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Albmina
Verde bromocresol. Colorimtrico
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ALBUMIN
Albumin
Bromocresol green. Colorimetric
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ALBUMIN
Albumine
Vert de bromocrsol. Colorimtrique
VALEURS DE REFERENCE
SIGNIFICATION CLINIQUE
3,5 5,0 g/dL1.
Lalbumine est lune des protines plasmatiques les plus importantes
Ces valeurs sont donnes titre dinformation. Il est conseill chaque
produite par le foie.
laboratoire de dfinir ses propres valeurs de rfrence.
Parmi ses multiples fonctions, on retiendra la nutrition, lentretien de la
pression oncotique et le transport des substances telles que la Ca++, la
bilirubine, les acides gras, les drogues et les strodes.
Des perturbations dans les valeurs de lalbumine signalent des maladies CARACTERISTIQUES DE LA METHODE
du foie, une malnutrition, des lsions de la peau telles que de la dermatite, Gamme de mesures: Depuis la lmite de dtection de 0,0349 g/dL jusqu la
des brlures importantes ou une dhydratation1, 7,8. limite de linarit de 6 g/dL.
Le diagnostic clinique doit tenir compte des donnes cliniques et des Si la concentration de lchantillon est suprieure la limite de linarit, diluer
donnes de laboratoire. 1/2 avec du CINa 9 g/L et multiplier le rsultat final par 2.
Prcisin:
REACTIFS Intra-srie (n=20) Inter-srie (n=20)
Moyenne (g/dL) 5,00 3,71 4,56 3,07
R Vert de bromocrsol pH 4,2 0,12 mmol/L SD 0,02 0,02 0,28 0,18
CV (%) 0,47 0,55 6,20 5,90
ALBUMINE CAL talon primaire de dtection de lalbumine 5 g/dL Sensibilit analytique: 1 g/dL = 0,2003 (A).
Exactitude: Les ractifs SPINREACT (y) ne montrent pas de diffrences
systmatiques significatives lorsquon les compare dautres ractifs
PREPARATION commerciaux (x).
Le ractif et le talon sont prts lemploi. Les rsultats obtenus avec 50 chantillons ont t les suivants:
Coefficient de corrlation (r)2: 0,99169.
CONSERVATION ET STABILITE Equation de la Coubre de rgression: y=1,045x - 0,028.
Tous les composants du kit sont stables jusqu la date de premption Les caractristiques de la mthode peuvent varier suivant lanalyseur employ.
indique sur ltiquette du flacon, et si les flacons sont maintenus
hermtiquement ferms 2-8C, labri de la lumire et des sources de
contamination. Ne pas utiliser les ractifs en dehors de la date indique. INTERFERENCES
Indices de dtrioration des ractifs: La bilirubine jusqu 110 mg/L, lhmoglobine jusqu 1 g/L et a lipmie jusqu
- Prsence de particules et turbidit. 10 g/L, interfrent1,4.
- Absorbation du blanc 630 nm 0,40. Diffrentes drogues ont t dcrites ainsi que dautres substances qui interfrent
dans la dtermination de lalbumine5, 6.
MATERIEL SUPPLEMENTAIRE
- Spectrophotomtre ou analyseur pour les lectures 630 nm.
- Cuvettes de 1,0 cm dclairage. REMARQUES
- Equipement classique de laboratoire. 1. ALBUMINE CAL: Etant donn la nature du produit, il est conseill de le
manipuler avec prcaution. En effet, il peut tre facilement contamin.
2. Le calibrage au moyen du patron de dtection peut donner lieu des erreurs
ECHANTILLONS systmatiques lors de mthodes automatiques. Dans de tels cas, il est
Srum ou plasma sans hemolysis1: Stabilit 1 mois 2-8C ou1 semaine conseill dutiliser des calibrages sriques
15-25C.
3. Utiliser des embouts de pipettes jetables propres pour diffuser le produit.
4. SPINREACT dispose de consignes dtailles pour lapplication de
PROCEDURE ce ractif dans diffrents analyseurs.
