WO2023063125A1 - 血液凝固反応の分析方法 - Google Patents
血液凝固反応の分析方法 Download PDFInfo
- Publication number
- WO2023063125A1 WO2023063125A1 PCT/JP2022/036831 JP2022036831W WO2023063125A1 WO 2023063125 A1 WO2023063125 A1 WO 2023063125A1 JP 2022036831 W JP2022036831 W JP 2022036831W WO 2023063125 A1 WO2023063125 A1 WO 2023063125A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- reaction
- cell
- measurement
- coagulation
- sample
- Prior art date
Links
- 238000006243 chemical reaction Methods 0.000 title claims abstract description 396
- 238000000034 method Methods 0.000 title claims abstract description 85
- 230000023555 blood coagulation Effects 0.000 title claims abstract description 45
- 238000005259 measurement Methods 0.000 claims abstract description 329
- 230000015271 coagulation Effects 0.000 claims abstract description 182
- 238000005345 coagulation Methods 0.000 claims abstract description 182
- 239000007788 liquid Substances 0.000 claims abstract description 84
- 239000008280 blood Substances 0.000 claims abstract description 31
- 210000004369 blood Anatomy 0.000 claims abstract description 31
- 239000000523 sample Substances 0.000 claims description 218
- 239000003153 chemical reaction reagent Substances 0.000 claims description 157
- 238000012360 testing method Methods 0.000 claims description 49
- 230000033001 locomotion Effects 0.000 claims description 16
- 239000012488 sample solution Substances 0.000 claims description 9
- 238000010792 warming Methods 0.000 claims description 3
- 238000004458 analytical method Methods 0.000 description 105
- 238000012546 transfer Methods 0.000 description 24
- 238000012545 processing Methods 0.000 description 22
- 239000003085 diluting agent Substances 0.000 description 19
- 206010053567 Coagulopathies Diseases 0.000 description 18
- 230000035602 clotting Effects 0.000 description 18
- 238000001514 detection method Methods 0.000 description 17
- 230000002159 abnormal effect Effects 0.000 description 16
- 230000008569 process Effects 0.000 description 16
- 238000010438 heat treatment Methods 0.000 description 15
- 238000009434 installation Methods 0.000 description 15
- 230000003111 delayed effect Effects 0.000 description 12
- 230000004044 response Effects 0.000 description 10
- UXVMQQNJUSDDNG-UHFFFAOYSA-L Calcium chloride Chemical compound [Cl-].[Cl-].[Ca+2] UXVMQQNJUSDDNG-UHFFFAOYSA-L 0.000 description 8
- 230000002035 prolonged effect Effects 0.000 description 7
- 230000007246 mechanism Effects 0.000 description 6
- 230000007423 decrease Effects 0.000 description 5
- 238000010586 diagram Methods 0.000 description 5
- 238000005375 photometry Methods 0.000 description 5
- 238000011144 upstream manufacturing Methods 0.000 description 3
- 230000001133 acceleration Effects 0.000 description 2
- 230000002411 adverse Effects 0.000 description 2
- 230000008859 change Effects 0.000 description 2
- 230000006870 function Effects 0.000 description 2
- 230000010354 integration Effects 0.000 description 2
- 230000002093 peripheral effect Effects 0.000 description 2
- PGOHTUIFYSHAQG-LJSDBVFPSA-N (2S)-6-amino-2-[[(2S)-5-amino-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-4-amino-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-5-amino-2-[[(2S)-5-amino-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S,3R)-2-[[(2S)-5-amino-2-[[(2S)-2-[[(2S)-2-[[(2S,3R)-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-5-amino-2-[[(2S)-1-[(2S,3R)-2-[[(2S)-2-[[(2S)-2-[[(2R)-2-[[(2S)-2-[[(2S)-2-[[2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-1-[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-amino-4-methylsulfanylbutanoyl]amino]-3-(1H-indol-3-yl)propanoyl]amino]-5-carbamimidamidopentanoyl]amino]propanoyl]pyrrolidine-2-carbonyl]amino]-3-methylbutanoyl]amino]-4-methylpentanoyl]amino]-4-methylpentanoyl]amino]acetyl]amino]-3-hydroxypropanoyl]amino]-4-methylpentanoyl]amino]-3-sulfanylpropanoyl]amino]-4-methylsulfanylbutanoyl]amino]-5-carbamimidamidopentanoyl]amino]-3-hydroxybutanoyl]pyrrolidine-2-carbonyl]amino]-5-oxopentanoyl]amino]-3-hydroxypropanoyl]amino]-3-hydroxypropanoyl]amino]-3-(1H-imidazol-5-yl)propanoyl]amino]-4-methylpentanoyl]amino]-3-hydroxybutanoyl]amino]-3-(1H-indol-3-yl)propanoyl]amino]-5-carbamimidamidopentanoyl]amino]-5-oxopentanoyl]amino]-3-hydroxybutanoyl]amino]-3-hydroxypropanoyl]amino]-3-carboxypropanoyl]amino]-3-hydroxypropanoyl]amino]-5-oxopentanoyl]amino]-5-oxopentanoyl]amino]-3-phenylpropanoyl]amino]-5-carbamimidamidopentanoyl]amino]-3-methylbutanoyl]amino]-4-methylpentanoyl]amino]-4-oxobutanoyl]amino]-5-carbamimidamidopentanoyl]amino]-3-(1H-indol-3-yl)propanoyl]amino]-4-carboxybutanoyl]amino]-5-oxopentanoyl]amino]hexanoic acid Chemical compound CSCC[C@H](N)C(=O)N[C@@H](Cc1c[nH]c2ccccc12)C(=O)N[C@@H](CCCNC(N)=N)C(=O)N[C@@H](C)C(=O)N1CCC[C@H]1C(=O)N[C@@H](C(C)C)C(=O)N[C@@H](CC(C)C)C(=O)N[C@@H](CC(C)C)C(=O)NCC(=O)N[C@@H](CO)C(=O)N[C@@H](CC(C)C)C(=O)N[C@@H](CS)C(=O)N[C@@H](CCSC)C(=O)N[C@@H](CCCNC(N)=N)C(=O)N[C@@H]([C@@H](C)O)C(=O)N1CCC[C@H]1C(=O)N[C@@H](CCC(N)=O)C(=O)N[C@@H](CO)C(=O)N[C@@H](CO)C(=O)N[C@@H](Cc1cnc[nH]1)C(=O)N[C@@H](CC(C)C)C(=O)N[C@@H]([C@@H](C)O)C(=O)N[C@@H](Cc1c[nH]c2ccccc12)C(=O)N[C@@H](CCCNC(N)=N)C(=O)N[C@@H](CCC(N)=O)C(=O)N[C@@H]([C@@H](C)O)C(=O)N[C@@H](CO)C(=O)N[C@@H](CC(O)=O)C(=O)N[C@@H](CO)C(=O)N[C@@H](CCC(N)=O)C(=O)N[C@@H](CCC(N)=O)C(=O)N[C@@H](Cc1ccccc1)C(=O)N[C@@H](CCCNC(N)=N)C(=O)N[C@@H](C(C)C)C(=O)N[C@@H](CC(C)C)C(=O)N[C@@H](CC(N)=O)C(=O)N[C@@H](CCCNC(N)=N)C(=O)N[C@@H](Cc1c[nH]c2ccccc12)C(=O)N[C@@H](CCC(O)=O)C(=O)N[C@@H](CCC(N)=O)C(=O)N[C@@H](CCCCN)C(O)=O PGOHTUIFYSHAQG-LJSDBVFPSA-N 0.000 description 1
- 108010094028 Prothrombin Proteins 0.000 description 1
- 102100027378 Prothrombin Human genes 0.000 description 1
- 108010000499 Thromboplastin Proteins 0.000 description 1
- 102000002262 Thromboplastin Human genes 0.000 description 1
- 230000005856 abnormality Effects 0.000 description 1
- 238000002835 absorbance Methods 0.000 description 1
- 230000005540 biological transmission Effects 0.000 description 1
- 238000004891 communication Methods 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
- 238000007796 conventional method Methods 0.000 description 1
- 230000001934 delay Effects 0.000 description 1
- 238000007865 diluting Methods 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 230000000977 initiatory effect Effects 0.000 description 1
- 238000007689 inspection Methods 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 238000000691 measurement method Methods 0.000 description 1
- 239000000203 mixture Substances 0.000 description 1
- 230000003287 optical effect Effects 0.000 description 1
- 238000007639 printing Methods 0.000 description 1
- 229940039716 prothrombin Drugs 0.000 description 1
- 230000009467 reduction Effects 0.000 description 1
- 230000002441 reversible effect Effects 0.000 description 1
- 238000000926 separation method Methods 0.000 description 1
- 238000004904 shortening Methods 0.000 description 1
- 238000004804 winding Methods 0.000 description 1
Images
Classifications
-
- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N33/00—Investigating or analysing materials by specific methods not covered by groups G01N1/00 - G01N31/00
- G01N33/48—Biological material, e.g. blood, urine; Haemocytometers
- G01N33/50—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
- G01N33/86—Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing involving blood coagulating time or factors, or their receptors
-
- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N35/00—Automatic analysis not limited to methods or materials provided for in any single one of groups G01N1/00 - G01N33/00; Handling materials therefor
- G01N35/02—Automatic analysis not limited to methods or materials provided for in any single one of groups G01N1/00 - G01N33/00; Handling materials therefor using a plurality of sample containers moved by a conveyor system past one or more treatment or analysis stations
- G01N35/04—Details of the conveyor system
Definitions
- the present invention relates to a method for analyzing blood coagulation reactions.
- a blood coagulation test is a test for diagnosing the blood coagulability of a subject by examining the coagulation reaction of the subject's blood sample.
- a blood coagulation test generally, after adding a predetermined reagent to a blood sample, the coagulation reaction is measured over time, and the blood coagulation time is measured based on the obtained time-series data of the coagulation reaction. Blood clotting time is used as an index for detecting abnormal blood coagulability.
- automatic analyzers for measuring blood coagulation time have been widely used.
- the sample and reagent are placed in a cell, and the coagulation reaction within the cell is measured over time using an optical method. Since the coagulation reaction is measured at the measurement port of the device, cells are supplied to and removed from the measurement port for each measurement.
- a typical automatic analyzer is provided with a plurality of measurement ports for measuring the coagulation reactions in the cells, so that the coagulation reactions in a plurality of cells can be measured in parallel. After the sample is dispensed into the cell supplied to the measurement port, the coagulation reaction within the cell is measured during the period from the addition of the reagent to the cell to the removal of the cell from the measurement port.
- the measurement time is set in advance and is the same between cells (specimens).
- Patent Literatures 1 and 2 disclose a drive mechanism for rotating and stopping a table having a plurality of measuring module for measuring the coagulation time of the cell in the reciprocating direction, and the measuring module is set to the attachment/detachment position of the cell, the sample separation position, and the like.
- a blood coagulation analyzer is described that can be moved to and stopped at dosing and reagent dispensing positions.
- Patent document 3 discloses a blood coagulation analysis apparatus having a fixed table provided with a plurality of photometric ports for measuring the clotting time of cuvettes (cells) and a cell transfer arm for supplying cells containing specimens to the photometric ports on the table. A device is described.
