WO2017101171A1 - 溶栓药物个体化应用剂量的体外测定试验方法 - Google Patents
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- G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
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- G01—MEASURING; TESTING
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- G01N2800/00—Detection or diagnosis of diseases
- G01N2800/28—Neurological disorders
- G01N2800/2871—Cerebrovascular disorders, e.g. stroke, cerebral infarct, cerebral haemorrhage, transient ischemic event
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- the invention relates to an in vitro determination test method for individualized application dose of thrombolytic drugs, which is suitable for guiding acute thrombolytic drugs such as urokinase and r-TPA for intravenous thrombolytic therapy when acute arterial infarction occurs in brain and heart. It belongs to the field of medical technology for monitoring beds.
- thrombolytic therapy is the most promising treatment for ischemic cardiovascular and cerebrovascular diseases.
- thrombolytic drugs because it has a large dose of thrombolytic drugs, it can cause fatal bleeding complications, and too small a dose will affect the effect of thrombolytic therapy.
- its application is greatly limited, so it is necessary to solve the problem of safe and effective individualized thrombolytic drug dosage for each specific patient at different times from a technical method.
- the invention aims to solve the above-mentioned problem of dose control of thrombolytic drugs for specific patients, and provides an in vitro determination test method for individualized application doses of thrombolytic drugs, which can determine effective thrombolysis of the tested patients and avoid bleeding. complication.
- An in vitro assay method for the individualized application dose of a thrombolytic drug comprising the following steps:
- No. 1 is a blank drying ring
- No. 2 is added with 100 ⁇ l of 0.9% normal saline
- No. 3 to No. 8 ring is added with low to high concentration of thrombolytic drug reagent and 0.9% respectively.
- a mixture of physiological saline is 100 microliters each, and the concentration of the thrombolytic drug is indicated on each ring;
