Practicability Studies on Continuous Monitoring of BloodConstituents

疾病的诊断在很大程度上依赖于临床实验室的数据，特别是血液生化成分水平变化的数据。获取这些数据的传统方法是在一定的时间间隔内从患者身上采集血液样本，然后一起进行评估：这被称为“不连续”方法。为了获得与患者的变化状态更密切相关的病理变化，对这些血液成分的“连续”监测必须是更好的选择方法。我们组织了一组合作研究，探讨将生化分析方法应用于此类持续监测的可行性。在1985-1987年的三年任期内，我们每个人都扩展了自己的研究，涉及临床分析，分析方法，数据处理等，并且每年召开两次小组会议，就共同关心的问题进行讨论。以下是获得的主要结果。(1)研究了一种可用于连续监测的生物反应器分析系统。建立了一种测定氨和尿素的独特的荧光光度法。(2)几种生物传感器系统，例如β-羟基丁酸的生物传感器、光学生物传感器等，已经被开发出来了。(3)1988年2月5日在东京举行的“诊断信息的构建：硬件和软件”联席会议上讨论了床边使用或外科手术期间使用连续监测的可行性。

Diagnosis of diseases is heavily dependent on the data from clinical laboratories, particularly those on the changes in the levels of biochemical constituents of the blood. The traditional way of access of these data is to collect blood samples from a patient at certain time intervals and to evaluate them together afterwards: this is to be called "discontinuous" method. In order to access the pathological changes more closely bound to the changing states of a patient, "continuous" monitoring of these blood constituents must be the method of better choice. We organized a group of co-operative studies for exploring the feasibility of applying biochemical analysis methods to such continuous monitoring. During the three-year term, 1985-1987, each one of us extended their own research related to clinical analysis, analytic method, data processing, etc., and in addition we have had group meetings twice every year and discussed on the mutually common problems. The followings are the major results obtained.(1) A bioreactor system for analysis which can be utilized for the continuous monitoring has been investigated. A unique chemiluminometric method for the determination of ammonia and urea has thus been developed. (2) Several biosensor systems such as a biosensor for beta-hydroxybutyrate, optical biosenor, etc., have been developed. (3) The practicability of continuous monitoring for the bed-side use or for the use during surgical operation has been discussed in a joint meeting on "Construction of Information for Diagnosis: Its hard- and Soft-wares," held in Tokyo on Februaty 5, 1988.