- the present invention relates to improving analysis efficiency by appropriately adjusting the measurement time of individual blood specimens in the analysis of blood coagulation reactions by an automatic analyzer.
- a method for analyzing a blood coagulation reaction measuring a coagulation reaction of a sample liquid containing a blood sample to be tested by a blood coagulation analyzer; Determining whether the coagulation reaction of the sample liquid has ended; terminating the measurement of the coagulation reaction of the sample liquid when it is determined that the coagulation reaction has ended;
- the blood coagulation analyzer comprises a unidirectionally rotating reaction table, The reaction table has a measurement port to which a cell can be attached, measuring the coagulation reaction of the sample liquid in the cell supplied to the measurement port; accumulating time-series data of the measured coagulation reaction, Determining whether the coagulation reaction has ended from the accumulated time-series data of the coagulation reaction, When it is determined that the coagulation reaction has ended, the measurement of the coagulation reaction of the sample liquid is finished, and the cell containing the sample liquid is removed from the measurement port; Method.
- measuring the coagulation reaction of the sample liquid containing the blood sample to be tested supplying a cell to a measurement port of the reaction table; dispensing a test blood sample into the cell and heating it dispensing a reagent into a cell containing the test blood sample to prepare a sample solution; measuring the coagulation reaction of the sample liquid; including Supplying a cell to the measurement port, dispensing the test blood sample to the cell, and dispensing a reagent to the cell containing the test blood sample are performed by the measurement port having a predetermined number for each.
- the reaction table rotates one or more times, during which The method according to any one of [6] to [9], wherein heating of the blood sample to be tested is continued.
- the efficiency of analysis of blood coagulation reactions by an automatic analyzer can be improved without complicating the configuration and operation of the device.
- FIG. 1 is a schematic diagram of a system for blood coagulation analysis used in the method of the present invention
- FIG. A A diagram for explaining the configuration of the analysis module 100.
- FIG. B A diagram for explaining the configuration of the measurement port 2.
- FIG. 10 is a diagram for explaining the circulation operation of the reaction table 1; A process from the supply of the cell to the measurement port 2 to the removal of the cell after the end of the measurement.
- A In the case of measurement with a single reagent system
- B In the case of measurement with a two-reagent system.
- FIG. A A diagram for explaining the configuration of the analysis module 100.
- FIG. B A diagram for explaining the configuration of the measurement port 2.
- FIG. 10 is a diagram for explaining the circulation operation of the reaction table 1; A process from the supply of the cell to the measurement port 2 to the removal of the cell after the end of the measurement.
- A In the case of measurement with a single rea
- the number of turns of the reaction table 1, the analysis step at that time, the position or section where the analysis step is performed, the cycle when the analysis step is performed, and the analysis from the start of the analysis A table describing the time until the analysis process is started and the time required for the analysis process (specimen heating, sample liquid heating, and reaction measurement).
- a blood coagulation reaction is generally represented by a coagulation reaction curve that indicates a change in the amount of coagulation reaction over time.
- Blood sample, blood clotting reaction, and blood clotting time may be simply referred to herein as sample, clotting reaction, and clotting time, respectively.
- Patent Documents 1 and 2 show the possibility of changing the measurement time for each sample (for example, FIG. 5 of Patent Document 1), but a specific method for individually controlling the measurement time for each sample. and control mechanisms are not disclosed.
- the coagulation reaction of the sample liquid is measured in parallel with the measurement of the coagulation reaction of the sample liquid by the blood coagulation analyzer. It is determined whether or not it has ended. If it is determined that the coagulation reaction has ended, the measurement of the coagulation reaction of the sample liquid is ended. If not, the measurement is basically continued until the coagulation reaction ends. Therefore, in the method of the present invention, the measurement time of the coagulation reaction can vary for each sample liquid. The method of the present invention can optimize the measurement time of the coagulation reaction for each sample liquid, thereby shortening the overall measurement time, so to speak, improving analysis efficiency.
- blood coagulation analyzers generally perform complex operations such as supplying cells to measurement ports, dispensing specimens and reagents into cells, moving measurement ports, and removing cells from measurement ports.
- the complication of the operation of the device makes it easier for the measured values to fluctuate and cause noise, which in turn leads to a decrease in measurement accuracy.
- the table on which the measurement port is placed rotates in the reciprocating direction to move the measurement port to a predetermined position.
- Such reciprocating motion allows the cell to be immediately moved to the desired position with a minimum travel distance, but the reciprocating motion of the table causes the cell to shake and the sample solution in the cell to shake. This would introduce noise into the clotting response curve (measured data), which would have a significant adverse effect on the measured value (clotting time). It is desirable to prevent blurring and noise in the measured values by simplifying the operation of the device.
- the method for analyzing blood coagulation reactions of the present invention is as follows: measuring a coagulation reaction of a sample liquid containing a blood sample to be tested by a blood coagulation analyzer; Determining whether the coagulation reaction of the sample liquid has ended; terminating the measurement of the coagulation reaction of the sample liquid when it is determined that the coagulation reaction has ended; including.
- the blood coagulation analyzer used in the method of the present invention comprises a reaction table equipped with a plurality of measurement ports to which cells can be attached at regular intervals. Each of the measurement ports can be provided with a cell for containing a sample liquid. During analysis, the coagulation reaction of the sample liquid in the cell supplied to the measurement port is measured. The coagulation reaction is preferably measured optically, but is not particularly limited as long as it is a known method.
- the reaction table rotates unidirectionally to move each measurement port to the cell attachment/detachment position and the sample and reagent dispensing position. Such an arrangement simplifies the construction and operation of the device and reduces the measurement blur and noise associated with the operation of the device.
- the measured data of the coagulation reaction of the sample liquid are sequentially sent to the data processing unit and accumulated as time-series data of the coagulation reaction.
- the data processing unit determines whether or not the coagulation reaction of the sample liquid has ended from the accumulated time-series data of the coagulation reaction. When it is determined that the coagulation reaction has ended, the measurement of the coagulation reaction of the sample liquid ends. The cell containing the sample liquid that has completed the coagulation reaction is removed from the measurement port and discarded.
- FIG. 1 shows a conceptual diagram of one embodiment of a system for blood coagulation analysis used in the method of the present invention.
- the system shown in FIG. 1 comprises a measuring unit, a control unit, an operating unit and an output unit for performing blood coagulation analysis.
- Blood coagulation analysis by the system can be performed by a program for performing the method of the invention.
- the control unit controls the operation of the entire system.
- a control unit may be constituted by, for example, one or more computers.
- the control unit includes a CPU, memory, storage, communication interface (I/F), etc., and processes commands from the operation unit, controls the operation of the measurement unit, saves and outputs measurement data and analysis results received from the measurement unit. It controls the output of measurement data and analysis results by the unit.
- the control unit may be connected to other devices such as external media and host computers. Control of the system by the control unit may be implemented by a program.
- the operation unit acquires input from the operator and transmits the obtained input information to the control unit.
- the operation unit includes a user interface (UI) such as a keyboard and touch panel.
- UI user interface
- the output unit outputs measurement data and analysis results of the measurement unit under the control of the control unit.
- the measurement unit mainly consists of an analysis module 100, which will be described later, and acquires measurement data of the coagulation reaction of the sample liquid containing the test specimen.
- n test samples are analyzed in parallel by n reaction parts (for example, measurement ports 2 to be described later).
- the acquired measurement data is analyzed in the data processing unit to determine whether or not the coagulation reaction has ended.
- the data processing unit can also perform arithmetic processing such as coagulation time calculation.
- Data measurement and analysis are controlled by the measurement controller. Alternatively, data measurement and analysis can be controlled by the control unit via the measurement control.
- the measurement control section and data processing section of the measurement unit are incorporated in the measurement unit.
- the measurement control and data processing are integrated in the control unit.
- the measurement control section and the data processing section constitute separate units.
- the measurement control and data processing are integrated and incorporated into the measurement unit or control unit.
- the analysis results in the data processing unit are sent to the output unit under the control of the control unit.
- Output from the output unit may take any form, such as display on a screen, transmission to a host computer, or printing.
- the output information from the output unit can include clotting response curve data, clotting time, and the like.
- FIG. 2A shows the configuration of an analysis module 100, which is one embodiment of the blood coagulation analyzer used in the method of the present invention.
- the horizontal direction of the figure is the X axis
- the vertical direction is the Y axis
- the direction perpendicular to these is the Z axis.
- the analysis module 100 includes a reaction table 1 , a measurement port 2 , a cell transfer section 3 , a specimen dispensing section 4 , a first reagent dispensing section 5 and a second reagent dispensing section 6 . Furthermore, the analysis module 100 shown in FIG. 2A includes sample racks (7 and 7a), a diluent rack 8, a first reagent placement section 9 and a second reagent placement section 10, a cell storage section 11, a sample placement section 20, a sample A rack Y-axis movement lane 20a, a sample rack X-axis movement lane 20b, a diluent rack installation section 30, and a diluent rack movement lane 30a are illustrated.
- the analysis module 100 drives the reaction table 1, the cell transfer section 3, the specimen dispensing section 4, the reagent dispensing sections 5 and 6, etc., and moves the specimen rack and diluent rack.
- a driving mechanism such as a motor, a pump, an actuator, etc. is provided for this purpose.
- the analysis module 100 may also include a control unit 12 for controlling the operation of the drive mechanism, the measurement by the measurement port 2, or the analysis of the measurement data.
- the analysis module 100 can also include a data processing unit 13 for analyzing the measured coagulation reaction data, determining whether the coagulation reaction of the sample liquid has ended, and calculating the coagulation time of the test specimen.
- the control unit 12 and the data processing unit 13 may be installed separately from the analysis module 100 .
- the reaction table 1 shown in FIG. 2A is a disk-shaped table, it may be configured with another structure capable of revolving motion, such as a revolving belt conveyor. Therefore, the orbit of the reaction table 1 is preferably circular (perfectly circular, elliptical), more preferablyperfectly circular, but may be of any other shape.
- the reaction table 1 has multiple measurement ports 2 .
- the measurement ports 2 of FIG. 2A are arranged along the circumference of the reaction table 1 . Therefore, the measurement port 2 revolves along the revolving orbit of the reaction table 1 .
- the terms “measurement port 2 orbiting” and “cell orbiting” mean that the measurement port 2 on the reaction table 1 or the cell mounted thereon moves along with the reaction table 1 orbiting.
- the plurality of measurement ports 2 be installed on the reaction table 1 at regular intervals.
- the reaction table 1 is rotated unidirectionally by a driving mechanism (not shown).
- the reaction table 1 intermittently circulates.
- the number of measurement ports 2 installed in the reaction table 1 can be appropriately adjusted depending on the size of the reaction table 1, the period of intermittent rotation, the time required for one rotation, and the like.
- each measurement port 2 comprises a cell mounting portion 2a.
- Cells are supplied from the cell storage portion 11 to the cell mounting portion 2a by the cell transfer portion 3 .
- the cell transfer section 3 also functions to take out the cell for which measurement has been completed from the cell mounting section 2a.
- a heating function is preferably provided around the cell mounting portion 2a in the measurement port 2 to heat the test specimen or sample liquid dispensed into the cell.
- the measurement port 2 has a detection section for measuring the coagulation reaction of the sample liquid in the cell.
- the detection unit is preferably a mechanism for optically measuring the coagulation reaction of the sample liquid. In the embodiment shown in FIG.