- the dose of intravenous thrombolytic drug 2 / 3 ⁇ body weight ⁇ concentration of thrombolytic drugs.
- This test method provides technical support and objective basis for ensuring individualized, safe and effective intravenous thrombolytic therapy in a short period of time, which can significantly reduce the bleeding complications of thrombolytic therapy and improve the therapeutic effect of thrombolytic therapy.
- Urokinase for injection r-TPA, 0.9% saline, Chancler rotating ring, blood collection device, filter paper, EP tube, etc.
- No. 1 is a blank drying ring
- No. 2 is added with 100 ⁇ l of 0.9% saline
- Rings 3 to 8 are added with low to high concentration of urokinase or r-TPA reagent and 0.9% respectively.
- a mixture of physiological saline was 100 ⁇ l each, and the concentration (unit/kg) of thrombolytic drugs such as urokinase was indicated on each ring.
- Thrombolytic drug reagents such as urokinase or r-TPA must be used now;
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Abstract
一种溶栓药物个体化应用剂量的体外测定试验方法,包括:抽取被检患者静脉血,分别加入八支旋转环中,1号为空环,2号为生理盐水,3至8号为低到高浓度的溶栓药品试剂,将八支旋转环放入血液混匀仪,启动混匀仪;从混匀仪中取出旋转环,将旋转环中形成的血栓和剩余血液取出放在滤纸表面,依次按顺序观察在八支旋转环中取出的血栓形态、大小、重量,记录上述形成体积和重量最小的血栓或最先没有形成血栓时所对应的溶栓药物的浓度;依据公式:本次静脉溶栓药物剂量=2/3×体重×溶栓药物的浓度,计算被检患者用药量。该方法既可确定被检患者有效溶栓,又能避免发生出血等并发症,从而指导急性心、脑梗死患者的静脉溶栓治疗。
Description
本发明涉及一种溶栓药物个体化应用剂量的体外测定试验方法,用于指导脑、心脏等部位发生急性动脉梗塞时,适合应用尿激酶、r-TPA等溶栓药物进行静脉溶栓治疗,属于监床医学技术领域。
人类的心、脑血管等部位的急性血栓性疾病的发病率、致残率和死亡率急剧上升,已成为导致人类死亡的第一位疾病原因,并具有年青化的趋势,已严重威胁着人类的健康。因此,提高血栓性疾病预防和治疗效果,降低其治疗费用,已刻不容缓,并引起了全球性的广泛关注。溶栓治疗做为目前缺血性心脑血管疾病最有前途的治疗方法,但因其具有溶栓药物剂量过大可以导致致死性出血并发症,而剂量过小会影响溶栓治疗效果等特点,而使其应用受到很大限制,因此需要从技术方法方面解决每位具体患者在不同时间的安全、有效个体化溶栓药物用量问题。
发明内容
本发明旨在解决上述针对具体患者的溶栓药物剂量控制问题,而提供一种溶栓药物个体化应用剂量的体外测定试验方法,既可以确定被检患者有效溶栓,又能避免发生出血等并发症。
本发明解决其技术问题采用的技术方案是:
一种溶栓药物个体化应用剂量的体外测定试验方法,包括下述步骤:
(1)将血液混匀仪开机,预热至温度37℃备用,电子天平调至水平校准备用;
(2)取常用溶栓药物一支,用电子天平将其平均分成20等份并分装入EP管,放入4℃冰箱冷藏保存备用;
(3)取上述装有溶栓药品的EP管一支,加入500微升0.9%生理盐水,用漩涡混合器充分混匀溶解备用;
(4)取八支Chancler旋转环并按顺序编号:1号为空白干燥环,2号加入100微升0.9%生理盐水,3至8号环分别加入低到高浓度溶栓药品试剂与0.9%生理盐水的混合液各100微升,并在每个环上标明溶栓药物的浓度;
(5)按被检患者的体重比计算低至高浓度的体外溶栓药物临床应用剂量;抽取被检患者的静脉血8毫升,将所抽的静脉血立即分别加入前述准备好的八支Chancler旋转环中,每个旋转环中的血量为1毫升;
(6)在拔出抽血针后1分30秒内,按顺序将八支Chancler旋转环全部放入血液混匀仪,启动血液混匀仪,持续运转工作15分钟后停止;
(7)从混匀仪中取出Chancler旋转环,将旋转环中形成的血栓和剩余血液取出放在滤纸表面,依次按顺序观察在八支Chancler旋转环中取出的血栓形态、大小、重量,记录上述形成体积和重量最小的血栓或最先没有形成血栓时所对应的溶栓药物的浓度;