1. Conditions de test:
Longueur dondes: .. . . . . . . . . . . . . . . . . . . . . . . . .630 nm (600-650)
Cuvette: . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . 1cm dclairage BIBLIOGRAPHIE
Temprature:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15-25C/37C 1. Gendler S. Uric acid. Kaplan A et al. Clin Chem The C.V. Mosby Co. St Louis.
2. Rgler le spectrophotomtre sur zro en fonction de leau distille Toronto. Princeton 1984; 1268-1273 and 425.
3. Pipetter dans une cuvette
(Remarque 3)
: 2. Rodkey F L. Clin Chem 1965; 11: 478-487.
3. Webster D. Clin Chem. 1974: Acta 53: 109-115.
Blanc talon Echantillon 4. Doumas BT Clin Chem. 1971: Acta 31: 87-96.
R (mL) 1,0 1,0 1,0 5. Young DS. Effects of drugs on Clinical Lab. Tests, 4th ed AACC Press, 1995.
6. Young DS. Effects of disease on Clinical Lab. Tests, 4th ed AACC 2001.
talon
(Remarque 1,2)
(L) -- 5 --
7. Burtis A et al. Tietz Textbook of Clinical Chemistry, 3rd ed AACC 1999.
Echantillon (L) -- -- 5 8. Tietz N W et al. Clinical Guide to Laboratory Tests, 3rd ed AACC 1995.
4. Mlanger et incuber pendant 5 min. 37C ou 10 min. 15-25C.
5. Lire labsorbation (a) du patron et lchantillon, en comparaison
PRESENTATION
avec le blanc du ractif. La couleur reste stable pendant 1 heure
temprature ambiance. Ref: 1001020 R:2 x 250 mL , CAL : 1 x 5 mL
Ref: 1001022 Cont. R:1 x 1000 mL , CAL : 1 x 5 mL
Ref: 1001023 R:2 x 50 mL , CAL : 1 x 2 mL
CALCULS
(A) chantillon - (A) Blanc
x 5 (talon conc.) = g/dL d'albumine dans lchantillon
(A) talon - (A) Blanc
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ALBUMIN
Albumina
Verde bromocresol. Colorimtrico
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LDH -LQ
LDH-LQ
Pyruvate. Kinetic UV. DGKC. Liquid
Quantitative determination of lactate dehydrogenase Units: One international unit (IU) is the amount of enzyme that transforms 1 mol
(LDH) of substrate per minute, in standard conditions. The concentration is expressed in
units per litre of sample (U/L).
IVD
Temperature conversion factors
Store at 2-8C To correct results to other temperatures multiply by:
PRINCIPLE OF THE METHOD
Assay Conversion factor to
Lactate dehydrogenase (LDH) catalyses the reduction of pyruvate by
temperature 25C 30C 37C
NADH, according the following reaction:
25C 1,00 1,33 1,92
LDH
Pyruvate + NADH + H+ L-lactate + NAD+ 30C 0,75 1,00 1,43
The rate of decrease in concentration of NADPH, measured photometrically, 37C 0,52 0,70 1,00
is proportional to the catalytic concentration of LDH present in the sample1.
QUALITY CONTROL
CLINICAL SIGNIFICANCE Control sera are recommended to monitor the performance of assay procedures:
Lactate dehydrogenase (LDH) is an enzyme with wide tissue distribution in SPINTROL H Normal and Pathologic (Ref. 1002120 and 1002210).
the body. If control values are found outside the defined range, check the instrument,
The higher concentrations of LDH are found in liver, heart, kidney, skeletal reagents and technique for problems.
muscle and erythrocytes. Each laboratory should establish its own Quality Control scheme and corrective
Increased levels of the enzyme are found in serum in liver disease, actions if controls do not meet the acceptable tolerances.
myocardial infarction, renal disease, muscular dystrophy and anemia1,4,5.
Clinical diagnosis should not be made on a single test result; it should REFERENCE VALUES1
integrate clinical and other laboratory data. 25C 30C 37C
120-240 U/L 160-320 U/L 230-460 U/L
REAGENTS These values are for orientation purpose; each laboratory should establish its own
Reagent 1 Imidazol 65 mmol/L reference range.