- the detection unit includes a light source 2b that irradiates the sample liquid in the cell with light, and measures the scattered light generated by scattering the light incident on the sample liquid to the side of 90 degrees. and a photometry unit 2c for performing the measurement.
- the photometry unit 2c may measure the transmitted light from the sample liquid or the absorbance of the sample liquid.
- the light source 2b comprises an LED and the photometric part 2c comprises a photodiode.
- the detection unit sequentially acquires the photometric amount from the sample liquid as measurement data at preset time intervals.
- a cell transfer section 3 serves to supply the cell from the cell storage section 11 to the cell mounting section 2a of the measurement port 2 or to take out the cell from the cell mounting section 2a.
- the specimen dispensing unit 4 serves to dispense the specimen in the specimen rack 7a and the diluent in the diluent rack 8 to the cells in the cell mounting part 2a.
- the first reagent dispensing unit 5 and the second reagent dispensing unit 6 respectively supply the first reagent in the first reagent installing unit 9 and the second reagent in the second reagent installing unit 10 to the cells of the cell mounting unit 2a.
- the cell transfer section 3 In the analysis module 100 shown in FIG. 2A, both the supply and removal of cells to and from the measurement port 2 are performed by the cell transfer section 3 .
- a cell supply section 3a and a cell removal section 3b are responsible for supplying and removing cells from the measurement port 2, respectively.
- the specimen pipetting unit 4, the first reagent pipetting unit 5, and the second reagent pipetting unit 6 are rotating arms that rotate around the positions indicated by the black circles.
- a circular dashed line indicates a movable path (trajectory) of the arm.
- the tip of each rotating arm is equipped with a dispensing probe.
- the cells supplied to the measurement port 2 are preferably disposable cells.
- the cells in the cell storage section 11 are aligned in an alignment supply section (not shown) and then supplied to the cell transfer section 3 .
- the cell transfer section 3 supplies cells to the cell mounting section 2a. After the measurement, the cells are taken out from the cell loading section 2a by the cell transferring section 3 and discarded to the cell discarding section (not shown).
- the cell transfer section 3 includes a cell detection sensor (not shown) for detecting the presence or absence of cells in the cell mounting section 2a.
- the specimen rack 7 stores specimen containers (blood collection tubes, sample cups, etc.) containing specimens to be tested.
- the sample rack 7 is placed in the sample placement section 20 .
- the sample rack 7 can accommodate a maximum of five sample containers at the same time. assigned.
- Ten sample racks 7 can be placed in the sample setting section 20 .
- the sample rack 7 moves in the direction of the arrow from the sample setting section 20, and is transferred to the sample rack Y-axis movement lane 20a through the sample rack X-axis movement lane 20b.
- the test sample placed on the sample rack 7a moved to the sample rack Y-axis movement lane 20a is aspirated into the sample pipetting unit 4 at a predetermined position (Ps).
- the sample rack 7a When the sample has been aspirated from all the sample containers of the sample rack 7a, the sample rack 7a is returned to the original position of the sample installation section 20 through the reverse route. Next, another sample rack 7 set in the sample setting section 20 is transferred to the sample rack Y-axis movement lane 20a.
- the diluent rack 8 contains a container containing the sample diluent used for diluting the test sample.
- the diluent rack 8 contains containers containing normal plasma used for cross-mixing tests.
- the sample rack 8 can accommodate a maximum of five containers at the same time, and container storage positions 1 to 5 are assigned in order from the beginning to the end (from top to bottom in the drawing) in the Y-axis direction.
- the diluent rack 8 is placed in the diluent rack mounting portion 30 and is movable on the diluent rack mounting portion 30 in the Y-axis direction (arrow direction).
- each sample diluent-filled container stored in the rack 8 moves to a predetermined position, and the sample diluent in the container is aspirated into the sample dispensing section 4 .
- Reagents used for preparing the sample liquid are stored in the first reagent placement section 9 and the second reagent placement section 10 .
- the first reagent setting part 9 and the second reagent setting part 10 can each accommodate ten containers containing the first reagent and ten containers containing the second reagent (gray portion).
- Position numbers from 1 to 10 are given from the beginning to the end (from top to bottom in the figure) in the Y-axis direction to distinguish the installation positions of the reagent containers.
- the first reagent installation part 9 and the second reagent installation part 10 are movable in the Y-axis direction (arrow direction), and their movable ranges are indicated by dotted lines.
- the first reagent and the second reagent are selectively used according to inspection items. For example, for prothrombin time (PT) measurement, only the first reagent is used, and for activated partial thromboplastin time (APTT) measurement, the first and second reagents are used.
- the first reagent and the second reagent used for analysis of the same sample are arranged side by side in their respective reagent setting portions. In this case, when only the first reagent is used for the analysis, the position of the adjacent second reagent placement section 10 is empty.
- a first reagent and a second reagent used for analysis are transported to a predetermined position (Pr) by the movement of the first reagent installation section 9 and the second reagent installation section 10, respectively, and then placed in the first reagent dispensing section 5 and the second reagent installation section 10. It is sucked into the two-reagent dispensing section 6 .
- FIG. 2A 40 measurement ports 2 are arranged at regular intervals on the circumference of a disk-shaped reaction table 1 .
- a cell transfer unit 3 Arranged around the reaction table 1 are a cell transfer unit 3 , a specimen pipetting unit 4 , a first reagent pipetting unit 5 and a second reagent pipetting unit 6 , each of which is a specific one for the reaction table 1 . access in place.
- the access positions to the reaction table 1 of the cell transfer section 3, the sample pipetting section 4, the first reagent pipetting section 5, and the second reagent pipetting section 6 are designated as position A, position B, position C, and position D, respectively. call.
- Position A, position B, position C and position D are set in this order along the rotation direction of the reaction table 1 . That is, there are position A, position B, position C, and position D in order from the upstream in the winding direction. That is, the supply and removal of cells to and from the measurement port 2 on the reaction table 1 by the cell transfer unit 3 are performed when the measurement port 2 reaches the position A.
- the reaction table 1 rotates from there and the measurement port 2 supplied with the cell reaches the position B
- the test sample is dispensed into the cell by the sample dispensing section 4 .
- the first reagent dispensing section 5 dispenses the first reagent into the cell.
- the second reagent dispensing section 6 dispenses the second reagent into the cell if necessary. Once the necessary reagents have been dispensed into the cell, the clotting reaction measurement is started.
- the test specimen is heated for a long time, after the test specimen is dispensed into the cell at position B, the first reagent is dispensed into the cell at position D, and then coagulation reaction measurement is started. good too.
- the cell into which the test specimen is dispensed at position B can be passed through positions C and D without dispensing the reagent.
- the reaction table 1 is rotated once, twice, or three times or more, during which time the test sample is Warming is continued.
- the cell reaches position C or position D for the second, third, or fourth time or later, the first reagent and, if necessary, the second reagent are dispensed into the cell, and then the clotting reaction is measured. be started.
- the reaction table 1 rotates toward the measurement end determination point (position E, which will be described later).
- position E which will be described later.
- the position E is located downstream of the position D in the rotation direction of the reaction table 1 , while it is upstream of the position A in the rotation direction of the reaction table 1 .
- the position A is shifted from the position E by one cycle of the reaction table 1 in the rotation direction. That is, when the position A is the most upstream in the rotation direction of the reaction table 1, the position E is arranged the most downstream (see FIG. 3).
- both the supply and removal of cells to measurement port 2 occur at position A.
- the supply and removal of cells to the measurement port 2 are performed at different locations on the reaction table 1.
- FIG. For example, cells may be supplied at position A, and cells may be taken out at position E after measurement is completed.
- the rotation speed (or the time required for one rotation) of the reaction table 1 is such that, during one rotation, the cell is attached to and detached from the measurement port 2, the test specimen and reagent are dispensed into the cell, and the test specimen and sample liquid are heated. , and time for measuring the coagulation reaction of the sample liquid. That is, while the reaction table 1 rotates once, a new cell is supplied to the measurement port 2 after taking out the cell after the measurement as necessary, and the test sample and the reagent are dispensed into the cell for a predetermined amount. It is heated for a period of time, and the coagulation reaction is measured for a predetermined period of time.
- the sample heating time is 40 to 60 seconds
- the sample liquid heating time after reagent addition is 160 to 180 seconds
- the coagulation reaction measurement time is 120 to 140 seconds. Therefore, 320 to 380 seconds, which is the sum of these, is the time required for analysis of one sample. Assuming that the interval of the intermittent rotation operation of the reaction table 1 is ⁇ (seconds) and the number of measurement ports 2 on the reaction table 1 is ⁇ , the time for one rotation of the reaction table 1 is [ ⁇ ] (seconds). be. Further, if the reaction table 1 is disc-shaped, the movement angle of the reaction table 1 in one intermittent rotation (one cycle) is [360°/ ⁇ ].
- Appropriate ranges of ⁇ and ⁇ can be determined in consideration of the time required for one round of the reaction table 1 and the time required for one cycle to perform a given analysis.
- the disk-shaped reaction table 1 with 40 measurement ports 2 shown in FIG. 2A intermittently rotates clockwise every 9 seconds by 9° (360°/40) per cycle. .
- the reaction table 1 rotates once in 40 cycles (360 seconds), and each measurement port 2 returns to its original position in the 41st cycle.
- FIG. 3A represents Reaction Table 1 at the start of the analysis (first cycle), when P01 is at position A.
- FIG. 3A When the analysis is started, the reaction table 1 rotates clockwise by a rotation angle of 9°, and makes one turn by moving 40 times (40 cycles).
- the reaction table 1 in FIG. 2A rotates clockwise during analysis due to the arrangement of the peripheral analysis processing units, but may rotate counterclockwise during analysis depending on the arrangement of the peripheral analysis processing units. can.
- FIG. 3B represents Reaction Table 1 for the second cycle, when P01 is at position B.
- FIG. 3C represents reaction table 1 at cycle 7, when P01 is at position C.
- FIG. As an example, the case of measuring the APTT of the test sample P01 with the analysis module 100 of FIG. 2A will be described.
- P01 is supplied with a new cell. If there is already a cell in P01, an operation to extract that cell is performed first.
- positions BD the test sample, first reagent, and second reagent are dispensed to P01.
- a measurement port 2 different from the measurement port 2 used in the previous analysis may be used for the next analysis.
- the measurement port 2 next to the measurement port 2 used in the previous analysis can be used for the next analysis.
- FIG. 3 as an example, if P01 was used in the previous analysis, then P40 would be used in the next analysis and P40 could be placed in position A at the start of the first cycle of analysis.
- FIGS. 4A and 4B A series of steps from the supply of the cell to the measurement port 2 on the reaction table 1 to the removal of the cell after the measurement is completed are shown in FIGS. 4A and 4B.
- the first stage shows the state of the cell at the measurement port 2
- the second stage shows the process number
- the third stage shows the position of the cell
- the fourth stage shows the analysis process.
- the coagulation reaction of the sample liquid is measured (FIG. 4A).
- the coagulation reaction of the sample liquid is measured after the second reagent is dispensed into the cell at position D (FIG. 4B).
- the coagulation reaction data measured by the photometry unit 2c is sequentially sent to the data processing unit 13 and accumulated as time-series data.
