JPS59147265A - Automatic blood sedimentation measuring method - Google Patents

Abstract

PURPOSE:To enhance the detection performance of an automatic blood sedimentation rate measuring instrument, by adapting a light source with a specific wavelength. CONSTITUTION:An automatic blood sedimentation measuring instrument is constituted so that a light source box 106 and a light receiving box 107 are integrally rotated by the rotary driving of the shaft 109 of a motor and measuring tubes 105 are successively pass through the gap between both boxes and automatically measures the blood sedimentation values of a large amount of set blood specimens to be examined. In this case, a filter with a pervious center wavelength of 500nm is adapted to the light source of the above mentioned automatic blood sedimentation measuring instrument to perform measurement. As mentioned above, by performing automatic measurement with respect to a large amount of blood specimens to be examined by the automatic blood sedimentation measuring instrument using the filter with the pervious center wavelength of about 500nm, the automatic measurement of a blood sedimentation value can be accurately performed without almost requiring labor.

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to a method that allows accurate measurement of erythrocyte sedimentation rate (hereinafter abbreviated as erythrocyte sedimentation rate).

Blood sedimentation is measured by forming a blood column in a blood sedimentation measurement tube (hereinafter simply referred to as blood sedimentation tube), standing it vertically, and measuring the sedimentation length of red blood cells over a predetermined period of time, usually visually. . However, in medium-sized or larger hospitals, the number of specimens is large every day, and reading the sedimentation distance by visually inspecting all of these many specimens is a great burden in terms of time, physical, and mental burden. Several blood sedimentation measuring devices have been announced to reduce this burden.

Most of these measurement methods optically detect the upper end surface of red blood cell columns. For example, as shown in FIG. 1, a light source 1 and a photodetector 2 are provided facing each other, and a blood sedimentation tube 3
The upper end surface of the red blood cell column is detected by detecting that the light from the light source is blocked by the red blood cell column 4 and is blocked from entering the photodetector. Figure 1 uses a combination of a relatively small light source and a small photodetector, and this pair of photodetection systems is moved up and down along the blood sedimentation tube to block light from entering the photodetector. The blood sedimentation value is determined by detecting the position. In Fig. 2, a long light source 1 is used to irradiate the entire necessary part of the blood sedimentation tube 3 with light, and a long photodetector 7 is used to block the light by red blood cell columns. The position is detected without moving the photodetection system (a combination of a light source and a photodetector) in the vertical direction, and the blood sedimentation value is determined. In addition, in FIG. 3, the light source 1 is long, but the photodetector is a small one, such as an image sensor 8, and the lens 5 detects the brightness and darkness depending on the amount of light transmitted through the blood sedimentation tube 3.
The blood sedimentation value is determined by forming an image on the light-receiving surface of an image sensor.

Now, the following methods are available for fully automatically measuring the blood sediment values of a large number of specimens using these methods.

In the method shown in Figure 1, there are two methods: 1. One set of photodetection system is provided for each blood sedimentation tube, and 2. The blood sedimentation tubes are arranged horizontally in a line, and one set of photodetection systems is moved horizontally and up and down at the position of the blood sedimentation tube. How to move the blood vessel in the direction: ■ To attach multiple blood sedimentation tubes arranged circumferentially on a rotating body, attach multiple measuring tubes vertically to the rotating body, and move the blood sedimentation tubes to the measuring position by rotating the rotating body at appropriate times. After moving and stopping, the photodetection system is fed out so as to sandwich the blood sedimentation tube, and then lowered vertically to detect the entire upper end surface of the red blood cell column (Japanese Patent Laid-Open No. 56-46461, Japanese Patent Laid-open No. 56-46462) )and so on. Among these methods, ■ is expensive because it requires the same number of light sources and photodetectors as blood sedimentation tubes, and ■■ requires rotational movement and vertical movement of the light detection thread, and is mechanically difficult. It has the disadvantage of being complicated.

On the other hand, the method shown in FIG. 3 has recently received attention as an excellent method that solves the above-mentioned drawbacks.

A specific example of the configuration of an automatic blood sedimentation measuring device using this method will be described below. FIGS. 4 and 5 are an external view and a front view of one example. Reference numeral 101 indicates a blood sedimentation tube mounting base, and a plurality of blood sedimentation tube mounting bases 102 are arranged in a circumferential manner.