Buffer Pyruvate 0,6 mmol/L
PERFORMANCE CHARACTERISTICS
Reagent 2 Measuring range: From detection limit of 3,42 U/L to linearity limit of 1600 U/L.
NADH 0,18 mmol/L
Substrate If the results obtained were greater than linearity limit, dilute the sample 1/10 with
NaCl 9 g/L and multiply the result by 10.
PREPARATION Precision:
Working reagent (WR):
Mix: 4 vol. (R1) Buffer + 1 vol. (R2) Substrate Intra-assay (n=20) Inter-assay (n=20)
Stability: 15 days at 2-8C or 5 days at 15-25C. Mean (U/L) 400 785 392 773
SD 3,15 10,97 6,23 9,93
STORAGE AND STABILITY CV (%) 0,79 1,40 1,59 1,28
All the components of the kit are stable until the expiration date on the label
when stored tightly closed at 2-8C, protected from light and contaminations Sensitivity: 1 U/L = 0,00009 A/min.
prevented during their use. Accuracy: Results obtained using SPINREACT reagents (y) did not show
Do not use reagents over the expiration date. systematic differences when compared with other commercial reagents (x).
Signs of reagent deterioration: The results obtained using 50 samples were the following:
- Presence of particles and turbidity. Correlation coefficient (r)2: 0,98382.
- Blank absorbance (A) at 340 nm <1,00. Regression equation: y= 0,8988x + 2,583.
The results of the performance characteristics depend on the analyzer used.
ADDITIONAL EQUIPMENT
- Spectrophotometer or colorimeter measuring at 340 nm. INTERFERENCES
- Thermostatic bath at 25C, 30C o 37C ( 0,1C)
Haemolysis interferes with the assay.
- Matched cuvettes 1,0 cm light path.
Some anticoagulants such as oxalates interfere with the reaction1.
- General laboratory equipment.
A list of drugs and other interfering substances with LDH determination has been
SAMPLES reported by Young et. al2,3.
Serum1. Separated from cells as rapidly as possible. Do not use oxalates as
anticoagulants since they inhibit the enzyme. NOTES
Do not use haemolysed samples. Stability: 2 days at 2-8C. SPINREACT has instruction sheets for several automatic analyzers.
PROCEDURE BIBLIOGRAPHY
1. Assay conditions: 1. Pesce A. Lactate dehydrogenase. Kaplan A et al. Clin Chem The C.V. Mosby Co.
Wavelength: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 340 nm St Louis. Toronto. Princeton 1984; 1124-117, 438.
2. Young DS. Effects of drugs on Clinical Lab. Tests, 4th ed AACC Press, 1995.
Cuvette: . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 cm light path
3. Young DS. Effects of disease on Clinical Lab. Tests, 4th ed AACC 2001.
Constant temperature: . . . . . . . . . . . . . . 25C /30C / 37C 4. Burtis A et al. Tietz Textbook of Clinical Chemistry, 3rd ed AACC 1999.
2. Adjust the instrument to zero with distilled water or air. 5. Tietz N W et al. Clinical Guide to Laboratory Tests, 3rd ed AACC 1995.
3. Pipette into a cuvette:
PACKAGING
25 - 30C 37C
WR (mL) 3,0 3,0 R 1: 1 x 60 mL
Ref: 41220
Sample (L) 100 50 Cont.
R 2: 1 x 15mL
R 1: 1 x 240 mL
Ref: 41222
4. Mix, incubate for 1 minute. R 2: 1 x 60 mL
5. Read initial absorbance (A) of the sample, start the stopwatch and read
absorbances at 1 minute intervals thereafter for 3 minutes.
6. Calculate the difference between absorbances and the average
absorbance differences per minute (A/min).
CALCULATIONS
25- 30C A/min x 4925 = U/L LDH
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LDH -LQ
LDH-LQ
Piruvato. Cintica UV. DGKC. Lquido
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LDH -LQ
LDH-LQ
Pyruvate. Cintique UV. DGKC. Liquide
BIBLIOGRAPHIE
25 - 30C 37C 1. Pesce A. Lactate dehydrogenase. Kaplan A et al. Clin Chem The C.V. Mosby Co.