(8)依据下述公式计算被检患者进行本次即刻静脉溶栓时应用溶栓药物的剂量;
本次静脉溶栓药物剂量=2/3×体重×溶栓药物的浓度。
采用上述技术方案的本发明,与现有技术相比,其有益效果是:
可以确定被检患者有效溶栓,又能避免发生出血等并发症,从而指导急性心、脑梗死患者的静脉溶栓治疗。此试验方法为确保在较短时间内开展个体化、安全、有效的静脉溶栓治疗提供了技术支撑和客观依据,可以明显降低溶栓治疗的出血并发症和提高溶栓治疗效果。
以下结合实施例对本发明作进一步阐述,但本实施例不对本发明构成任何限制。
本实施例所述的溶栓药物个体化应用剂量的体外测定试验方法,按下述步骤进行:
(一)设备准备:
血液混匀仪,电子天平,漩涡混合器,移液器等。
(二)实验用品:
注射用尿激酶,r-TPA,0.9%生理盐水,Chancler旋转环,采血装置,滤纸,EP管等。
(三)实验准备:
(1)实验仪器的准备;将血液混匀仪开机预热20分钟温度至37度备用,电子天平调至水平校准备用:
(2)溶栓药品的准备:取10万单位注射用尿激酶或20mg的r-TPA一支,用电子天平将其平均分成20等份并分装入EP管,放入4℃冰箱冷藏保存备用。
(四)实验试剂的配制:
取上述装有注射用尿激酶或r-TPA的EP管一支,加入500微升0.9%生理盐水,用漩涡混合器充分混匀溶解备用。
(五)体外测定试验前的Chancler旋转环准备:
取八支Chancler旋转环并按顺序编号:1号为空白干燥环,2号加入100微升0.9%生理盐水:3至8号环分别加入低到高浓度尿激酶或r-TPA试剂与0.9%生理盐水的混合液各100微升,并在每个环上标明尿激酶等溶栓药物的浓度(单位/公斤)。
(六)体外测定实验:
(1)根据被检患者的体重进行溶栓药物个体化应用剂量的体外测定试验,按体重比计算低至高浓度的体外溶栓注射用尿激酶或r-TPA的临床应用剂量:
(2)抽取被检患者的静脉血8毫升(避免溶血现象);
(3)将所抽的静脉血立即分别加入前述准备好的八支Chancler旋转环中,每个旋转环中的血量为1毫升(避免血液凝固、产生气泡);
(4)在拔出抽血针后1分30秒内,按顺序将八支Chancler旋转环全部放入血液混匀仪,启动血液混匀仪,血液混匀仪持续运转工作15分钟后停止;
(5)从血液混匀仪中取出Chancler旋转环,将旋转环中形成的血栓和剩余血液取出放在滤纸表面,依次按顺序观察在八支Chancler旋转环中取出的血栓形态、大小、重量,记录上述形成体积和重量最小的血栓或最先没有形成血栓时所对应的尿激酶或r-TPA的浓度(Q),然后依据下述公式计算被检患者进行本次即刻静脉溶栓时应用尿激酶或r-TPA的剂量;
公式:本次静脉溶栓药物剂量(单位)=2/3×体重(公斤)×Q。
(七)注意事项:
(1)尿激酶或r-TPA等溶栓药物试剂必须现用现配;
(2)注入Chancler旋转环内血液剂量要精确;
(3)Chancler旋转环连接紧密、避免发生溶血、凝血、气泡;
(4)抽出的血液必须在1分30秒内,全部注入Chancler旋转环中,并放入血液混匀仪,立即启动。
以上所述仅为本发明较佳可行的实施例而已,并非因此局限本发明的权利范围,凡运用本发明说明书内容所作的等效变化,均包含于本发明的权利范围之内。
Claims (1)
- 一种溶栓药物个体化应用剂量的体外测定试验方法,其特征在于,包括下述步骤:(1)将血液混匀仪开机,预热至温度37℃备用,电子天平调至水平校准备用;(2)取常用溶栓药物一支,用电子天平将其平均分成20等份并分装入EP管,放入1℃冰箱冷藏保存备用;(3)取上述装有溶栓药品的EP管一支,加入500微升0.9%生理盐水,用漩涡混合器充分混匀溶解备用;(4)取八支Chancler旋转环并按顺序编号:1号为空白干燥环,2号加入100微升0.9%生理盐水,3至8号环分别加入低到高浓度溶栓药品试剂与0.9%生理盐水的混合液各100微升,并在每个环上标明溶栓药物的浓度;(5)按被检患者的体重比计算低至高浓度的体外溶栓药物临床应用剂量;抽取被检患者的静脉血8毫升,将所抽的静脉血立即分别加入前述准备好的八支Chancler旋转环中,每个旋转环中的血量为1毫升;(6)在拔出抽血针后1分30秒内,按顺序将八支Chancler旋转环全部放入血液混匀仪,启动血液混匀仪,持续运转工作15分钟后停止;(7)从混匀仪中取出Chancler旋转环,将旋转环中形成的血栓和剩余血液取出放在滤纸表面,依次按顺序观察在八支Chancler旋转环中取出的血栓形态、大小、重量,记录上述形成体积和重量最小的血栓或最先没有形成血栓时所对应的溶栓药物的浓度;(8)依据下述公式计算被检患者进行本次即刻静脉溶栓时应用溶栓药物的剂量;本次静脉溶栓药物剂量2/3×体重×溶栓药物的浓度。
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CN105467108A (zh) * | 2015-12-19 | 2016-04-06 | 开滦总医院 | 溶栓药物个体化应用剂量的体外测定试验方法 |
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