1271519 九、發明說明： 【發明所屬之技術領域】 本發明係利用微電子機械系統(Micro-Electro-Mechanical System) 製造的晶片，進行超靈敏免疫化學冷光法(Immunochemiluminometric asssy)來偵測人體血清中C-反應蛋白(Oreactive protein ; CRP)的濃 度0 【先前技術】 C_反應蛋白在正常人企清的值很低，但在發炎或感染反應，患者 血清中則有很高量的C-反應蛋白存在。近幾年研究指出在正常人且尚 未有心血管梗塞者其血清的C-反應蛋白濃度雖然在正常值範圍，但利 用高靈敏性C-反應蛋白的檢測(稱為高敏感c_反應蛋白，hs_CRP)，可 以測出其較高濃度。所謂高靈敏性C-反應蛋白係指檢驗方法的改進， 使得測定的靈敏性或偵測極限由過去的5_10 mg/L改進至0.2 mg/L或 以下。根據Roberts等人的定義，在C-反應蛋白濃度為〇·2 mg/L之檢 驗再現性(CV%)需小於10%，才能稱之為，，高靈敏性c—反應蛋白，，檢驗。 在這種靈敏性之檢驗才能用來預測心血管疾病之風險。已有證據顯示 C-反應蛋白不僅預估風險，而且可能直接影響動脈硬化早期的形成。 而在已患有心血管疾病之病人，則血清c_反應蛋白濃度的高低，可做 為治療方式選取、再發生機率及預後評估之依據。因此快速及準確的 測定C·反應蛋白微量的上升，可以找出高危險群，給予有效的治療以 降低死亡率；或預防心血管疾病的發生。 C-反應蛋白的測定主要以”三明治，，免疫檢驗為主。此種測量方法須 將專一辨認〇反應蛋白的抗體或磷脂醯膽鹼ph〇sph〇rylch〇line (pc)連 結在-固體支持物上’以便與鋼檢體的c_反應蛋白作用。傳統上， 膜（membrane)、珠（bead)、試管（testtubes)、微量小盤（micr〇titer_^^ 皆可用來作g]體支持物。浸試紙檢驗& <Dip_stiek United 12715191271519 IX. Description of the Invention: [Technical Field of the Invention] The present invention utilizes a wafer manufactured by a Micro-Electro-Mechanical System to perform immunofluorescence immunosynthesis (Immunochemiluminometric asssy) to detect human serum. The concentration of C-reactive protein (CRP) is 0. [Prior Art] The value of C_reactive protein in normal humans is very low, but in the case of inflammation or infection, there is a high amount of C-reaction in the serum of patients. Protein is present. In recent years, studies have shown that in normal people and those who have not had cardiovascular infarction, the serum C-reactive protein concentration is in the normal range, but the detection of highly sensitive C-reactive protein (called high-sensitivity c_reactive protein, hs_CRP) ), you can measure its higher concentration. The highly sensitive C-reactive protein refers to an improvement in the test method such that the sensitivity or detection limit of the assay is improved from the past 5-10 mg/L to 0.2 mg/L or less. According to the definition of Roberts et al., the test reproducibility (CV%) of C-reactive protein concentration of 〇·2 mg/L needs to be less than 10%, which can be called, high-sensitivity c-reactive protein, and test. This sensitivity test can be used to predict the risk of cardiovascular disease. There is evidence that C-reactive protein not only predicts risk, but may also directly affect the early formation of arteriosclerosis. In patients with cardiovascular disease, the level of serum c_reactive protein can be used as a basis for treatment selection, recurrence, and prognosis. Therefore, rapid and accurate determination of a small increase in C·reactive protein can identify high-risk groups, provide effective treatment to reduce mortality, or prevent cardiovascular disease. The determination of C-reactive protein is mainly based on "sandwich, immunoassay. This measurement method must link the antibody or phospholipid choline ph〇sph〇rylch〇line (pc) that specifically recognizes 〇 reactive protein to - solid support On the object 'to interact with the c_reactive protein of the steel sample. Traditionally, membrane, bead, testtubes, micro-plates (micr〇titer_^^ can be used for g] body support Dip test paper &<Dip_stiek United 1271519