RT (mL) 3,0 3,0 St Louis. Toronto. Princeton 1984; 1124-117, 438.
chantillon (L) 100 50 2. Young DS. Effects of drugs on Clinical Lab. Tests, 4th ed AACC Press, 1995.
3. Young DS. Effects of disease on Clinical Lab. Tests, 4th ed AACC 2001.
4. Mlanger et incuber pendant 1 minute. 4. Burtis A et al. Tietz Textbook of Clinical Chemistry, 3rd ed AACC 1999.
5. Lire l'absorbance (A) initiale de l'chantillon, mettre en marche le 5. Tietz N W et al. Clinical Guide to Laboratory Tests, 3rd ed AACC 1995.
chronomtre et lire l'absorbance chaque minute pendant 3 minutes.
6. Calculer la moyenne de la diffrence d'absorbance par minute (A/min). PRSENTATION
R 1: 1 x 60 mL
Rf: 41220
R 2: 1 x 15 mL
Cont.
R 1: 1 x 240 mL
Rf: 41222
R 2: 1 x 60 mL
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LDH -LQ
LDH-LQ
Piruvato. Cintica UV. DGKC. Lquido
AMOSTRAS NOTAS
Soro1. Separado das hemcias o mais rpido possvel. No utilizar oxalatos A SPINREACT dispe de instrues detalhadas para aplicao deste
como anticoagulantes, uma vez que interferem nos resultados. reagente em diferentes analisadores.
No utilizar amostras hemolizadas. Estabilidade: 2 dias a 2-8 C.
BIBLIOGRAFA
PROCEDIMENTO 1. Pesce A. Lactate dehydrogenase. Kaplan A et al. Clin Chem The C.V. Mosby Co.
1. Condies do teste: St Louis. Toronto. Princeton 1984; 1124-117, 438.
Comprimento de onda: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .340 nm 2. Young DS. Effects of drugs on Clinical Lab. Tests, 4th ed AACC Press, 1995.
Cuvette: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 cm caminho de luz 3. Young DS. Effects of disease on Clinical Lab. Tests, 4th ed AACC 2001.
Temperatura constante: . . . . . . . . . . . . . . . . . . . . . 25 C / 30 C / 37 C 4. Burtis A et al. Tietz Textbook of Clinical Chemistry, 3rd ed AACC 1999.
2. Ajustar o espectrofotmetro para zero com a gua destilada ou ar. 5. Tietz N W et al. Clinical Guide to Laboratory Tests, 3rd ed AACC 1995.
3. Pipetar numa cuvette:
25 C - 30 C 37 C APRESENTAO
RT (mL) 3,0 3,0 R 1: 1 x 60 mL
Amostra (L) 100 50 Ref: 41220
R 2: 1 x 15 mL
Cont.
R 1: 1 x 240 mL
4. Misturar, incubar durante 1 minuto. Ref: 41222
R 2: 1 x 60 mL
5. Ler a absorvncia (A) inicial da amostra, colocar o cronmetro em
funcionamento e ler a absorvncia a cada minuto durante 3 minutos.
6. Calcular a mdia da diferena de absorvncia por minuto (A/min).
CLCULOS
25 C- 30 C A/min x 4925 = U/L LDH
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GOT (AST)-LQ
GOT-LQ
NADH. Cintico UV. IFCC rec. Lquido
GOT-LQ
NADH. Kinetic UV. IFCC rec. Liquid
Quantitative determination of aspartate aminotransferase 5. Read initial absorbance (A) of the sample, start the stopwatch and read
GOT (AST) absorbances at 1 minute intervals thereafter for 3 minutes.
6. Calculate the difference between absorbances and the average absorbance
IVD differences per minute (A/min).