An appropriate number of pillars 103 are vertically fixed at appropriate intervals around the blood sedimentation tube mount 102, and a disk-shaped blood sedimentation tube fixing plate 104 is provided above the pillars 103. A blood sedimentation tube fixing device is provided on this fixing plate in correspondence with the blood sedimentation tube mounting pedestal 101.
By pressing the lower end of 5 against the mounting pedestal 101 and setting it in the blood sedimentation tube fixing device corresponding to the upper metal layer before blood sedimentation, the specimen is held vertically without leaking from the lower end of the blood sedimentation tube, so that it can be used for blood sedimentation measurement. It has become. A light source box 106 houses a light source lamp having a long linear filament If. Reference numeral 107 is a light receiver box in which an image sensor is housed as a light receiver. The use of this image sensor made it possible for the first time to measure blood sedimentation without vertically moving the light source and photodetector along the blood sedimentation tube. It is possible to measure a large number of samples using only a simple operating mechanism, and as a result, it has attracted much attention as an automatic blood sedimentation measuring device that can be placed low and is less likely to malfunction.

Now, the operations and functions of the blood sedimentation automatic measuring device of this configuration example are as follows. Light source box 106 and light receiving unit box 10
7 by a coupling device 108, and this light receiving box 107 is connected to support/drive shafts 109, 109'.
is held in This support/drive shaft 109 is connected to a motor 110, and the motor 1100 turns rotates the light receiving box 107 and the light source box 106 connected thereto. At that time, the light source box 10
6 and the light receiving unit box 107 so that the blood sedimentation tube is sandwiched between the tubes and the light receiving unit box 107. In other words, the light source box 106 and the light receiving box 107 are arranged opposite to each other on both sides of the measuring tube, and are configured to rotate. Irradiates the measurement tube with light from the light source inside the light source box,
The transmitted light of the measuring tube passes through all the lenses and is then detected by the image sensor. The area above the upper surface of the sedimented red blood cells is transparent plasma, so the irradiated light passes through and reaches the light receiving part, but the area below the upper surface of the sedimented red blood cells is opaque.
Light irradiated to this part does not pass through. Utilizing this brightness and image, it is possible to observe the boundary between υ light transmission and non-transmission by photometry using an image sensor, and by measuring the difference between this and the initial height position of the blood column surface, blood sedimentation can be observed. value can be measured. By driving the motor 110i, the light source box 106 and light receiving box 107 are rotated as a unit, and the measurement tubes are configured to pass through the gap between them one after another. It is possible to automatically measure blood sediment values for a large number of samples. Since the blood sedimentation value usually needs to be recorded only after 30 minutes, 1 hour, or 2 hours, the rotation speed may be slow (for example, 1 rotation per minute).

In addition to the above-mentioned parts, the light source box and light receiving box contain light sources 1]9 and 1 for determining whether a blood sedimentation tube is attached or not.
Light source 121 for reading 20 and blood sedimentation tube installation position number
It also houses a light receiver 122. As a method for reading the position number, for example, position number discrimination holes 123 are provided in a part of the blood sedimentation tube fixing plate 104 corresponding to the blood sedimentation tube attachment positions, and the light source 121 and the light receiver 122 are inserted between the position number discrimination holes during operation. There is a way to make it look like this.

For example, as shown in FIG. 6, it is possible to discriminate up to 63 positions by combining the methods of drilling holes at 6 positions. Reference numeral 124 indicates measurement position number indicator lights, and at least as many lights as the number of blood sedimentation tubes that can be attached are provided. A printer 125 prints the blood sedimentation value measurement results together with measurement position numbers and the like.

Reference numerals 126 and 127 indicate operation switches such as a power switch and a measurement time selection switch. In addition, although not shown, there is a timekeeping device with the necessary specifications, a microcomputer, etc.
Equipped with etc.

Next, the measurement operation and functions of the above-mentioned device example will be described.

1. Collect a predetermined amount of blood sample into the blood sedimentation tube, and place it on the blood sedimentation tube mounting base 1.
Set the appropriate number on 02.

2. Turn on all the switches (you can turn on the switches first and then perform step 1 above).

3 The photodetection systems 106 and 107 rotate, and the light source 119 and light receiver 120 discriminate whether or not a blood sedimentation tube is attached (this is necessary because the incident light to the light receiver 120 is blocked at the location where the blood sedimentation tube is attached) At the same time, the position number is read by the all-party source 121 and the light receiver 122, and the memory storage and time measurement for the position number are started. Measurement position number display light 124 at the same time as cutting
The lamp corresponding to the approximate number lights up in red to fully display that ``measurement is in progress''.