Patent 6406862)以nitrocellulose paper切成條狀作為固體支持物，再連 結上專一辨認C-反應蛋白的抗體，與C-反應蛋白作用後，再與有結合 horseradish peroxidase的抗C-反應蛋白抗體反應。經洗去未結合的抗 C-反應蛋白抗體後，最後再加入酵素受質ΤΜΒ(3,3，，5,5，-tetramethylbenzidine)作用呈色判讀。這些技術皆有反應時間長以及反應 靈敏度較差，無法準確偵測C-反應蛋白5〜7mg/L以下的濃度等缺點。 後來’使用乳膠粒加強的免疫比濁法（latex particle-enhanced immunoturbidimetric assay)偵測，使得c-反應蛋白的偵測可以準確至 0·15 mg/L，因此稱之為”高靈敏性c_反應蛋白，，檢驗。圖5為目前臨床 檢驗常用之”高靈敏性C-反應蛋白，，檢驗的廠牌以及其偵測極限和再現 性與本方法之比較。 本方法利用微電子機械系統所加工製成的微晶片，以不溶於水的 介質PMMA生物；作為固體支持物，具有翻小、使驗體量少、 反應時間短的特點，藉由poiy-Lqysine活化固體支持物表面，提高與抗 C-反應蛋白抗體的接合效率；且利用化學冷光作為偵測系統，具有背 景值低、靈敏性及特異性高的優勢，因此整合此兩大領域技術之下， 可以大幅增加C_反應蛋白檢測的敏感度與正礙生性且縮短檢測時間。 =PMMA生物晶 >；作為固體支持物來檢測反應蛋白 ，可適用於大量 筛檢臨床檢體並錢轉恆定品f，來減少因檢測材料品質不一所導 致的誤差，並具有驗反麟間、減少檢體制量等優勢。 【發明内容】 ，圖1所不’本發明之較佳實施例巾包含—具有聚甲基丙稀酸甲 μΓ於p、、』以聚左旋離胺酸2(P〇ly^Sine)活化後，以一辨識抗體3 人骑f化的生物晶片1表面上，該辨識抗體3可與C-反應蛋白接 應蛋白接於_沖、—讀育在室溫下進行，使樣品4中C-反 、邱几-上，加入帶有化學冷光物質(acridinium ester)之 1271519 訊號抗體5，該訊號抗體5可以與樣品4中C-反應蛋白接合，在經過 第二次孵育後，使其形成一，，三明治，，結構。沖洗後，加入鹼性過氧化氫 溶液即時量測其冷光強度，以測量Ο反應蛋白之濃度。 利用校正液濃度為”0，，之樣本在反覆測定10後，計算平均值與標準 差’並利用”平均值+2倍的標準差，，的濃度做為偵測極限的計算；得到 此方法C-反應蛋白之偵測極限為0·004 mg/L。標準曲線之線性範圍由 〇·〇1 mg/L到50.00 mg/L。其再現性，組内變異係數(Intra_ass㈣的CV 值小於7.3%，組間變異係數(inter_assay)的cv值小於9.1%。對於臨床 檢體有溶血、黃疸及乳糜等現象並不會干擾其測定值。且反應時間很 短’在三十分鐘内即可完成偵測。本方法與現有臨床檢驗儀器Dade Behring所使用的南靈敏C-反應蛋白(N High sensitivity-CRP)分析法比 較’兩者相關性結果一致(r=0.992，y=1.030x+0.623，Sy/X=1.911 mg/L， N=50)。綜合上述結果，本發明具有高靈敏性及精確性並且臨床上適用 性極高0 【實施方式】 實施例一 1·利用準分子雷射儀及設計好的光罩，在聚甲基丙烯酸甲酯材質的晶 片表面加工，取得大小為4·5χ4·5 mm的反應區。 2·在晶片表面以聚左旋離胺酸（p〇ly-L-lysine)活化。 3·接上第一層抗C-反應蛋白辨識抗體。 4·加入標準液或稀釋至合適濃度之待測樣品(抗原）。 5·加入標示有冷光物質吖啶酯(Acridinium ester)的第二層抗C-反應蛋 白訊號抗體。（如圖1所示） 6·加入鹼性過氧化氫的溶液產生冷光，以光電倍增管偵測所產生的冷 光強度訊號，並量化成數據作為定量用，C-反應蛋白之線性範圍由 0·01 mg/L到50.00 mg/L ;其結果如圖2所示。圖2(A)為在抗原與抗 體不同赙育時間’冷光與C-反應蛋白濃度之關係。如圖所示，孵育 時間由10分鐘至2小時皆具反應線性。圖2(B)是抗原與抗體第—次 1271519 及第二次孵育時間分別為20分鐘與10分鐘的反應線性圖及95%的 可信賴區間。 實施例二 1·重複實施例一之步驟i•到6.。 2·刀析其再現性，包括組内(Intra-assay)及組間(lnte]：_assay)在各種不同 〉辰度之檢體其變異係數值(cv)均小於91%。 實施例三 工·重複實施例一之步驟j•到6·。 2·但在步驟4·所加入的檢體中，内含不同濃度的可能干擾物質於待測 血清。包括不同濃度的乳麋(A)、溶血(B)及黃疸(c)，即分別測試三 酉文甘油脂（tnglyCeride)、血紅素（hemoglobin)及膽紅素（bilirubin) 等干擾物，對實施例一之干擾。其結果如圖3所示，其干擾均小於 10% 〇 ' 實施例四 ^為驗證本方法，將臨床檢體分別以實施例一之步驟1·到6.，及利用 才父，液濃度為”〇”之樣本在反覆測定10後，計算平均值與標準差，並利 用平均值+2倍的標準差”的濃度做為偵測極限的計算；次此方法可測 的c反應蛋白之偵測極限為〇〇〇4 ，與目前臨床檢驗使用方法之 比較，其結果如圖5所示。 實施例五 為驗也本方法，將臨床檢體分別以實施例一之步驟1·到6.，及臨床 使用的Behring High sensitivity-CRP方法測定；將所得的數據，進 1相關，分析。結果如圖4所示，無論抗原抗體解育時間各為⑷2小 時/1小時或(B) 2〇分鐘/10分鐘，均得到與Behring法一致性的結果。 本發明分析之解析度比臨床實驗室現有方法佳，其靈敏度也較好。 1271519 【圖式簡單說明】 圖1 ··晶片簡單說明示意圖（待測樣品與生物晶片反應圖示）。主要元 件付號1PMMA生物晶片；符號2聚左旋離胺酸；符號3辨識抗體；符 號4待測樣品；符號5訊號抗體。 圖2 :反應線性圖。在抗原與抗體不同的第一次與第二次孵育時間， 冷光強度與Ο反應蛋白濃度之關係。（B)抗原與抗體第一次及第二次孵 育時間分別為20分鐘與10分鐘的反應線性圖及95%的可信賴區間。 圖3 ·干擾分析。（A)乳麋樣品，（B)溶血樣品，（c)黃疸樣品。 圖4·生物晶#超錄紐化學冷光法與Behring免疫混濁法測定人體 血清檢體hs-CRP之相關性分析。(Α)第-二欠與第二二欠孵育時間分別& 小時與1小時。⑻第—次與第二讀育時間分別為％分鐘與1於。 圖5:目前上市有關，，高靈敏〇反應蛋白，，檢驗方法與生物晶片 里 疫化學冷光法之方法特性。（A)最低偵測極限；（B)反應再現性。 11Patent 6406862) was cut into strips as a solid support by nitrocellulose paper, and then an antibody which specifically recognizes C-reactive protein was ligated, and reacted with C-reactive protein, and then reacted with an anti-C-reactive protein antibody which binds to horseradish peroxidase. After the unbound anti-C-reactive protein antibody was washed away, the enzyme was finally added to the enzyme for recognition by colorimetric (3,3,5,5,-tetramethylbenzidine). These techniques have the disadvantages of long reaction time and poor reaction sensitivity, and cannot accurately detect the concentration of C-reactive protein below 5 to 7 mg/L. Later, using the latex particle-enhanced immunoturbidimetric assay, the detection of c-reactive protein was accurate to 0.15 mg/L, so it was called "high sensitivity c_". Reactive protein, test. Figure 5 is a high-sensitivity C-reactive protein commonly used in clinical tests, the label of the test, and its detection limit and reproducibility compared with this method. The method utilizes a microchip processed by a microelectromechanical system to be a PMMA organism which is insoluble in water; as a solid support, it has the characteristics of being small, reducing