Store at 2-8C
CALCULATIONS
PRINCIPLE OF THE METHOD A/min x 1750 = U/L of AST
Aspartate aminotransferase (AST) formerly called glutamate oxaloacetate
(GOT) catalyses the reversible transfer of an amino group from aspartate Units: One international unit (IU) is the amount of enzyme that transforms 1 mol
to -ketoglutarate forming glutamate and oxalacetate. The oxalacetate of substrate per minute, in standard conditions. The concentration is expressed
produced is reduced to malate by malate dehydrogenase (MDH) and in units per litre of sample (U/L).
NADH:
Temperature conversion factors
AST To correct results to other temperatures multiply by:
L-Aspartate + -Ketoglutarate Glutamate + Oxalacetate
MDH Assay Conversion factor to
Oxalacetate + NADH + H +
Malate + NAD+
temperature 25C 30C 37C
The rate of decrease in concentration of NADH, measured photometrically,
25C 1,00 1,37 2,08
is proportional to the catalytic concentration of AST present in the sample1.
30C 0,73 1,00 1,54
37C 0,48 0,65 1,00
CLINICAL SIGNIFICANCE
The AST is a cellular enzyme, is found in highest concentration in heart
muscle, the cells of the liver, the cells of the skeletal muscle and in smaller QUALITY CONTROL
amounts in other tissues. Control sera are recommended to monitor the performance of assay procedures:
Although an elevated level of AST in the serum is not specific of the SPINTROL H Normal and Pathologic (Ref. 1002120 and 1002210).
hepatic disease, is used mainly to diagnostic and to verify the course of If control values are found outside the defined range, check the instrument,
this disease with other enzymes like ALT and ALP. reagents and technique for problems.
Also it is used to control the patients after myocardial infarction, in skeletal Each laboratory should establish its own Quality Control scheme and corrective
muscle disease and other1,4,5. actions if controls do not meet the acceptable tolerances.
Clinical diagnosis should not be made on a single test result; it should 1
integrate clinical and other laboratory data. REFERENCE VALUES
25C 30C 37C
REAGENTS Men up to 19 U/L 26 U/L 38 U/L
TRIS pH 7,8 80 mmol/L Women up to 16 U/L 22 U/L 31 U/L
R1 Lactate dehydrogenase (LDH) 800 U/L These values are for orientation purpose; each laboratory should establish
Buffer Malate dehydrogenase (MDH) 600 U/L its own reference range.
L-Aspartate 200 mmol/L
PERFORMANCE CHARACTERISTICS
R2 NADH 0,18 mmol/L Measuring range: From detection limit of 0 U/L to linearity limit of 467 U/L.
Substrate -Ketoglutarate 12 mmol/L If the results obtained were greater than linearity limit, dilute the sample 1/10 with
NaCl 9 g/L and multiply the result by 10.
PRECAUTIONS Precision:
R1: H290-May be corrosive to metals. Intra-assay (n=20) Inter-assay (n=20)
Follow the precautionary statements given in MSDS and label of the product. Mean (U/L) 48,1 159 47,4 156
SD 0,56 0,57 1,42 4,35
PREPARATION CV (%) 1,16 0,36 3,00 2,79
Working reagent (WR):
Mix: 4 vol. (R1) Buffer + 1 vol. (R2) Substrate. Sensitivity: 1 U/L = 0,00053 A/min.
Stability: 21 days at 2-8C or 72 hours at room temperature (15-25C). Accuracy: Results obtained using SPINREACT reagents (y) did not show
systematic differences when compared with other commercial reagents (x).
The results obtained using 50 samples were the following:
STORAGE AND STABILITY Correlation coefficient (r): 0,99956.
All the components of the kit are stable until the expiration date on the
Regression equation: y= 1,042x - 0,342.
label when stored tightly closed at 2-8C, protected from light and
The results of the performance characteristics depend on the analyzer used.
contaminations prevented during their use.
Do not use reagents over the expiration date.
INTERFERENCES
Signs of reagent deterioration:
Anticoagulants currently in use like heparin, EDTA, oxalate and fluoride do not
- Presence of particles and turbidity.
- Blank absorbance (A) at 340 nm < 1,00. affect the results. Haemolysis interferes with the assay 1
A list of drugs and other interfering substances with AST determination has been
ADDITIONAL EQUIPMENT reported 2,3.