4. The photodetection systems 106 and 107 continue to rotate, and each time they pass through each blood sedimentation tube, the blood sedimentation value is measured, stored in memory, and printed out.

5 Continue the measurement and print the selected measurement time (normally, blood sediment value) on the printer 125 along with all position numbers.At the same time, change the approximate number of the measurement position number indicator 124 to a green light to indicate that the measurement has been completed. The blood sedimentation tube whose position number is lit in green indicates that it can be removed and replaced with the blood sedimentation tube containing the next new blood sample.When the blood sedimentation tube is removed after the measurement is completed, The measurement position number indicator light turns red when the blood is cleared and a new blood sedimentation tube is attached.

The operations from step 3 above are performed.

7. In the event of an accident, for example ■ When you accidentally remove the blood sedimentation tube during measurement.

■ When the power is cut off due to a power outage, etc., and measurements cannot be taken at the specified time.

■ When the light source rung of the photodetection system burns out.

■ When the optical detection system stops rotating due to a failure.

In the event of an accident, a report is issued, the type of accident is printed on the printer 125, and the blood sedimentation value immediately before the accident occurs is printed out even outside of the designated time, making use of the previous measurement results and reducing the burden of re-examination. It is supposed to be done.

8, total number 411] When the constant rotation is completed, the rotation of the photodetection system is automatically turned off, and the power is automatically turned off.

With the advent of automatic blood sedimentation meters as described above, it has become possible to significantly reduce the huge burden of the past.
It has become widely used.

However, the pathological conditions of patients vary widely, and accordingly, the properties of blood also vary widely. For example, bilirubin increases in the blood of patients with liver disease, and as a result, the plasma (the part above the top of the red blood cell layer when red blood cells sediment), which should normally be transparent, turns yellow. . The blood of anemic patients and patients receiving artificial dialysis is dilute.
When blood sedimentation measurements are performed, the boundaries of the upper surface of red blood cells become unclear. In such cases where the red color is unclear, it has traditionally been prescribed to read the position where it is thought that the red color will not become any darker.

By the way, in the conventional method of measuring the erythrocyte sedimentation rate by irradiating a blood sedimentation measurement tube containing a blood sample with photo-sound and measuring the transmitted light, a method uses infrared sound as the irradiation light and calibrates the transmitted infrared light. However, when the present inventors collected measurement data using such long-wavelength light for a large number of specimens, a large proportion of specimens with the above-mentioned tendency showed visual values (conventional values). There was a discrepancy with the value obtained by measuring with the human eye using the method described above. In addition, in the conventional method, long wavelength light such as this infrared ray is used because the yellow color shown by the plasma of patients with a high bilirubin content is the red color that passes through long wavelength light. For a sample that does not show a sedimentation interface and is dispersed over a certain range, light with a longer wavelength will pass through the dispersed red blood cell particles and reach the photodetector, and the light will reach the photodetector only in the area where the red blood cell sedimentation density is high. This is because it is considered to be impermeable.

However, the discrepancy between the actual measurement results and the visual value is as described above. Therefore, the present inventor searched for a method to obtain a good agreement between visual values and optically measured values, which had been known for many years, and found that it is better to use short wavelength green or blue light than red. We have reached a conclusion that cannot be reached from the conventional wisdom mentioned above, that a good agreement can be obtained. For example, when we automatically measured a large number of samples using the automatic hematology analyzer with a filter around the center of transmission wavelength around 500 nm and compared it with the visually observed values, we found that the percentage of "discordant samples" that showed a mismatch of 3 or more times was approximately It was halved to 4%. This is a significant performance improvement compared to the case where light in the red or near-red region was used, where the mismatch rate was about 13%.

It goes without saying that it may be necessary to change the judgment output level of the output of the photodetector as the wavelength used changes.

Therefore, in carrying out the automatic blood sedimentation measurement method of the present invention, if one-hour value measurement is selected, and the blood sedimentation value of the sample after one hour is, for example, 80n++n or more, an alarm is sounded or the measurement position is It is more advantageous to achieve the object of the present invention if the number display light 124 is configured so that the rung of the corresponding position number blinks, and the measurement is stopped by visual inspection of only the sample with that number, and the automatic measurement fee is compensated. It is.

As detailed above, by implementing the present invention in its entirety, it is possible to automatically measure the blood sedimentation level of samples of all types accurately and with almost no effort. Remarkable.