the amount of the test body, and having a short reaction time, by poiy-Lqysine Activates the surface of the solid support to improve the efficiency of binding to anti-C-reactive protein antibodies; and utilizes chemical luminescence as a detection system, which has the advantages of low background value, high sensitivity and high specificity, so it integrates these two fields of technology. , can greatly increase the sensitivity and positive susceptibility of C_reactive protein detection and shorten the detection time. =PMMA Biocrystal>; As a solid support to detect the reaction protein, it can be applied to a large number of screening clinical samples and convert to a constant product f to reduce the error caused by the quality of the test materials, and has the reverse The advantages of reducing the amount of inspection system. SUMMARY OF THE INVENTION The preferred embodiment of the present invention comprises: having polymethyl methacrylate methyl Γ Γ after p, 』 is activated by poly-L-amino acid 2 (P〇ly^Sine) , on the surface of a biochip 1 with an antibody recognizing 3 people, the identification antibody 3 can be ligated with the C-reactive protein, and the C-reaction is carried out at room temperature to make the C-reverse in the sample 4. On the Qiuji-up, a 1271519 signal antibody 5 with a chemically acridinium ester is added. The signal antibody 5 can be conjugated to the C-reactive protein in sample 4, and after the second incubation, it is formed into one. , sandwiches, structures. After rinsing, the alkaline light hydrogen peroxide solution was added to measure the luminescence intensity immediately to measure the concentration of sputum reaction protein. Using the calibration solution concentration "0, the sample is measured after the repeated measurement 10, calculate the mean value and the standard deviation' and use the "average value + 2 times the standard deviation" as the calculation of the detection limit; The detection limit of C-reactive protein was 0.004 mg/L. The linear range of the standard curve ranges from mg·〇1 mg/L to 50.00 mg/L. Its reproducibility, intra-group coefficient of variation (Intra_ass (four) CV value is less than 7.3%, inter-assay coefficient of variation (inter_assay) cv value is less than 9.1%. For clinical samples, hemolysis, jaundice and chyle do not interfere with the measured value And the reaction time is very short 'detection can be completed within 30 minutes. This method is compared with the N High sensitivity-CRP analysis method used by Dade Behring, the existing clinical test instrument. The results were consistent (r=0.992, y=1.030x+0.623, Sy/X=1.911 mg/L, N=50). Combining the above results, the present invention has high sensitivity and accuracy and is highly clinically applicable. [Embodiment] Example 1 1. Using a quasi-molecular laser and a designed photomask, the surface of a polymethyl methacrylate wafer was processed to obtain a reaction zone having a size of 4·5 χ 4·5 mm. Activate the poly-L-lysine on the surface of the wafer. 3. Connect the first layer of anti-C-reactive protein recognition antibody. 4. Add the standard solution or dilute to the appropriate concentration of the sample to be tested ( Antigen) 5. Adding the acridine ester (Acridinium este) r) The second layer of anti-C-reactive protein signal antibody (as shown in Figure 1) 6. Adding alkaline hydrogen peroxide solution to produce luminescence, detecting the cold light intensity signal generated by photomultiplier tube, and quantizing The data was used for quantification. The linear range of C-reactive protein ranged from 0. 