- the data processing unit 13 determines whether or not the coagulation reaction of the sample liquid has ended from the accumulated time-series data of the coagulation reaction of the sample liquid. If the coagulation reaction has finished when the cell reaches position E, the measurement is finished and the cell is removed from the measurement port 2 at the next position A.
- the data processing unit 13 creates a coagulation reaction curve from the accumulated time-series data of the coagulation reaction. If necessary, the coagulation reaction curve may be differentiated to create velocity data or acceleration data of the coagulation reaction. These clotting reaction curves, their velocity data and acceleration data can be used to determine the end of the clotting reaction.
- the coagulation reaction end point Re decreases to 0 or a constant value after the coagulation reaction curve R reaches a plateau and the first derivative curve of R (rate data of the coagulation reaction) reaches a peak (maximum rate). It can be determined according to any criteria such as the point in time (see Japanese Patent Application No. 2020-068877), the earliest point at which the ratio of the integrated value of R in a minute time period is less than the threshold (International Publication No. 2021/132552). .
- the detection of Re in the data processing unit 13 is performed in parallel with the measurement of the coagulation reaction data (in real time, so to speak).
- i represents the measurement point number
- Zs can be appropriately set depending on the analysis item, but is greater than 1 and 1.100 or less, for example, in the case of APTT measurement, preferably 1.050 or less, more preferably Zs is 1.010 to 1.001.
- Z(i) is calculated after i reaches a predetermined calculation start point and after R(i) reaches a predetermined value or more. is preferred. In this procedure, while measuring the coagulation reaction, R(i) is obtained, Z(i) is calculated, and Re is detected.
- a signal indicating the end of the reaction is sent from the data processing section 13 to the control section 12 .
- the reaction table 1 makes one turn and P01 reaches position E
- the control unit 12 receives a reaction end signal, the control unit 12 ends the measurement of the coagulation reaction of the sample liquid of P01.
- the cell at P01 is then removed from measurement port 2 at position A on the next cycle. If Re is not detected when P01 reaches position E for the first time after the reaction table 1 makes one turn, the measurement of the coagulation reaction of the sample liquid of P01 is continued.
- the cell of P01 enters the second round on the reaction table 1 while the measurement is continued without the cell of P01 being taken out from the measurement port 2 .
- the reaction table 1 makes two turns and P01 reaches position E for the second time
- the controller 12 receives a reaction end signal, the measurement of the coagulation reaction of the sample liquid of P01 ends, and P01 reaches position E for the second time.
- the cell is removed from measurement port 2 at position A on the next cycle. If Re is not detected even after two rounds of the reaction table 1, the cell of P01 can continue to be measured in the third round on the reaction table 1.
- FIG. By the same procedure, the cell can be kept on the reaction table 1 and circulated until the end of the reaction is detected, and the measurement of the coagulation reaction can be continued.
- the cell containing the sample liquid attached to the measurement port 2 can be measured until its clotting reaction is completed.
- an upper threshold value for the measurement time of the cell containing the sample liquid may be set in advance. If the control unit 12 has not received a signal indicating the end of the reaction when the cell P01 circulates several times on the reaction table 1 and the measured time reaches the upper threshold value, the control unit 12 causes the cell P01 to It can be taken out from the measurement port 2 and sent to the data processing unit 13 as a result that there is no reaction completion signal.
- the upper threshold value of the measurement time can be set appropriately according to the coagulation time measurement method (for example, PT measurement, APTT measurement, cross-mixing test).
- a plurality of measurement ports 2 arranged on the circumference of the reaction table 1 sequentially reach positions A to E as the reaction table 1 rotates, and if cells are supplied there, the analysis step of the method of the present invention progresses. Therefore, the analysis module 100 can sequentially and continuously analyze the coagulation reaction of a plurality of sample liquids. Analysis by the analysis module 100 can be performed at one or more measurement ports 2 , but analysis need not be performed at all of the plurality of measurement ports 2 .
- FIG. 5 shows the flow of coagulation reaction analysis according to the method of the present invention using the analysis module 100 shown in FIG. 2A. Detailed procedures of the flow of FIG. 5 are shown below.
- S101 Supply cells to measurement port 2 at position A (first cycle).
- S102 Dispense sample into cell at position B (2nd cycle).
- S103 Heat the specimen until the 6th cycle.
- S104 Dispense the first reagent into the cell at position C (7th cycle).
- S105 If there is a second reagent, go to S106; if not, go to S108.
- S106 Until the 25th cycle, heat the sample solution in which the first reagent is added to the specimen.
- S107 Dispense the second reagent into the cell at position D (26th cycle).
- S108 ⁇ For 1 reagent system (previous step is S105)> Reaction measurement (photometry) is started after the first reagent is dispensed into the cell in S104.
- ⁇ For 2-reagent system (previous step is S107)> Reaction measurement (photometry) is started after the first reagent is dispensed into the cell in S107.
- S109 Continuously monitor whether or not the coagulation reaction has ended based on the acquired measurement data, and if the reaction has ended, proceed to S110. If the cell has reached position E while the reaction has not been completed, the process moves to S201.
- S110 If the reaction has ended, calculate the coagulation time and output the calculation result.
- Sample Sample at position 1 of sample rack 7a
- Analysis items 2 items, PT and APTT (hereafter referred to as AP)
- AP APTT
- Reagents PT reagent (1 reagent system) for P01
- APTT reagent 2 reagent system
- Measurement time Analysis process until the time when the reaction table 1 makes one revolution for both PT and AP) (first cycle)
- PT At position A, the cell transfer section 3 supplies a new cell to the cell loading section 2a of P01 of the measurement port 2.
- (Second cycle) PT At position B, 50 ⁇ L of the sample aspirated from the sample container stored in the sample rack 7 is dispensed into the cell of P01. The dispensed sample is heated on measurement port 2 .
- AP At position A, the cell transfer unit 3 supplies a new cell to the cell loading unit 2a of P02 of the measurement port 2;
- AP At position B, 50 ⁇ L of the sample aspirated from the sample container stored in the sample rack 7 is dispensed into the cell of P02. The dispensed sample is heated on measurement port 2 .
- PT At position C, the first reagent dispensing unit 5 aspirates a predetermined amount of the PT reagent from the first reagent container installed in the first reagent installation unit 9, and dispenses 100 ⁇ L of the PT reagent into the cell of P01, and the sample liquid is added. Prepare. Acquisition of measurement data (reaction measurement) is started immediately after dispensing the reagent.
- AP At position C, the first reagent dispensing unit 5 dispenses 50 ⁇ L of the APTT reagent aspirated from the first reagent container installed in the first reagent installation unit 9 by a predetermined amount into the cell of P02.
- the dispensed reagent is heated on the measurement port 2 together with the dispensed sample.
- (Mth cycle (7 ⁇ M ⁇ 40)) PT Analyze the progress of the coagulation reaction of the PT in real time based on the acquired time-series measurement data, calculate the coagulation time when Re (the end point of the coagulation reaction) is detected, and output the calculated coagulation time as the PT value.
- (Nth cycle (27 ⁇ N ⁇ 40)) AP The APTT coagulation reaction progress is analyzed in real time based on the acquired time-series measurement data, the coagulation time is calculated when Re is detected, and the calculated coagulation time is output as the APTT value.
- the first reagent dispensing unit 5 dispenses 50 ⁇ L of the APTT reagent sucked from the first reagent container installed in the first reagent installation unit 9 by a predetermined amount into the cell of P01.
- the dispensed reagent is heated on the measurement port 2 together with the dispensed sample.
- the second reagent dispensing unit 6 aspirates a predetermined amount of the calcium chloride solution from the second reagent container installed in the second reagent installation unit 10, and dispenses 50 ⁇ L of the calcium chloride solution into the cells of the reaction unit P01 to obtain a sample liquid. to prepare.
- reaction measurement is started immediately after dispensing the reagent. (from the 27th to the 79th cycle) Continue reaction measurement.
- the reaction table 1 rotates intermittently while acquiring measurement data from the cell of P01.
- the APTT coagulation reaction progress is analyzed in real time based on the acquired time-series measurement data, the coagulation time is calculated when Re is detected, and the calculated coagulation time is output as the APTT value.
- 80th cycle Since it was determined that the coagulation reaction had ended when the position E was reached (Re detection), the reaction measurement at P01 was terminated and the acquired measurement data was saved. (81st cycle) The cell of P01 that has reached position A is taken out and discarded.
- Cross-mixing test (delayed response)
- the cross-mixing test has an immediate reaction and a delayed reaction depending on the difference in the heating time of the sample for measurement.
- the time for heating the sample for measurement in the delayed reaction of the cross-mixing test is 2 hours.
- This operational example describes a rapid method of cross-mixing test delayed reaction in which the heating time is shortened to about 13 minutes.
- Sample Sample in position 3 of sample rack 7a
- Analysis item APTT (rapid method for delayed reaction in cross-mixing test)
- Sample heating time 45 seconds for immediate response, the same as for normal APTT measurement (see Figure 7), and 765 seconds for delayed response (see Figure 8).
- Measurement time Analysis process until the time when the reaction table 1 rotates three times) (first cycle)
- S At position A, the cell transfer section 3 supplies a new cell to the cell loading section 2a of P01 of the measurement port 2.
- the dispensed sample and normal plasma are heated on the measurement port 2 .
- the dispensed normal plasma is warmed on measurement port 2 . (from the 5th to the 86th cycle)
- SML Common Continue to warm samples in cells P01, P02 and P03.
- (106th cycle) S At position D in the third round of the reaction table 1, the second reagent dispensing unit 6 sucks a predetermined amount of calcium chloride solution from the second reagent container installed in the second reagent installation unit 10, P01 50 ⁇ L is dispensed into the cell to prepare a sample solution. Acquisition of measurement data (reaction measurement) is started immediately after reagent dispensing.
- (108th cycle) L At position D as in the 106th cycle, 50 ⁇ L of calcium chloride solution is dispensed into the cell of P03 to prepare a sample solution. Reaction measurement is started immediately after reagent dispensing. (Nth cycle: the number of cycles in which the second reagent (calcium chloride solution) was dispensed ⁇ N ⁇ the number of cycles to take out cells)
- Nth cycle the number of cycles in which the second reagent (calcium chloride solution) was dispensed ⁇ N ⁇ the number of cycles to take out cells
- Common to SML: P01, P02, and P03 analyze the progress of the coagulation reaction in real time based on the acquired time-series measurement data, calculate the coagulation time (APTT) when Re is detected, and output the calculation result.
- APTT coagulation time
- FIG. 6 to 8 show the number of revolutions of the reaction table 1 in the analysis steps of Operation Examples 1 to 4, the analysis step at that time, the position or section where the analysis step is performed, and the analysis.
- a table showing the cycle in which the process is performed, the time from the start of analysis to the start of the analysis process, and the time required for the analysis process (specimen heating, sample liquid heating, and reaction measurement) is shown.
- FIG. 6 is for PT measurement
- FIG. 7 is for APTT measurement
- FIG. 8 is for delayed response in cross-mixing test.
- the upper table shows the case where the measurement ends when the reaction table 1 makes one turn (operation example 1)
- the lower table shows the case where the measurement ends when the reaction table 1 makes two turns.
- FIG. 6 shows the case where the measurement ends when the reaction table 1 makes two turns.
