ABSTRACT
El estudio de gases en sangre involucra pruebas relacionadas con el equilibrio ácido-base y estado de oxigenación (pH, pO2, SO2, pCO2, HCO3 -). Además, en los equipos multiparamétricos se realizan otras determinaciones (mediciones relacionadas) como: Na+, K+, Cl-, Ca2+, glucosa y lactato. El objetivo de este trabajo fue comparar los resultados de medición de dos tipos de recipientes (tipo 2: jeringa preparada en el laboratorio con heparinato de Na+ líquido diluido y tipo 3: microtubo con heparinato de Li líquido) contra el recipiente recomendado por el CLSI en su guía 46-A2 (tipo 1: jeringa con heparinato de Li liofilizado balanceado con zinc). El análisis se hizo desde un punto de vista estadístico y clínico para establecer la posibilidad de usar indistintamente estos tres tipos de recipientes. Se analizaron un total de 254 muestras. Para evaluar la aceptación clínica de los resultados se tomó como estándar de calidad la variabilidad biológica. No se encontraron diferencias clínicamente significativas en los analitos del recipiente tipo 2 respecto del tipo 1, excepto para Ca2+. Se rechazaron desde el punto de vista clínico varios analitos del recipiente tipo 3. En conclusión, el uso del recipiente tipo 3 fue inapropiado. Sin embargo, el recipiente tipo 2 sería apto para el análisis de este tipo de muestras.
Blood gas analysis involves tests related to the acid-base balance and oxygenation state (pH, pO2, SO2, pCO2, HCO3 -). In multiparametric equipment, some ion and metabolite (related measurements) are performed: Na+, K+, Cl-, Ca²+, glucose and lactate. The objective of this study was to compare two types of containers (type 2: syringe prepared in the laboratory with diluted liquid sodium heparinate and type 3: microtube with liquid lithium heparinate) against the container recommended by CLSI in its guide 46-A2 (type 1: syringe with lyophilized lithium heparinate balanced with inc). The analysis was made from a statistical and clinical point of view to establish the possibility of indiscriminately using these three types of containers. A total of 254 samples were analyzed. To establish the clinical acceptance of the results, the biological variability quality standard was used. No clinically significant differences were found in the analytes of the type 2 container compared to type 1, except for Ca+. Several analytes of the type 3 container were rejected from the clinical point of view. In conclusion, the use of the type 3 container is inappropriate; however, the type 2 container would be suitable for the analysis of this type of samples.
O estudo de gases em sangue envolve testes relacionados com o equilíbrio ácido-base e estado de oxigenação (pH, pO2, SO2, pCO2, HCO3 -). Além disso, nos equipamentos multiparâmetros, outras determinações (medições relacionadas) como: Na+ , K+, Cl-, Ca2+, glicose e lactato são realizadas. O objetivo deste trabalho foi comparar os resultados de medição de dois tipos de recipientes (tipo 2: seringa preparada no laboratório com heparinato de Na+ líquido diluído e tipo 3: microtubo com heparinato de Li líquido) contra o recipiente recomendado pelo CLSI em seu guia 46-A2 (tipo 1: seringa com heparinato de Li liofilizado equilibrado com zinco). A análise foi feita do ponto de vista estatístico e clínico, para estabelecer a possibilidade de utilização indiscriminada desses três tipos de recipientes. Um total de 254 amostras foram analisadas. Para avaliar a aceitação clínica dos resultados, a variabilidade biológica foi tomada como padrão de qualidade. Não foram encontradas diferenças clinicamente significativas nos analitos do recipiente tipo 2 em relação ao tipo 1, exceto para Ca²+. Vários analitos do recipiente tipo 3 foram rejeitados do ponto de vista clínico. Em conclusão, o uso do contêiner tipo 3 foi inadequado. No entanto, o recipiente tipo 2 seria apto para a análise deste tipo de amostras.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Syringes , Acid-Base Equilibrium , Blood Gas Analysis , Hydrogen-Ion Concentration , Sodium , Zinc , Blood , Lactic Acid , State , Equipment and Supplies , Gases , Glucose , LaboratoriesABSTRACT
Aims: Endothelin-1 (ET-1) is a potent vasoconstrictive peptide, and its activity is mediated by the type A receptor (EDNRA). This action may play a significant role in the etiology of hypertension. There are different works that shows an association between certain polymorphisms of endothelin axis and clinical phenotype of hypertension. We describe the genetic variability +138/ex1 insertion/deletion (I/D) adenosine (A) in the ET-1 gene and polymorphism thymidine/cytosine (T/C) His323His in the EDNRA gene associated at the clinical variability in hypertensive patients. Study Design: Observational, transversal and analytical study. Place and Duration of Study: Hypertension Service at the Internal Medicine Department of Córdoba Hospital, and Biochemical and Molecular Biology Department in School of Medicine, National University of Cordoba, Argentine. Patients considered hypertensive between April 2009 and April 2010. Methodology: Were assessed 136 patients serum lipid profiles, renal and hepatic functions and were taken Thoracic X-rays, electrocardiograms, and echocardiographs. DNA extracted from circulating leukocyte were used to analyze the polymorphisms of genes by PCR-RFLP. Results: For the polymorphisms of Receptor A from Endothelin -1 studied the presence of cytosine homozygous genotype was less frequent in males (P = .02). For both genders, the same genotype was associated to low plasma alkaline phosphatase activity and cholesterol levels. The presence of thymidine nucleotide allele correlated with plasma alkaline phosphatase activity and cholesterol levels. The Thymidine allele correlated with the degree of cardiovascular compromise (r = 0.54, P= .002). For the genetic variant in the ET-1 gene, the homozygous adenine deletion was associated to normal plasma levels of glutamate/pyruvate transaminase enzyme activity, uric acid concentration, cholesterol, and Low Density Lipoprotein in hypertensive subjects without clinical risk. Conclusion: We observed a gender-specific protective effect for EDNRA gene variations, the subjects that carried the TT genotype presented more aggressive symptomatology. These results show an association between plasmatic biochemical parameters, the clinical condition, and polymorphisms in the endothelin axis genes.