课件：血液标本的正确采集.ppt

9.进食咖啡因 血糖、脂肪酸、肾素、儿茶酚胺增高 10.吸烟 Fig4-1:吸烟(慢性作用)与不吸烟者 血液分析 物浓度的差异(%) Fig4-2:吸烟对不同血液分析物的影响 硫氰化物浓度 11.饮酒 Fig4-3: 饮酒对临床化学分析物的 急性和毒性影响 THANK YOU SUCCESS * * 可编辑 12.成瘾药物 Table 4-1 Biological effects of addictive drugs on plasma concentrations of selected analytes(206) Addictive Drug Increased /Decreased in plasma 1.Amphetamine Increased:free fatty acids. 3.Heroin Increased :Pco2,T,4cholesterol,potassium due to secere rhabdomyolysis. Decreased:Po2,albumin. 2.Morphine Increased :α-amylase,lipase,AST,ALT,bilirubin,alkalinephosphatase,gastrin,TSH,and prolatin Decreased:insulin,norepinephrine,neurotensin,pancreatic pilypeptide. 4.Cannabis Increased :sodium,potassium,urea,insulin,chloride. Decreased:creatinine,glucose,uric acid 13.生物钟 Fig5-2: 血浆皮质醇的日变化(线下为睡眠状态） Fig5-1:线性的和周期的生物钟影响 季节性 生理性 昼夜性 Table 5-1 Diurnal variation of selected analytes(S=serum;U=urine analytes Maximum (time of day) Minimum (time of day) Amplitude(percentage od daily mean) analytes Maximum (time of day) Minimum (time of day) Amplitude(percentage od daily mean) ACTH 6-10 0-4 150-200 Norepinephrine 9-12 2-5 50-120 Cortisol 5-8 21-3 180-200 Hemoglobin 6-18 22-24 8-15 Testosterone 2-4 20-24 30-50 Eosinophils 4-6 18-20 30-40 TSH 20-2 7-13 5-15 Iron(S) 14-18 2-4 50-70 T4 8-12 23-3 10-20 Potassium(S) 14-16 23-1 5-10 Somatotropin 21-23* 1-21 300-400 Phosphate(s) 2-4 8-12 30-40 Prolactin 5-7 10-12 80-100 Sodium(U) 4-6 12-16 60-80 Aldosterone 2-4 12-14 60-80 Phosphate(U) 18-24 4-8 60-80 Renin 0-6 10-12 120-140 Volume(U) 2-6 12-16 60-80 Epinephrine(S) 9-12 2-5 30-50 Body temp. 18-20 5-7 0.8-1.0℃ 五、血液标本正确的采集方法 （建议） 食后12h取血 上午7-9点采血 治疗措施实施前采血（药代研究例外） 体内药物浓度测定要采达峰时间和稳态相的血标本 要记录采血时间，时间不对不如不采血（结果不能及时报告是一种浪费） 6.不要在输液侧采血 Table 6-2 Recommendations for scheduling infusions and blood sampling infusion Earliest time of blood sampling in hours after cessation of infusion Fat emulsion Carbohydrate-rich solutions Amino acids and protein hydrolysates Electrolytes