直接離子選擇性電極及間接離子選擇性電極測量人體血清電解質鈉、鉀及氯離子比較之探討

1. 直接離子選擇性電極及間接離子選擇性電極測量人體血清電解質鈉、鉀及氯離子比較之探討直接離子選擇性電極及間接離子選擇性電極測量人體血清電解質鈉、鉀及氯離子比較之探討 • 臨床檢驗化學中有ㄧ類分析物無法藉由比色呈色法測得準確的數據，如我們人體中的電解質：鈉、鉀及氯離子的濃度，需藉助其他的分析儀，如火焰比色計（Flame Photometry）、原子吸收分光光度計（Atomic absorption spectrophotometry）及離子選擇性電極（Ion selective electrodes）；離子選擇性電極為一種電化學半反應電池，用來量測溶液中特定離子的濃度，其電極電位隨待測溶液內離子的濃度而變化。由於電解質檢驗儀裝置簡便、量測方法簡單以及高準確性和精密度，近年來已經成為具有實用價值的離子濃度偵測器。國內許多醫院均選擇間接離子選擇性電極（Indirect Ion-Selective Electrode；Indirect ISE），應用於臨床檢驗化學電解質檢驗，用來分析鈉、鉀及氯離子的濃度。?明瞭人體血清檢體使用直接離子選擇性電極（Direct Ion-Selective Electrode；Direct ISE）及間接離子選擇性電極測量鈉、鉀及氯離子，是否具有差異性，且直接選擇性電極是否為較佳之電解質測量方法，及使用間接離子選擇性電極測量電解質時所生之偏差，有否解決方案等問題，遂進行本實驗。 • 本研究係以北部某區域教學醫院之洗腎及門診病人主要探討的對象，於文獻查證研究設計完成後，實施資料收集及測量，經隨機取樣後，共收集233人血清檢體，使用Roche Integra生化分析儀之直接離子選擇性電極及間接離子選擇性電極測量人體血清電解質鈉、鉀及氯離子，測得之分析數據經資料處理、除錯後進行多變量分析，予以統計分析與討論歸納出以下的結果： • ㄧ、正常血清及血脂異常血清檢體使用直接及間接離子選擇性電極測量鈉、鉀及氯離子，有顯著差異，且使用間接離子選擇性電極之測量值偏低。 • 二、高密度脂蛋白及低密度脂蛋白等2項變數之濃度對於直接及間接離子選擇性電極測量鈉、鉀及氯離子之差異，無明顯相關。總膽固醇及三酸甘油脂等2項變數之濃度對於直接及間接離子選擇性電極測量鈉、鉀及氯離子之差異，有明顯相關。 • 三、使用有機試劑 Ethyl Acetate去除血清中之脂質，可修正直接及間接離子選擇性電極測量鈉、鉀及氯離子之差異。 • 四、使用超高速離心設備去除血清中之脂質，可修正直接及間接離子選擇性電極測量鈉、鉀及氯離子之差異。 • 本研究結果顯示，所建立之預測模式具有臨床檢驗參考價值。惟檢體來源及實驗分析測試只使用單一廠牌生化分析儀，恐有代表性不足之爭議，有待未來其他研究者之調查研究，以建立更廣泛之預測模式，提供臨床生化檢驗領域之參考。

2. Direct Ion-Selective Electrode （ISE） Determination of Sodium, Potassium and Chloride in Serum Samples Compared withvIndirect Ion-Selective Electrode Determination • There are substances common as well as electrolyte can not detect by colorimetry method. Determination of Sodium, Potassium and Chloride can process by Flame Photometry、Atomic absorption spectrophotometry and Ion-Selective Electrode. Ion selective electrode is one kind of electrochemical half-reaction cell, its electrode potential varies with the ion concentration in the testing solution. It is used to measure the concentration of one specific ion in the solution. The electrolyte analyzer has been used as a practical ion concentration detect sensor because of its simplicity of device constructing, simple operation, high accuracy and precision. The ion selective electrodes are used in the clinical chemistry electrolyte analyzer to test the concentrations of sodium and potassium ion in the serum sample in Taiwan commonly. There are many hospitals applied Indirect Ion-Selective Electrode（Indirect ISE）clinical chemistry analyzer. Are there significant differences between Indirect ISE and Direct Ion-Selective Electrode（Direct ISE）？ Are the Direct ISE more accuracy routine clinical chemistry analysis method？ Are there some methods to eliminate the common interferences as well as lipid in routine serum sample？ • We investigate the determination of sodium and potassium ion and focus on differences between Indirect ISE and Direct ISE in this thesis. We collect two hundred and thirty-three serum samples. Each sample splits into two aliquots. One aliquot process Indirect ISE electrolyte analysis and the other test by Direct ISE in Roche Integra and Hitachi clinical chemistry instrument. We get some results from this study： • 1.There are significant differences between Indirect ISE and Direct ISE to analyze electrolyte. If the electrolytes are measured by Indirect ISE analyzer, there is a predictable decrease data results. • 2.HDL-C and LDL-C two valuables have no significant correlations with differences between Indirect ISE and Direct ISE electrolyte analyzer. TG and T-cho two valuables have significant correlations with differences between Indirect ISE and Direct ISE electrolyte analyzer. • 3.We apply organic reagent（Ethyl Acetate） to eliminate serum lipid and correct bias which from Indirect ISE analysis. • 4.We apply ultracentrifuge method to eliminate serum lipid and correcte bias from Indirect ISE analyzer. • The results of this research shows the valuable mode in practical clinical chemistry field. Because this research is only small scope initial study about ISE, samples are minor and only apply one kind of clinical chemistry analyzer. We can not get a better precise score. As a consequence and extinguish predicting model is set up for clinical chemistry analysis field increasing personal health and clinical diagnosis abilities.