- the upper table shows the case where the measurement ends when the reaction table 1 makes one turn (operation example 1)
- the middle table shows the case where the measurement ends when the reaction table 1 makes two turns (operation example 2).
- the table below shows the case where the measurement is completed when the reaction table 1 makes three revolutions.
- the delayed reaction of the cross-mixing test takes time to warm the sample (mixture of test sample and normal sample), so the number of cycles of the reaction table 1 increases.
- the upper table shows the case where the measurement is completed when the reaction table 1 makes three turns (operation example 3), and the lower table shows the case where the measurement ends when the reaction table 1 makes four turns (operation example 4).
- the number attached to the position indicates how many times the measuring port 2 reaches that position. For example, E2 means that the measuring port 2 reaches the position E for the second time.
- a measurement time of 297 seconds for PT measurement and 126 seconds for APTT measurement should be ensured while the reaction table 1 rotates once.
- the measurement time of 657 seconds for PT measurement and 486 seconds for APTT measurement can be secured while the reaction table 1 rotates twice. Therefore, in the case of PT and APTT measurements, the coagulation reaction of most specimens including normal specimens completes during one turn of the reaction table 1 and does not enter the second turn on the reaction table 1 . Even for an abnormal specimen with a prolonged coagulation time, in most cases, it is sufficient to measure the coagulation reaction until the reaction table 1 makes two revolutions.
- the time for one revolution of the reaction table 1 minus the heating time for the specimen or sample solution is 120 to 140 seconds. was found to be the maximum measurement time required to measure the clotting reaction.
- the method of the present invention it is possible to complete the measurement in a relatively short period of time for a sample with a normal coagulation reaction or a sample with a mildly prolonged coagulation time, while the measurement can be completed in a relatively short time.
- a long measurement time can be ensured for a sample that has an abnormal reaction and whose coagulation time is greatly prolonged. Therefore, in the method of the present invention, even when continuously analyzing a group of specimens that may include not only normal specimens but also abnormal specimens with prolonged clotting times, the specimen measurement time may be Since it is not necessary to set a long time according to a certain abnormal sample, the throughput of analysis does not decrease.
- the method of the present invention is carried out, it will be possible to carry out a cross-mixing test (rapid method of immediate reaction and delayed reaction) in parallel with normal coagulation time measurement (PT, APTT, etc.). Therefore, various types of blood coagulation reaction analysis can be collectively performed without incurring a significant decrease in throughput.
- a cross-mixing test rapid method of immediate reaction and delayed reaction
- normal coagulation time measurement PT, APTT, etc.
- various types of blood coagulation reaction analysis can be collectively performed without incurring a significant decrease in throughput.
- the analysis module 100 shown in FIG. 2A when continuous APTT measurements are performed on a large number of samples according to the method of the present invention, the analysis progresses as in Operation Example 1 (reaction table 1 only goes around once). and 400 cases per hour can be processed. If three delayed response measurements in the cross-mixing test as in Operation Example 3 are included here, the processing capacity per hour temporarily decreases to 394 during the three measurements, but the three measurements
- the reaction table 1 for measuring the cell containing the sample liquid rotates only in one direction, so when the table rotates in a reciprocating manner (for example, Patent Documents 1 and 2), cells that may occur Since there is no shaking of the sample liquid in the cell or shaking of the sample liquid in the cell, it is possible to prevent blurring and noise in the measured values caused by the shaking and permeation of the liquid.
- the reaction table 1 rotates only unidirectionally as described above, and the supply and removal of cells to and from the reaction table 1 are performed at one point, In addition, dispensing of specimens and reagents to the cells on the reaction table 1 is performed at predetermined positions on the reaction table 1 under operation control by the rotating arm. Whether or not to end the measurement of the cell on the reaction table 1 and remove it may be determined at the timing when the cell on the reaction table completes one turn and moves to a predetermined position.
- the operation control of the analysis module 100 is simpler than that of devices that supply cells and dispense reagents to arbitrary positions on the reaction table 1 (for example, the devices described in Patent Documents 1 to 3).
- the devices described in Patent Documents 1 to 3 it is necessary to recognize the position of a measurement port for attachment/detachment of a cell, or dispensing of a sample or reagent, and to control the movement of a reaction table, a dispensing probe, or the like.
- PT parallel coagulation time measurements
- APTT APTT
- Timing of operations such as dispensing probes must be controlled.
- the control unit 12 of the analysis module 100 does not need to hold or control the position and timing information of the measurement port 2 to which the cell should be attached/detached or the sample or reagent should be dispensed. do not have. This leads to system control load reduction for the blood coagulation analysis used in the method of the present invention.
- clotting response curves of a normal specimen and two abnormal specimens with prolonged clotting times were obtained.
- the cell was irradiated with light with a wavelength of 660 nm using an LED as a light source, and the scattered light amount of 90-degree side scattered light was measured at intervals of 0.1 seconds.
- the coagulation reaction end point Re the earliest time point at which the integration ratio Z(i) at time point i is less than the threshold value Zs (1.010) was detected according to the method described in International Publication No. 2021/132552.
- FIG. 9 shows the coagulation reaction curve and APTT of each specimen.
- the horizontal axis indicates time