- Spectrophotometer or colorimeter measuring at 340 nm.
- Thermostatic bath at 25C, 30C o 37C ( 0,1C)
NOTES
SPINREACT has instruction sheets for several automatic analyzers.
- Matched cuvettes 1,0 cm light path.
- General laboratory equipment.
BIBLIOGRAPHY
SAMPLES 1. Murray R. Aspartate aminotransferase. Kaplan A et al. Clin Chem The C.V.
Serum or plasma1: Stability 7 days at 2-8C. Mosby Co. St Louis. Toronto. Princeton 1984; 1112-116.
2. Young DS. Effects of drugs on Clinical Lab. Tests, 4th ed AACC Press, 1995.
PROCEDURE 3. Young DS. Effects of disease on Clinical Lab. Tests, 4th ed AACC 2001.
4. Burtis A et al. Tietz Textbook of Clinical Chemistry, 3rd ed AACC 1999.
1. Assay conditions:
5. Tietz N W et al. Clinical Guide to Laboratory Tests, 3rd ed AACC 1995.
Wavelength: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 340 nm
Cuvette: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 cm light path
PACKAGING
Constant temperature: . . . . . . . . . . . . . . . . . . . . . . 25C / 30C / 37C
2. Adjust the instrument to zero with distilled water or air. R1: 1 x 60 mL
Ref: 41270 R2: 1 x 15 mL
3. Pipette into a cuvette:
R1: 1 x 240 mL
WR (mL) 1,0 Ref: 41272 Cont.
R2: 1 x 60 mL
Sample (L) 100 R1: 1 x 480 mL
Ref: 41273
R2: 1 x 120 mL
4. Mix, incubate for 1 minute.
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GOT (AST)-LQ
GOT-LQ
NADH. Cintique UV. IFCC rec. Liquide
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GOT (AST)-LQ
GOT-LQ
NADH. Cintico UV. IFCC rec. Lquido
BEIS46-P 26/05/15 SPINREACT,S.A./S.A.U. Ctra.Santa Coloma, 7 E-17176 SANT ESTEVE DE BAS (GI) SPAIN
Tel. +34 972 69 08 00 Fax +34 972 69 00 99. e-mail: spinreact@spinreact.com
GOT (AST)
GOT (AST)
NADH. Cintico UV. IFCC rec.
Determinacin cuantitativa de aspartato aminotransferasa 5. Leer la absorbancia (A) inicial de la muestra, poner en marcha el cronometro
GOT (AST) y leer la absorbancia cada minuto durante 3 minutos.
IVD 6. Calcular el promedio del incremento de absorbancia por minuto ( A/min).
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GOT (AST)
GOT (AST)
NADH. Kinetic UV. IFCC rec.
Quantitative determination of aspartate aminotransferase CALCULATIONS
GOT (AST)
A/min x 1750 = U/L of AST
IVD
Store at 2-8C Units: One international unit (IU) is the amount of enzyme that transforms 1 mol
of substrate per minute, in standard conditions. The concentration is expressed
PRINCIPLE OF THE METHOD in units per litre of sample (U/L).
Aspartate aminotransferase (AST) formerly called glutamate oxaloacetate
(GOT) catalyses the reversible transfer of an amino group from aspartate Temperature conversion factors
to -ketoglutarate forming glutamate and oxalacetate. The oxalacetate To correct results to other temperatures multiply by:
produced is reduced to malate by malate dehydrogenase (MDH) and
NADH: Assay Conversion factor to
AST temperature 25C 30C 37C
Aspartate + -Ketoglutarate Glutamate + Oxalacetate
25C 1,00 1,37 2,08
MDH 30C 0,73 1,00 1,54
Oxalacetate + NADH + H+ Malate + NAD+
The rate of decrease in concentration of NADH, measured photometrically, 37C 0,48 0,65 1,00
is proportional to the catalytic concentration of AST present in the sample1. QUALITY CONTROL
CLINICAL SIGNIFICANCE Control sera are recommended to monitor the performance of assay procedures:
The AST is a cellular enzyme, is found in highest concentration in heart SPINTROL H Normal and Pathologic (Ref. 1002120 and 1002210).
muscle, the cells of the liver, the cells of the skeletal muscle and in smaller If control values are found outside the defined range, check the instrument,
amounts in other weaves. reagents and technique for problems.