01 mg/L to 50.00 mg/L. The results are shown in Figure 2. Figure 2 (A) shows the difference between the antigen and the antibody. The relationship between C-reactive protein concentration. As shown in the figure, the incubation time is linear from 10 minutes to 2 hours. Figure 2 (B) shows the antigen and antibody first - 1271919 and the second incubation time is 20 minutes and 10 minute reaction linearity diagram and 95% confidence interval. Example 2 1. Repeat steps 1 to 6 of Example 1. 2. Resolve its reproducibility, including intra-assay and inter-group (lnte]: _assay) The coefficient of variation (cv) of the specimens of various types of different lengths is less than 91%. Embodiment 3: Repeat steps 1 to 6 of Example 1 2. But in step 4 · The sample to be added contains different concentrations of possible interfering substances in the serum to be tested, including different concentrations of chyle (A), hemolysis (B And jaundice (c), which respectively tested interfering substances such as tnglyCeride, hemoglobin and bilirubin, interfered with Example 1. The results are shown in Figure 3. The interference is less than 10% 〇' Example 4 is to verify the method, the clinical samples are separately determined by the steps 1 to 6. of the first embodiment, and the sample with the liquid concentration of "〇" After 10, calculate the mean and standard deviation, and use the concentration of the mean + 2 times the standard deviation" as the detection limit; the detection limit of the c-reactive protein measured by this method is 〇〇〇4. Compared with the current clinical test methods, the results are shown in Figure 5. Example 5 In order to test the method, the clinical samples were determined by the steps 1 to 6 of the first embodiment and the Behring High sensitivity-CRP method for clinical use; the obtained data were correlated and analyzed. As a result, as shown in Fig. 4, the results of the consistency with the Behring method were obtained regardless of whether the antigen-antibody germination time was (4) 2 hours / 1 hour or (B) 2 〇 minutes / 10 minutes. The resolution of the analysis of the invention is better than the existing methods in the clinical laboratory, and the sensitivity is also good. 1271519 [Simple description of the diagram] Figure 1 · Brief description of the wafer (representation of the sample to be tested and biochip). The main component pays 1PMMA biochip; symbol 2 poly-L-amino acid; symbol 3 recognizes the antibody; symbol 4 sample to be tested; symbol 5 signal antibody. Figure 2: Reaction linearity diagram. The relationship between the intensity of the cold light and the concentration of the sputum reaction protein during the first and second incubation times of the antigen and the antibody. (B) The first and second incubation times of the antigen and antibody were 20 minutes and 10 minutes, respectively, and a 95% confidence interval. Figure 3 · Interference analysis. (A) chyle sample, (B) hemolyzed sample, (c) xanthine sample. Figure 4·Biocrystal# Ultra-recording chemistry cold light method and Behring immunoturbidimetric method for the determination of human serum samples hs-CRP. (Α) The first-two owing and the second-second under-incubation time were & hours and 1 hour respectively. (8) The first and second reading times are % minutes and 1 respectively. Figure 5: Current market-related, highly sensitive 〇reactive protein, test methods and biofilm physicochemical luminescence methods. (A) minimum detection limit; (B) reaction reproducibility. 11