As mentioned above, the conventional infrared region transmission filter (600n
An example of a filter that does not transmit light below m but transmits light sound of 600 to 3000 nm.If the filter is used all around the circumference, not only will there be a large discrepancy rate with the visual value, but there will also be discrepancy even in the case of samples with small blood sediment values. is observed.

However, according to the present invention, in the method using light with a central wavelength of 500 nm, the rate of discrepancy with the visually observed value is small, and the specimens showing discrepancy are limited to cases where the blood sediment value is 80° or higher. The normal blood sedimentation value is 10 or less for boys and 15 or less for girls, and for both men and women, up to 25F is considered mild promotion, 25 to 50 is moderate promotion, and 50F or above is considered highly promotion. Therefore, 80 meters or more is a significant increase, and it can be said that for such a value, it is meaningless to say that there is a measurement error of 5 meters or 10 meters.

Examples of the present invention and comparative examples are all listed below.

Embodiment Automatic measurement of blood sediment by using the apparatus shown in FIGS. 3 to 5 and applying a filter with a transmission center wavelength of 500 nm to the light source 1.
::carried out.

As a result, as shown in the chart in Figure 7, the discrepancy rate between the readings by the automatic blood sedimentation measuring device and the readings visually was 4.2%.
Met.

The results shown in FIG. 8 were obtained in the same manner as in the example except that an infrared transmission filter was used as the comparative example filter.

In this case, the mismatch rate was 12.5%, and the improvement effect of the present invention was clearly recognized.

[Brief explanation of the drawing]

Figures 1 to 3 are exemplary diagrams showing combinations of light sources and photodetectors in the conventional automatic blood sediment measurement method, and Figures 4 and 5 are automatic blood sediment measurement devices using the method shown in Figure 3. FIG. 6 is an illustrative diagram showing the method of position reading and method 9 in FIGS. 3 and 4, and FIG. A chart showing the correlation between the readings by the blood sedimentation automatic measurement method and the visual readings according to the example, and Figure 8 shows the correlation between the readings by the blood sedimentation automatic measurement method and the visual readings according to the comparative example. This is a diagram. 1...Light source 2...Photodetector 3...Blood sedimentation tube 4... ...... Red blood cell column 5 ...... Lens 7 ...... Long photodetector 8 ...
・・・・・・・・・ Image sensor agent Patent attorney Minoura Seijutsune 111 official letter (spontaneous) May 7, 1980 Commissioner of the Patent Office Fuhio Wakasugi 1, Indication of case 1988 Patent application No. 20758 No. 2, Title of the invention: Blood sedimentation automatic measurement pouf method 3, Relationship to the amendment case Patent applicant address: 4-13-14 Kichijoji Kitamachi, Musashino City, Tokyo
Name: Denki Kagaku Keiki Co., Ltd. 4, Agent address: 16 Kanda Kita Jorimono-cho, Chiyoda-ku, Tokyo
101 English pill 3rd floor amendment content 1. On page 5, line 12 of the specification, [-rotation axis] was corrected to read ``rotation''. 2. On page 12, line 7 of the specification letter, the words “halved” and “near red region” have been replaced with “decreased J a3
Yohi corrected it as "near infrared region". 3.Delete from line 13 to the end of page 12 of the statement box. 4. Add the following sentence between page 13, line 19 of the statement box and the blank line. [Thus, using light with a C1 center wavelength of 500 nm is sufficient to achieve the purpose of automatic blood sedimentation measurement, but it will be even more effective if the following mechanism is added. In other words, in carrying out the automatic blood sedimentation measurement method of the present invention, if, for example, one-hour value measurement is selected, if the blood sedimentation value of the sample after one hour is, for example, 80 mm or more, will an alarm sound be emitted? Alternatively, the object of the present invention can be achieved by configuring the lamp corresponding to the corresponding position number behind the measurement position number indicator light 124 to blink, and by visually measuring only the specimen with that number to supplement automatic measurement. This is even more advantageous. ”

Claims (2)

[Claims] (1) A method of measuring the erythrocyte sedimentation rate by irradiating a blood sedimentation measuring tube containing a blood sample with photo-sound and measuring all of the transmitted light, characterized in that the center wavelength of the irradiated light is 600 nm or less. Automatic blood sediment measurement method. (2) The automatic blood sedimentation measurement method according to claim 1, which is configured to issue an alarm when the blood sedimentation value exceeds the set value within a set time.