定的意义

目的 观察冠心病患者血清胆红素、尿酸含量变化及其临床意义.方法 用全自动生化分析仪测定41例冠心病患者及30例健康者(对照组)血清胆红素、尿酸含量.结果 冠心病患者血清总胆红素和直接胆红素含量低于对照组(P＜0.01),尿酸含量较对照组升高(P＜0.01),血清间接胆红素也低于健康对照组,但差异无统计学意义(P＞0.05).结论 血清胆红素、尿酸在冠心病的发病中起重要作用,对评估冠心病患者的预后和疗效有一定的价值.     

急性冠状动脉综合征患者血清尿酸和胆红素浓度分析

对我院急性冠状动脉综合征患者血清尿酸和胆红素浓度分析如下。1对象和方法1．1对象2002—01～2004—12在我院住院行冠状动脉造影的患者，均符合美国心脏病学会／美国心脏病协会（ACC／AHA）1998诊断治疗指南标准。排除重度肥胖、严重高血压、痛风、心力衰竭、肝胆疾病、肾功能障碍及长期服利尿剂的患者。分3组：ACS组、稳定型心绞痛（SAP）组、对照组。冠状动脉造影诊断冠心病的标准：至少有一支冠状动脉内径狭窄≥50％。     

血清胆红素和尿酸与缺血性心脏病的相关性研究

目的：探讨血清胆红素及尿酸与缺血性心脏病的关系。方法：测定158例缺血性心脏病患者（实验组）及132例健康者（对照组）血清总胆红素、直接胆红素、间接胆红素和尿酸的含量。结果：实验组尿酸含量较对照组明显升高（P〈0．01），总胆红素、直接胆红素和间接胆红素含量明显低于对照组（P〈0．01）。结论：血清胆红素和尿酸水平的变化对缺血性心脏病的诊断及病情变化监测具有重要的临床意义。     

冠心病患者血清尿酸和胆红素的变化

目的:探讨冠心病患者血清尿酸和胆红素的变化和意义。方法:选择60例冠心病患者(冠心病组),52例健康体检者(对照组),分别测定血清尿酸和胆红素水平。结果:冠心病组血尿酸水平显著高于对照组(P<0.01),总胆红素显著低于对照组(P<0.01),冠心病组间接胆红素低于对照组(P<0.05),直接胆红素水平两组间差异无统计学意义(P>0.05)。结论:血尿酸升高、血清总胆红素水平降低与冠心病密切相关,可能在冠心病的发生发展中起着一定的作用。     

三种直接胆红素检测系统的性能评价

目的对钒酸盐氧化法、改良J-G法和3,5-二氯苯重氮四氟硼酸盐法（3,5-DCB-4FB）检测直接胆红素（DBil）进行性能评价,探讨3,5-DCB-4FB法是否适用于DBil检测。方法用钒酸氧化法、改良J-G法和3,5-DCB-4FB法分别测定血清DBil,探讨3种方法的精密度、线性、敏感性、抗干扰性和回收率。并分别与Doumas法（手工）进行比较。结果 3种方法平均精密度均在1%～5%之间;平均回收率为103.28%、99.04%、100.69%;线性范围（敏感性）为1.06～335.10μmol/L（1.06）、1.01～310.00μmol/L（1.01）、0.76～310.00μmol/L（0.76）。钒酸盐氧化法抗血红蛋白（Hb）干扰能力优于后2种方法;3种方法与Doumas法进行比较具有良好相关性（r2〉0.975）,医学决定水平处的系统误差（SE）分别为-9%、-7%、-1.1%。结论 3,5-DCB-4FB法具有良好的精密度、敏感性、抗干扰能力、线性范围和相关性,与改良J-G法具有很好的一致性。3,5-DCB-4FB法适用于临床常规检测。     

Methodological principles in the enzymatic determination of substrates illustrated by the measurement of uric acid

The enzymatic method of Haeckel for the determination of uric acid in serum has been used to compare three different kinetic approaches with the corresponding equilibrium (end-point) procedure. The kinetic methods were: measurement of the difference in absorbance between two pre-selected fixed instants during the course of the reaction under first-order conditions; measurement of the initial rate of reaction at substrate concentrations sufficiently low for first-order kinetics to apply, and determination of initial rate with substrate concentrations approximating to, or greater than, the Michaelis constant (pseudo-zero order kinetics). In the third method results were obtained by solving the Michaelis-Menten equation.The results emphasise the superiority of the two-point kinetic approach, which is apparent even when the timed absorbance values are obtained from an analogue signal displayed on a recorder chart. Conditions are described for the determination of uric acid in serum according to this principle.     