- the vertical axis indicates measurement data (scattered light amount)
- the coagulation reaction curve is corrected so that the data at the start of the reaction (when the second reagent is dispensed) is 0.
- a square mark on the coagulation reaction curve represents the point at which the cell containing the specimen reaches position E on the reaction table 1, and a circle mark represents APTT.
- the dotted line represents the time (tRe) at the clotting reaction end point Re.
- FIG. 9A is a coagulation reaction curve of a normal specimen, Re was detected while the reaction table 1 made one turn, and measurement was completed. APTT was 32.2 seconds.
- FIG. 9B is the coagulation reaction curve of the abnormal specimen 1.
- FIG. The APTT was extended to 94.5 seconds, but Re was detected while the reaction table 1 made one turn, and the measurement was terminated.
- FIG. 9C is the coagulation reaction curve of the abnormal sample 2.
- FIG. Re was not detected until the reaction table 1 made one round, and the measurement was completed in the second round.
- APTT was extended by 108.8 seconds.
- reaction table 2 measurement port 3 cell transfer unit 4 specimen pipetting unit 5 first reagent pipetting unit 6 second reagent pipetting unit 100 analysis module
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Immunology (AREA)
- Hematology (AREA)
- Engineering & Computer Science (AREA)
- Chemical & Material Sciences (AREA)
- Analytical Chemistry (AREA)
- Biochemistry (AREA)
- Pathology (AREA)
- Molecular Biology (AREA)
- Urology & Nephrology (AREA)
- General Physics & Mathematics (AREA)
- General Health & Medical Sciences (AREA)
- Biomedical Technology (AREA)
- Physics & Mathematics (AREA)
- Medicinal Chemistry (AREA)
- Cell Biology (AREA)
- Food Science & Technology (AREA)
- Biotechnology (AREA)
- Microbiology (AREA)
- Investigating Or Analysing Biological Materials (AREA)
Abstract
Description
〔1〕血液凝固反応の分析方法であって、
血液凝固分析装置により、被検血液検体を含む試料液の凝固反応を計測すること、
該試料液の凝固反応が終了したか否かを判定すること、
該凝固反応が終了したと判定された場合、該試料液の凝固反応の計測を終了すること、
を含み、
該血液凝固分析装置は、一方向性に周回する反応テーブルを備え、
該反応テーブルは、セルを装着可能な測定ポートを備え、
該測定ポートに供給されたセル内の該試料液の凝固反応が計測され、
計測した該凝固反応の時系列データが蓄積され、
蓄積された該凝固反応の時系列データから、該凝固反応が終了したか否かが判定され、
該凝固反応が終了したと判定された場合、該試料液の凝固反応の計測を終了し、該試料液を収容するセルを該測定ポートから取り出す、
方法。
〔2〕前記反応テーブルが円盤状である、〔1〕記載の方法。
〔3〕前記反応テーブルが間欠的に周回動作し、かつ1周回する時間が320~380秒である、〔1〕又は〔2〕記載の方法。
〔4〕前記間欠的周回動作のインターバルがα秒、前記反応テーブル上の測定ポートの数がβ個であり、ここでα=8~20、β=16~47であり、ただし[α×β]=320~380秒であり、
1回の前記間欠的周回動作における前記反応テーブルの移動角度が[360°÷β]である、〔3〕記載の方法。
〔5〕前記被検血液検体を含む試料液の凝固反応の計測が、
前記反応テーブルの測定ポートにセルを供給すること、
該セルに被検血液検体を分注し、加温すること
該被検血液検体を収容するセルに試薬を分注し、試料液を調製すること、
該試料液の凝固反応を計測すること、
を含み、
該測定ポートへのセルの供給、該セルへの該被検血液検体の分注、及び該被検血液検体を収容するセルへの試薬の分注は、該測定ポートがそれぞれのための所定の位置に到達したときに行われ、
かつ
該試料液の凝固反応の計測の終了は、該測定ポートがそのための所定の位置に到達したときに行われる、
〔1〕~〔4〕のいずれか1項記載の方法。
〔6〕前記反応テーブルの測定ポートが所定の位置Aに到達したときに、前記セルが該測定ポートに供給され、該測定ポートが所定の位置Bに到達したときに、該セルに被検血液検体が分注され、該測定ポートが所定の位置C又は位置Dに到達したときに、該セルに試薬が分注され、その後、該測定ポートが該所定の位置A又は所定の位置Eに到達したときに、該セルが該測定ポートから取り出される、〔5〕記載の方法。
〔7〕前記位置Aが、前記位置Eから前記反応テーブルの間欠的周回動作の1回分だけ周回方向にずれた位置にある、〔6〕記載の方法。
〔8〕前記測定ポートに供給されたセルが前記反応テーブル上で前記位置Eに到達したときに、該セル内の試料液の凝固反応が終了したと判定されていれば、該試料液の凝固反応の計測を終了し、次いで、該位置Eにおいて、又は該セルが前記位置Aに到達したときに、該セルを該測定ポートから取り出す、〔6〕又は〔7〕記載の方法。
〔9〕前記測定ポートに供給されたセルが前記反応テーブル上で前記位置Eに到達したときに、該セル内の試料液の凝固反応が終了したと判定されていない場合、該セルを該測定ポートから取り出すことなく反応テーブル上で周回させ、該セル内の試料液の凝固反応の計測を継続する、〔6〕~〔8〕のいずれか1項記載の方法。
〔10〕前記位置Bで前記測定ポートに供給されたセルに被検血液検体を分注した後、該測定ポートが初めて前記位置C又は位置Dに到達したときに、該セルに試薬が分注される、〔6〕~〔9〕のいずれか1項記載の方法。
〔11〕前記位置Bでセルに被検血液検体を分注した後、前記位置C又は位置Dで該セルに試薬を分注する前に、前記反応テーブルが1周以上周回し、その間に該被検血液検体の加温が継続される、〔6〕~〔9〕のいずれか1項記載の方法。
血液凝固分析装置により、被検血液検体を含む試料液の凝固反応を計測すること、
該試料液の凝固反応が終了したか否かを判定すること、
該凝固反応が終了したと判定された場合、該試料液の凝固反応の計測を終了すること、
を含む。
また分析モジュール100は、駆動機構の動作や測定ポート2による計測、又は計測データの分析を制御するための制御部12を備え得る。また分析モジュール100は、計測した凝固反応データを分析し、試料液の凝固反応が終了したか否かを判定したり、被検検体の凝固時間を算出するためのデータ処理部13を備え得る。あるいは、制御部12及びデータ処理部13は、分析モジュール100とは別途に設置されてもよい。
反応テーブル1の動作制御を簡略化するため、複数の測定ポート2は、反応テーブル1上に等間隔に設置されていることが好ましい。反応テーブル1は、駆動機構(非表示)によって一方向性に周回する。セル移送部3、検体分注部4、試薬分注部5~6の測定ポート2へのアクセス及び動作を考慮すると、反応テーブル1は間欠的に周回動作することが好ましい。反応テーブル1に設置される測定ポート2の数は、反応テーブル1の大きさや間欠的周回動作の周期、1周回に要する時間などに依存して適宜調整され得る。
測定ポート2は、セル内の試料液の凝固反応を計測するための検出部を備える。該検出部は、好ましくは、光学的に試料液の凝固反応を計測するための機構である。図2Bに示す実施形態において、該検出部は、セル内の試料液に対して光を照射する光源2bと、試料液に入射した光が90度側方に散乱されて生じた散乱光を測光するための測光部2cとを備える。あるいは、測光部2cでは、試料液からの透過光、又は試料液の吸光度が計測されてもよい。好ましい実施形態において、光源2bはLEDを備え、測光部2cはフォトダイオードを備える。
該検出部は、予め設定した時間間隔で試料液からの測光量を計測データとして順次取得する。データ取得の時間間隔は、好ましくはK/10秒(K=1~5の整数)、より好ましくは0.1秒である。
図2Aに示す分析モジュール100では、測定ポート2へのセルの供給と取り出しはいずれもセル移送部3によって行われる。別の実施形態では、1つのセル移送部3の代わりに、セル供給部3aとセル取り出し部3bがそれぞれ測定ポート2へのセルの供給と取り出しを担う。
図2Aにおいて、検体分注部4、第1試薬分注部5、第2試薬分注部6は、黒丸印で示した位置を中心に回転する回転アームであり、黒丸印の周囲に示した円形の破線は、アームの移動可能経路(軌跡)を示す。各々の回転アームの先端は分注プローブを備える。
第1試薬と第2試薬は、検査項目に応じて使い分けられる。例えばプロトロンビン時間(PT)の測定の場合は、第1試薬のみが使用され、活性化部分トロンボプラスチン時間(APTT)の測定の場合は、第1試薬と第2試薬が使用される。好ましくは、同じ検体の分析に使用される第1試薬と第2試薬は、横並びになるように、それぞれの試薬設置部に配置されている。この場合、分析に第1試薬のみ用いるときには、隣接する第2試薬設置部10の位置は空である。分析に使用される第1試薬と第2試薬は、それぞれ第1試薬設置部9と第2試薬設置部10の移動によって所定の位置(Pr)に運ばれ、第1試薬分注部5及び第2試薬分注部6に吸引される。
図2Aでは、円盤状の反応テーブル1の円周上に等間隔に40個の測定ポート2が配置されている。反応テーブル1の周りには、セル移送部3、検体分注部4、第1試薬分注部5及び第2試薬分注部6が配置され、これらはそれぞれ反応テーブル1に対して特定の一ヶ所でアクセスする。セル移送部3、検体分注部4、第1試薬分注部5、及び第2試薬分注部6の反応テーブル1へのアクセス位置を、それぞれ位置A、位置B、位置C及び位置Dと呼ぶ。位置A、位置B、位置C及び位置Dは、反応テーブル1の周回方向に沿って、この順序で設定される。すなわち、周回方向の上流から順に、位置A、位置B、位置C、位置Dがある。
すなわち、セル移送部3による、反応テーブル1上の測定ポート2へのセルの供給及び取り出しは、該測定ポート2が位置Aに到達したときに行われる。そこから反応テーブル1が回転し、セルを供給された測定ポート2が位置Bに到達すると、検体分注部4により該セルに被検検体が分注される。反応テーブル1がさらに回転し、該測定ポート2が位置Cに到達すると、第1試薬分注部5により該セルに第1試薬が分注される。反応テーブル1がさらに回転し、該測定ポート2が位置Dに到達すると、必要な場合、第2試薬分注部6により該セルに第2試薬が分注される。必要な試薬がセルに分注されると、凝固反応計測が開始される。被検検体の加温時間を長くする場合、位置Bでセルに被検検体が分注された後、位置Dにて該セルに第1試薬が分注され、次いで凝固反応計測が開始されてもよい。あるいは、被検検体の加温時間をさらに長くする場合、位置Bで被検検体を分注されたセルを、試薬を分注せずに位置C、Dを通過させることができる。この場合、該セルに被検検体を分注した後、該セルに試薬を分注する前に、反応テーブル1は1周、2周、又は3周以上周回し、その間に該被検検体の加温が継続される。該セルが2度目、3度目、又は4度目以降に位置C又は位置Dに到達したときに、該セルに第1試薬、及び必要に応じて第2試薬が分注され、次いで凝固反応計測が開始される。反応テーブル1は回転しながら、計測終了判定点(後述する位置E)に向かう。位置Eで計測を終了した場合、該測定ポート2のセルは、位置Aに戻ったときに、セル移送部3によって該測定ポート2から取り出される。位置Eは、反応テーブル1の周回方向において位置Dの下流に位置し、一方、位置Aに対しては反応テーブル1の周回方向の上流にある。好ましくは、位置Eから反応テーブル1の1サイクル分だけ周回方向にずれた位置が、位置Aである。すなわち、位置Aを反応テーブル1の周回方向の最上流とした場合、位置Eは最下流に配置される(図3を参照)。
一実施形態においては、測定ポート2へのセルの供給と取り出しはいずれも位置Aで行われる。別の実施形態においては、測定ポート2へのセルの供給と取り出しは反応テーブル1上の別の位置で行われる。例えば、位置Aでセルの供給を行い、位置Eで計測終了後にセルの取り出しを行ってもよい。
好ましい実施形態において、検体加温時間は40~60秒であり、試薬添加後の試料液の加温時間は160~180秒であり、凝固反応の計測時間は120~140秒である。したがって、これらを合計した320~380秒が、1検体の分析に必要な時間である。反応テーブル1の間欠的周回動作のインターバルをα(秒)、反応テーブル1上の測定ポート2の数をβとすると、反応テーブル1が1周する時間は、[α×β](秒)である。また反応テーブル1が円盤状であれば、1回の間欠的周回動作(1サイクル)での反応テーブル1の移動角度は、[360°÷β]である。所定の分析を行うために反応テーブル1の1周回に必要な時間、及び1サイクルに必要な時間を考慮して、適切なαとβの範囲を決定することができる。
好ましい実施形態において、α=8~20、β=16~47であり、ただし反応テーブル1が1周回する時間[α×β]は320~380秒である。
より好ましい実施形態において、α=8、β=40~47である。別のより好ましい実施形態において、α=9、β=36~42である。別のより好ましい実施形態において、α=10、β=32~38である。別のより好ましい実施形態において、α=12、β=27~31である。別のより好ましい実施形態において、α=15、β=22~25である。別のより好ましい実施形態において、α=18、β=18~21である。別のより好ましい実施形態において、α=20、β=16~19である。
一例として、図2Aの分析モジュール100でP01の被検検体のAPTTを測定する場合を説明する。位置Aでは、P01に新たなセルが供給される。P01に既にセルがあった場合は、そのセルを取り出す操作を先に行う。位置B~Dでは、P01に被検検体、第1試薬、及び第2試薬が分注される。位置Dでの第2試薬の分注後から凝固反応の計測が開始される。反応テーブル1が1周したとき、P01は位置Eにあり、このときP01の検体の凝固反応が終了していれば、凝固反応の計測が終了する。反応テーブル1が1周してP01が位置Eに到達したときに、P01の検体の凝固反応が終了していなければ、凝固反応の計測が続けられたまま、P01は再び位置Aに移動し、次の周回に入る。
Z(i)={R(i+1)+R(i+2)+...+R(i+m)}/{R(i-m)+R(i-m+1)+...+R(i-1)}
上式において、iは計測点番号を表し、mは、凝固反応の計測条件や分析項目等によって適宜設定することができ、例えばm=10~30である。Z(i)が閾値Zs未満となる最も早い計測点又は時点でのR(i)を、凝固反応終了点Reとして検出する。Zsは、分析項目に応じて適宜設定され得るが、1より大きく、かつ1.100以下であり、例えばAPTT測定の場合、好ましくは1.050以下であり、より好ましくは、Zsは1.010から1.001の範囲である。初期反応異常などによるReの誤検出を防ぐためには、Z(i)の算出は、iが所定の算出開始点に達した以降であってR(i)が所定値以上となってから行われることが好ましい。本手順においては、凝固反応を計測しながら、並行してR(i)を取得及びZ(i)を算出し、Reを検出する。
反応テーブル1が1周してP01が初めて位置Eに到達したときに、Reが検出されていなかった場合、P01の試料液の凝固反応の計測は継続される。P01のセルは測定ポート2から取り出されることなく、計測が続けられたままP01のセルは反応テーブル1上で2周目に入る。
反応テーブル1が2周してP01が2度目に位置Eに到達したときに、制御部12が反応終了の信号を受け取っていれば、P01の試料液の凝固反応の計測は終了し、P01のセルは、次のサイクルで位置Aにおいて測定ポート2から取り出される。反応テーブル1が2周してもReが検出されなかった場合、P01のセルは反応テーブル1上で3周目に入って計測され続けることができる。同様の手順で、セルを反応終了が検出されるまで反応テーブル1上に留めて周回させ、凝固反応の計測を継続することができる。
このように、測定ポート2に装着された試料液を収容するセルは、その凝固反応が終了するまで計測され得る。
S101:位置Aで測定ポート2にセルを供給(1サイクル目)。
S102:位置Bでセルに検体を分注(2サイクル目)。
S103:6サイクル目まで検体を加温。
S104:位置Cで第1試薬をセルに分注(7サイクル目)。
S105:第2試薬があればS106に、なければS108に進む。
S106:25サイクル目までの間、検体に第1試薬が添加された試料液
を加温。
S107:位置Dで第2試薬をセルに分注(26サイクル目)。
S108:<1試薬系(前ステップはS105)の場合>
S104での第1試薬のセル分注後から反応計測(測光)を
開始。
<2試薬系(前ステップはS107)の場合>
S107での第1試薬のセル分注後から反応計測(測光)を
開始。
S109:取得した計測データを基に凝固反応が終了したか否かを継続的
に監視し、反応終了の場合はS110へ移る。
反応未終了のままセルが位置Eに来た場合はS201へ移る。
S110:反応終了の場合、凝固時間を算出し、算出結果を出力する。
反応未終了の場合は、計測データの分析結果に応じた
内容(*)を出力する。
*:例)「反応なし」又は「反応途中」のフラグ、
「凝固時間が>X秒」など
S111:位置E(40×Nサイクル目、N≧1)で計測終了
S112:位置A(40×N+1サイクル目、N≧1)で測定ポート2
からセル取出、測定を終了。
S201:計測を継続し、セルは次の周回に入る
(40×N+1サイクル目)
S202:取得した計測データを基に凝固反応が終了したか否かを継続的
に監視し、反応終了の場合はS110へ移る。
反応未終了のままセルが位置Eに到達した場合はS203へ
移る。
S203:セルが次の周回に入るか否かを設定条件を基に判断し、
計測終了の場合はS110へ移る。
計測続行の場合はS201へ移る。
分析条件)
検体 :検体ラック7aのポジション1の検体
分析項目:PTとAPTT(以下、AP)の2項目(PTの測定値は凝固時間とする。)
試薬 :P01にPT試薬(1試薬系)、P02にAPTT試薬(2試薬系)
計測時間:PT、APとも反応テーブル1が1周する時間まで
分析工程)
(第1サイクル)
PT:位置Aにおいてセル移送部3が測定ポート2のP01のセル装着部2aに新しいセルを供給する。
(第2サイクル)
PT:位置BにおいてP01のセルに、検体ラック7に収納されている検体容器から吸引した検体50μLを分注する。分注された検体は測定ポート2上で加温される。
AP:位置Aにおいてセル移送部3が測定ポート2のP02のセル装着部2aに新しいセルを供給する。
(第3サイクル)
AP:位置BにおいてP02のセルに、検体ラック7に収納されている検体容器から吸引した検体50μLを分注する。分注された検体は測定ポート2上で加温される。
(第7サイクル)
PT:位置Cにおいて第1試薬分注部5が、第1試薬設置部9に設置された第1試薬容器から所定量だけ吸引したPT試薬を、P01のセルに100μL分注し、試料液を調製する。試薬の分注直後に計測データの取得(反応計測)を開始する。
(第8サイクル)
AP:位置Cにおいて第1試薬分注部5が、第1試薬設置部9に設置された第1試薬容器から所定量だけ吸引したAPTT試薬を、P02のセルに50μL分注する。分注された試薬は分注済みの検体とともに測定ポート2上で加温される。
(第27サイクル)
AP:位置Dにおいて第2試薬分注部6が、第2試薬設置部10に設置された第2試薬容器から所定量だけ吸引した塩化カルシウム液を、P02のセルに50μL分注し、試料液を調製する。試薬の分注直後に計測データの取得(反応計測)を開始する。
(第Mサイクル(7<M<40))
PT:取得した時系列計測データを基にPTの凝固反応進行状況をリアルタイムに分析し、Re(凝固反応終了点)を検出したときに凝固時間を算出し、算出した凝固時間をPT値として出力する。
(第Nサイクル(27<N<40))
AP:取得した時系列計測データを基にAPTTの凝固反応進行状況をリアルタイムに分析し、Reを検出したときに凝固時間を算出し、算出した凝固時間をAPTT値として出力する。
(第40サイクル)
PT:位置Eに到達したときに、凝固反応が終了したと判定されていたため(Re検出)、P01の反応計測を終了し、取得した計測データを保存する。
(第41サイクル)
PT:位置Aに到達したP01のセルを取り出して廃棄する。
AP:位置Eに到達したときに、凝固反応が終了したと判定されていたため(Re検出)、P02の反応計測を終了、取得した計測データを保存する。
(第42サイクル)
AP:位置Aに到達したP02のセルを取り出して廃棄する。
分析条件)
検体 :検体ラック7aのポジション2の検体
分析項目:APTTの1項目
試薬 :動作例1と同じ
計測時間:反応テーブル1が2周する時間まで
分析工程)
(第1サイクル)
位置Aにおいてセル移送部3が測定ポート2のP01のセル装着部2aに新しいセルを供給する。
(第2サイクル)
位置BにおいてP01のセルに、検体ラック7に収納されている検体容器から吸引した検体50μLを分注する。分注された検体は反応部で加温される。
(第7サイクル)
位置Cにおいて第1試薬分注部5が、第1試薬設置部9に設置された第1試薬容器から所定量だけ吸引したAPTT試薬を、P01のセルに50μL分注する。分注された試薬は分注済みの検体とともに測定ポート2上で加温される。
(第26サイクル)
位置Dにおいて第2試薬分注部6が、第2試薬設置部10に設置された第2試薬容器から所定量だけ吸引した塩化カルシウム液を、反応部P01のセルに50μL分注し、試料液を調製する。試薬の分注直後に計測データの取得(反応計測)を開始する。
(第27から第79サイクルまで)
反応計測を継続。P01のセルから計測データを取得しながら反応テーブル1が間欠的に周回動作する。
取得した時系列計測データを基にAPTTの凝固反応進行状況をリアルタイムに分析し、Reを検出したときに凝固時間を算出し、算出した凝固時間をAPTT値として出力する。
(第40サイクル)
位置Eに到達したときに、凝固反応が終了したと判定されていなかったため(Re未検出)、反応計測を継続。
(第80サイクル)
位置Eに到達したときに、凝固反応が終了したと判定されていたため(Re検出)、P01の反応計測を終了、取得した計測データを保存する。
(第81サイクル)
位置Aに到達したP01のセルを取り出して廃棄する。
クロスミキシング試験は、測定用試料の加温時間の違いで即時反応と遅延反応がある。通常、クロスミキシング試験の遅延反応での測定用試料の加温時間は2時間である。本動作例は、加温時間を約13分に短縮したクロスミキシング試験遅延反応の迅速法について説明する。
検体 :検体ラック7aのポジション3の検体
分析項目:APTT(クロスミキシング試験の遅延反応の迅速法)
試薬 :希釈液ラックのポジション2に正常血漿容器を収納する以外は動作例1と同じ試料 :検体と正常血漿の混合比が1:0(試料S)、1:1(試料M)、0:1(試料L)の3条件(各n=1)。
試料の加温時間:即時反応は通常のAPTT測定と同じ45秒(図7参照)、遅延反応は765秒(図8参照)。
計測時間:反応テーブル1が3周する時間まで
分析工程)
(第1サイクル)
S:位置Aにおいてセル移送部3が測定ポート2のP01のセル装着部2aに新しいセルを供給する。
(第2サイクル)
S:位置BにおいてP01のセルに、検体ラック7のポジション3の容器から吸引した検体50μLを分注する。分注された検体を測定ポート2上で加温する。
M:位置Aにおいてセル移送部3が測定ポート2のP02のセル装着部2aに新しいセルを供給する。
(第3サイクル)
M:検体分注部4を用いて、先ず希釈液ラック8のポジション2に収納されている容器から正常血漿を吸引し、次に検体ラック7のポジション3の容器から検体を吸引する。位置Bにおいて、分注部4のプローブ内の正常血漿25μLと検体25μLを合わせた50μLをP02のセルに分注する。分注された検体と正常血漿(混合試料)を測定ポート2上で加温する。
L:位置Aにおいてセル移送部3が測定ポート2のP03のセル装着部2aに新しいセルを供給する。
(第4サイクル)
L:位置BにおいてP03のセルに、希釈液ラック8のポジション2の容器から吸引した正常血漿50μLを分注する。分注された正常血漿を測定ポート2上で加温する。
(第5から第86サイクルまで)
SML共通:P01、P02及びP03の各セル中の試料の加温を続ける。
(第87サイクル)
S:反応テーブル1の第3周目の位置Cにおいて、第1試薬分注部5が、第1試薬設置部9に設置された第1試薬容器から所定量だけ吸引したAPTT試薬を、P01のセルに50μL分注する。当該試薬分注後、P01のセル中の試料(分注された試薬と加温処理済み検体)の加温を続ける。
(第88サイクル)
M:第87サイクルと同様に位置CにおいてP02のセルにAPTT試薬を50μL分注する。当該試薬分注後、P02のセル中の試料(分注された試薬と加温処理済み混合試料)の加温を続ける。
(第89サイクル)
L:第87サイクルと同様に位置CにおいてP03のセルにAPTT試薬を50μL分注する。当該試薬分注後、P03のセル中の試料(分注された試薬と加温処理済み正常血漿)の加温を続ける。
(第106サイクル)
S:反応テーブル1の第3周目の位置Dにおいて、第2試薬分注部6が、第2試薬設置部10に設置された第2試薬容器から所定量だけ吸引した塩化カルシウム液を、P01のセルに50μL分注し、試料液を調製する。試薬分注直後に計測データの取得(反応計測)を開始する。
(第107サイクル)
M:第106サイクルと同様に位置Dにおいて、P02のセルに塩化カルシウム液を50μL分注し、試料液を調製する。試薬分注直後から反応計測を開始する。
(第108サイクル)
L:第106サイクルと同様に位置Dにおいて、P03のセルに塩化カルシウム液を50μL分注し、試料液を調製する。試薬分注直後から反応計測を開始する。
(第Nサイクル:第2試薬(塩化カルシウム液)を分注したサイクル数<N<セル取り出しサイクル数)
SML共通:P01、P02及びP03とも取得した時系列計測データを基に凝固反応進行状況をリアルタイムに分析し、Reを検出したときに凝固時間(APTT)を算出するとともに算出結果を出力する。
(第120サイクル)
S:P01は、反応テーブル1の第3周目の位置Eに到達したときに既に凝固反応が終了したと判定されていたため(Re検出)、反応計測を終了し、取得した計測データを保存する。
(第121サイクル)
S:反応テーブル1の第4周目の位置Aに到達したP01のセルを取り出して廃棄する。M:P02は、反応テーブル1の第3周目の位置Eに到達したときに既に凝固反応が終了したと判定されていたため(Re検出)、反応計測を終了し、取得した計測データを保存する。
(第122サイクル)
M:反応テーブル1の第4周目の位置Aに到達したP02のセルを取り出して廃棄する。L:P03は、反応テーブル第3周目の位置Eに到達したときに既に凝固反応が終了したと判定されていたため(Re検出)、反応計測を終了し、取得した計測データを保存する。
(第123サイクル)
L:反応テーブル1の第4周目の位置Aに到達したP03のセルを取り出して廃棄する。
分析条件)
検体 :検体ラック7aのポジション3の検体
分析項目:APTT(クロスミキシング試験の遅延反応の迅速法)
試薬 :希釈液ラックのポジション2に正常血漿容器を収納する以外は動作例1と同じ試料 :動作例3と同じ
試料の加温時間:動作例3と同じ
計測時間:反応テーブル1が4周する時間まで(ただし試料MとLは反応テーブル1が3周したときに計測終了)
分析工程)
(第1から第119サイクルまで)
動作例3と同じ
(第Nサイクル:第2試薬(塩化カルシウム液)を分注したサイクル数<N<セル取り出しサイクル数)
SML共通:P01、P02、P03とも取得した時系列計測データを基に凝固反応進行状況をリアルタイムに分析し、Reを検出したときに凝固時間(APTT)を算出するとともに算出結果を出力する。
(第120サイクル)
S:P01は、反応テーブル1の第3周目の位置Eに到達したときに凝固反応が終了したと判定されていなかったため(Re未検出)、反応計測を継続する。