阿司匹林对老年人血尿酸的影响

目的探讨长期服用小剂量肠溶阿司匹林对老年高血压患者血尿酸的影响。方法用随机双盲法将老年轻、中度高血压 10 5例分为阿司匹林治疗组和对照组。治疗组给肠溶阿司匹林 40 mg/ d,加尼莫地平、开搏通降压治疗 :对照组单用尼莫地平 40 mg/ d、开搏通37.5～ 75 mg/ d,不用肠溶阿司匹林 ,持续治疗 1年。记录治疗前及治疗第 6、12月的血压、心率及血尿酸变化。结果阿司匹林治疗组血尿酸较对照组显著升高 [由 ( 0 .43± 0 .0 7) mmol/ L至 ( 0 .5 6± 0 .0 3) mmol/ L ] ,两组间第 6、12月血尿酸差值比较 P<0 .0 1,有显著性差异。两组血压及其余生化指标无显著差异。结论长期小剂量阿司匹林治疗可引起高尿酸血症 ,应采取措施加以预防     

The influence of plasma bilirubin on zinc protoporphyrin measurement by a hematofluorimeter

A fluorimeter has recently been developed to detect lead poisoning and iron deficiency by measuring erythrocyte ZPP directly from whole blood. Plasma bilirubin fluorescence has been found to influence this technique. ZPP levels determined by the fluorimeter were elevated by artificially increasing the plasma bilirubin concentration, both within and above the normal range, in whole blood samples. A rise in ZPP levels were also observed when the hemoglobin concentration was lowered by dilution with native plasma. When blood samples of patients with hyperbilirubinemia were analyzed, direct measurement of ZPP by this fluorimeter yielded significantly higher levels than did an alternate extraction method. Photodegradation of bilirubin in whole blood samples did not decrease fluorescent interference. Although the bilirubin measurably decreased, fluorescence increased following a 5 hr exposure to light.     

A new enzymatic approach for estimating total and direct bilirubin

We designed an enzymatic assay for total (TBil) and direct bilirubin (DBil), the principle of which involves measuring the decrease in absorbance at 450 nm produced by bilirubin oxidase from Myrothecium verrucaria. Since TBil and DBil are oxidized at pH 7.2 and 3.7, respectively, the degree of bilirubin oxidation is measurable in each case. An analysis of bilirubin by high-performance liquid chromatography, before and after the enzymatic reaction with bilirubin oxidase, verified the specificity of the enzyme. The results obtained using this method varied linearly with TBil and DBil concentrations up to at least 250 mg/L and 150 mg/L, respectively. Reducing substances, commonly used anticoagulants and hemoglobin showed no apparent interference. The degree of day-to-day precision (CV) for TBil and DBil ranged from 1.2% (206.2 mg/L) to 10.6% (3.5 mg/L) and from 1.8% (84.3 mg/L) to 12.4% (2.1 mg/L), respectively. Values measured using this new method correlated well with those obtained by Malloy-Evelyn's method and the slide method employing the Kodak Ektachem analyzer.     

Adaptation of blank-corrected methods for measurement of total and conjugated bilirubin and uric acid to the centrifugal analyzer.

The blank-corrected determination in serum of total and conjugated bilirubin and of uric acid has been adapted to the centrifugal analyzer. Bilirubin is measured by a modified Jendrassik and Grof procedure; uric acid is determined kinetically by using a reaction based on reduction of ferric ion, including a uricase-treated blank. Sensitivity and precision of both methods are excellent, and results compare well with those obtained by commonly used procedures.