(第121サイクル)
M:P02は、反応テーブル1の第3周目の位置Eに到達したときに既に凝固反応が終了したと判定されていたため(Re検出)、反応計測を終了し、取得した計測データを保存する。
(第122サイクル)
M:反応テーブル1の第4周目の位置Aに到達したP02のセルを取り出して廃棄する。L:P03は、反応テーブル1の第3周目の位置Eに到達したときに既に凝固反応が終了したと判定されていたため(Re検出)、反応計測を終了し、取得した計測データを保存する。
(第123サイクル)
L:反応テーブル1の第4周目の位置Aに到達したP03のセルを取り出して廃棄する。
(第160サイクル)
S:P01が、反応テーブル1の第4周目の位置Eに到達したときに既に凝固反応が終了したと判定されていたため(Re検出)、反応計測を終了し、取得した計測データを保存する。
(第161サイクル)
S:反応テーブル1の第5周目の位置Aに到達したP01のセルを取り出して廃棄する。
・凝固反応の計測では、セルにLEDを光源とする波長660nmの光を照射し、0.1秒間隔で90度側方散乱光の散乱光量を測光した。
・凝固反応終了点Reとして、国際公開番号第2021/132552号に記載の方法に従って、時点iでの積算比Z(i)が閾値Zs(1.010)未満となる最も早い時点を検出した。積算比Z(i)は、微小時間帯での凝固反応(散乱光量)R(i)の積算値の比であり、以下のとおり算出した:
積算比Z(i)=Rb(i)/Ra(i)
Ra(i)=R(i-20)からR(i-1)までの和
Rb(i)=R(i+1)からR(i+20)までの和
R(i)=時点iでの計測データ(散乱光量)
・凝固反応RがReの50%以上に到達した最も早い時点をAPTTとして決定した。
・反応テーブル1の1周目における反応計測時間(セルが位置Dから位置Eに到達するまでの時間)は126秒であった。セルが反応テーブル1上で2周した場合、反応計測時間は486秒であった。
図9Aは、正常検体の凝固反応曲線であり、反応テーブル1が1周する間にReが検出され、計測終了した。APTTは32.2秒であった。図9Bは、異常検体1の凝固反応曲線である。APTTは94.5秒に延長していたが、反応テーブル1が1周する間にReが検出され、計測終了した。図9Cは、異常検体2の凝固反応曲線である。反応テーブル1が1周するまでReが検出されず、2周目で計測終了した。APTTは108.8秒で延長あった。
2 測定ポート
3 セル移送部
4 検体分注部
5 第1試薬分注部
6 第2試薬分注部
100 分析モジュール
Claims (11)
- 血液凝固反応の分析方法であって、
血液凝固分析装置により、被検血液検体を含む試料液の凝固反応を計測すること、
該試料液の凝固反応が終了したか否かを判定すること、
該凝固反応が終了したと判定された場合、該試料液の凝固反応の計測を終了すること、
を含み、
該血液凝固分析装置は、一方向性に周回する反応テーブルを備え、
該反応テーブルは、セルを装着可能な測定ポートを備え、
該測定ポートに供給されたセル内の該試料液の凝固反応が計測され、
計測した該凝固反応の時系列データが蓄積され、
蓄積された該凝固反応の時系列データから、該凝固反応が終了したか否かが判定され、
該凝固反応が終了したと判定された場合、該試料液の凝固反応の計測を終了し、該試料液を収容するセルを該測定ポートから取り出す、
方法。 - 前記反応テーブルが円盤状である、請求項1記載の方法。
- 前記反応テーブルが間欠的に周回動作し、かつ1周回する時間が320~380秒である、請求項1記載の方法。
- 前記間欠的周回動作のインターバルがα秒、前記反応テーブル上の測定ポートの数がβ個であり、ここでα=8~20、β=16~47であり、ただし[α×β]=320~380秒であり、
1回の前記間欠的周回動作における前記反応テーブルの移動角度が[360°÷β]である、請求項3記載の方法。 - 前記被検血液検体を含む試料液の凝固反応の計測が、
前記反応テーブルの測定ポートにセルを供給すること、
該セルに被検血液検体を分注し、加温すること、
該被検血液検体を収容するセルに試薬を分注し、試料液を調製すること、
該試料液の凝固反応を計測すること、
を含み、
該測定ポートへのセルの供給、該セルへの該被検血液検体の分注、及び該被検血液検体を収容するセルへの試薬の分注は、該測定ポートがそれぞれのための所定の位置に到達したときに行われ、
かつ
該試料液の凝固反応の計測の終了は、該測定ポートがそのための所定の位置に到達したときに行われる、
請求項1~4のいずれか1項記載の方法。 - 前記反応テーブルの測定ポートが所定の位置Aに到達したときに、前記セルが該測定ポートに供給され、該測定ポートが所定の位置Bに到達したときに、該セルに被検血液検体が分注され、該測定ポートが所定の位置C又は位置Dに到達したときに、該セルに試薬が分注され、その後、該測定ポートが該所定の位置A又は所定の位置Eに到達したときに、該セルが該測定ポートから取り出される、請求項5記載の方法。
- 前記位置Aが、前記位置Eから前記反応テーブルの間欠的周回動作の1回分だけ周回方向にずれた位置にある、請求項6記載の方法。
- 前記測定ポートに供給されたセルが前記反応テーブル上で前記位置Eに到達したときに、該セル内の試料液の凝固反応が終了したと判定されていれば、該試料液の凝固反応の計測を終了し、次いで、該位置Eにおいて、又は該セルが前記位置Aに到達したときに、該セルを該測定ポートから取り出す、請求項6記載の方法。
- 前記測定ポートに供給されたセルが前記反応テーブル上で前記位置Eに到達したときに、該セル内の試料液の凝固反応が終了したと判定されていない場合、該セルを該測定ポートから取り出すことなく反応テーブル上で周回させ、該セル内の試料液の凝固反応の計測を継続する、請求項6記載の方法。
- 前記位置Bで前記測定ポートに供給されたセルに被検血液検体を分注した後、該測定ポートが初めて前記位置C又は位置Dに到達したときに、該セルに試薬が分注される、請求項6記載の方法。
- 前記位置Bでセルに被検血液検体を分注した後、前記位置C又は位置Dで該セルに試薬を分注する前に、前記反応テーブルが1周以上周回し、その間に該被検血液検体の加温が継続される、請求項6記載の方法。
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CN202280069079.6A CN118103714A (zh) | 2021-10-15 | 2022-09-30 | 凝血反应的分析方法 |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP2021169648 | 2021-10-15 | ||
JP2021-169648 | 2021-10-15 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2023063125A1 true WO2023063125A1 (ja) | 2023-04-20 |
Family
ID=85988558
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/JP2022/036831 WO2023063125A1 (ja) | 2021-10-15 | 2022-09-30 | 血液凝固反応の分析方法 |
Country Status (2)
Country | Link |
---|---|
CN (1) | CN118103714A (ja) |
WO (1) | WO2023063125A1 (ja) |
Citations (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JPH06109742A (ja) | 1992-09-30 | 1994-04-22 | Shimadzu Corp | 血液凝固分析装置 |
JPH06109743A (ja) | 1992-09-30 | 1994-04-22 | Shimadzu Corp | 血液凝固分析装置 |
JPH08101199A (ja) * | 1994-09-30 | 1996-04-16 | Shimadzu Corp | 血液凝固分析装置 |
JP2000321286A (ja) | 1999-05-10 | 2000-11-24 | Shimadzu Corp | 血液凝固分析装置 |
WO2015098473A1 (ja) * | 2013-12-25 | 2015-07-02 | 株式会社日立ハイテクノロジーズ | 自動分析装置及び分析方法 |
WO2020075803A1 (ja) * | 2018-10-10 | 2020-04-16 | 株式会社Lsiメディエンス | 分析装置 |
JP2020068877A (ja) | 2018-10-29 | 2020-05-07 | 億▲キン▼醫學科技企業有限公司 | 医療用エアークッションベッドのスマート制御システム |
WO2021132552A1 (ja) | 2019-12-26 | 2021-07-01 | 積水メディカル株式会社 | 血液凝固時間測定方法 |
-
2022
- 2022-09-30 CN CN202280069079.6A patent/CN118103714A/zh active Pending
- 2022-09-30 WO PCT/JP2022/036831 patent/WO2023063125A1/ja active Application Filing
Patent Citations (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JPH06109742A (ja) | 1992-09-30 | 1994-04-22 | Shimadzu Corp | 血液凝固分析装置 |
JPH06109743A (ja) | 1992-09-30 | 1994-04-22 | Shimadzu Corp | 血液凝固分析装置 |
JPH08101199A (ja) * | 1994-09-30 | 1996-04-16 | Shimadzu Corp | 血液凝固分析装置 |
JP2000321286A (ja) | 1999-05-10 | 2000-11-24 | Shimadzu Corp | 血液凝固分析装置 |
WO2015098473A1 (ja) * | 2013-12-25 | 2015-07-02 | 株式会社日立ハイテクノロジーズ | 自動分析装置及び分析方法 |
WO2020075803A1 (ja) * | 2018-10-10 | 2020-04-16 | 株式会社Lsiメディエンス | 分析装置 |
JP2020068877A (ja) | 2018-10-29 | 2020-05-07 | 億▲キン▼醫學科技企業有限公司 | 医療用エアークッションベッドのスマート制御システム |
WO2021132552A1 (ja) | 2019-12-26 | 2021-07-01 | 積水メディカル株式会社 | 血液凝固時間測定方法 |
Also Published As
Publication number | Publication date |
---|---|
CN118103714A (zh) | 2024-05-28 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
JP7193564B2 (ja) | 自動分析装置及び自動分析方法 | |
US11209448B2 (en) | Automatic analyzer | |
US7341691B2 (en) | Automatic analyzing apparatus | |
US5846491A (en) | Device for automatic chemical analysis | |
JP3889877B2 (ja) | 自動分析装置およびその支援システム | |
EP3086123B1 (en) | Automatic analysis device | |
US4634576A (en) | Automatic analyzing apparatus | |
JP3063584B2 (ja) | 自動分析装置 | |
JP3901587B2 (ja) | 自動分析装置および自動分析装置におけるデータ管理方法 | |
US20190041386A1 (en) | Automated analysis device | |
JP6689597B2 (ja) | 血液凝固分析装置 | |
JPH06109742A (ja) | 血液凝固分析装置 | |
JP6698665B2 (ja) | 自動分析装置 | |
JP5236612B2 (ja) | 自動分析装置 | |
JP5063623B2 (ja) | 分析装置、及び円盤ディスクの回転制御方法 | |
WO2007139212A1 (ja) | 自動分析装置 | |
JP2004271265A (ja) | 自動分析装置 | |
JP3990943B2 (ja) | 自動分析システム | |
JP2011013127A (ja) | 自動分析装置及び自動分析装置の制御方法 | |
WO2023063125A1 (ja) | 血液凝固反応の分析方法 | |
JPS6188158A (ja) | 自動分析装置 | |
JP7142155B2 (ja) | 自動分析装置 | |
JP4408404B2 (ja) | 自動分析装置 | |
JPH06109743A (ja) | 血液凝固分析装置 | |
JPS61262639A (ja) | 自動分析装置 |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
121 | Ep: the epo has been informed by wipo that ep was designated in this application |
Ref document number: 22880821 Country of ref document: EP Kind code of ref document: A1 |
|
WWE | Wipo information: entry into national phase |
Ref document number: 2023554402 Country of ref document: JP |
|
WWE | Wipo information: entry into national phase |
Ref document number: 2022880821 Country of ref document: EP |
|
NENP | Non-entry into the national phase |
Ref country code: DE |
|
ENP | Entry into the national phase |
Ref document number: 2022880821 Country of ref document: EP Effective date: 20240515 |