Although an elevated level of AST in the serum is not specific of the Each laboratory should establish its own Quality Control scheme and corrective
hepatic disease, is used mainly to diagnostic and to verify the course of actions if controls do not meet the acceptable tolerances.
this disease with other enzymes like ALT and ALP.
Also it is used to control the patients after myocardial infarction, in skeletal REFERENCE VALUES1
muscle disease and other1,4,5. 25C 30C 37C
Clinical diagnosis should not be made on a single test result; it should Men up to 19 U/L 26 U/L 38 U/L
integrate clinical and other laboratory data. Women up to 16 U/L 22 U/L 31 U/L
These values are for orientation purpose; each laboratory should establish its
REAGENTS own reference range.
R1 TRIS pH 7,8 80 mmol/L PERFORMANCE CHARACTERISTICS
Buffer L-Aspartate 200 mmol/L Measuring range: From detection limit of 0 U/L to linearity limit of 360 U/L.
NADH 0,18 mmol/L If the results obtained were greater than linearity limit, dilute the sample 1/10 with
R2 Lactate dehydrogenase (LDH) 800 U/L NaCl 9 g/L and multiply the result by 10.
Substrate Malate dehydrogenase (MDH) 600 U/L Precision:
-Ketoglutarate 12 mmol/L
Intra-assay (n=20) Inter-assay (n=20)
PREPARATION Mean (U/L) 55,5 165 55,0 162
Working reagent (WR): SD 1,30 3,44 0,92 2,52
Dissolve one tablet of R.2 Substrate with one vial of R1 Buffer. CV (%) 2,35 2,07 1,68 1,55
Ref: 1001160 Dissolve ( ) one tablet of R2 Substrate in one vial of R1.
Ref: 1001161 Dissolve ( ) one tablet of R2 Substrate in 15 mL of R1. Sensitivity: 1 U/L = 0,00051 A/min.
Ref.: 1001162 Dissolve one tablet of R2 Substrate in 50 mL of R1. Accuracy: Results obtained using SPINREACT reagents (y) did not show
Cap and mix gently to dissolve contents. systematic differences when compared with other commercial reagents (x).
Stability: 21 days at 2-8C or 72 hours at room temperature (15-25C). The results obtained using 50 samples were the following:
Correlation coefficient (r)2: 0,98277.
STORAGE AND STABILITY Regression equation: y= 0,9259x - 5,1685.
All the components of the kit are stable until the expiration date on the The results of the performance characteristics depend on the analyzer used.
label when stored tightly closed at 2-8C, protected from light and
contaminations prevented during their use. INTERFERENCES
Do not use the tablets if appears broken. Anticoagulants currently in use like heparin, EDTA, oxalate and fluoride do not
Do not use reagents over the expiration date. affect the results. Haemolysis interferes with the assay1
Signs of reagent deterioration: A list of drugs and other interfering substances with AST determination has been
- Presence of particles and turbidity. reported2,3.
- Blank absorbance (A) at 340 nm < 1,00.
NOTES
ADDITIONAL EQUIPMENT SPINREACT has instruction sheets for several automatic analyzers.
- Spectrophotometer or colorimeter measuring at 340 nm. Instructions for many of them are available on request.
- Thermostatic bath at 25C, 30C o 37C ( 0,1C)
- Matched cuvettes 1,0 cm light path. BIBLIOGRAPHY
- General laboratory equipment. 1. Murray R. Aspartate aminotransferase. Kaplan A et al. Clin Chem The C.V.
Mosby Co. St Louis. Toronto. Princeton 1984; 1112-116.
SAMPLES 2. Young DS. Effects of drugs on Clinical Lab. Tests, 4th ed AACC Press,
Serum or plasma1: Stability 7 days at 2-8C. 1995.
3. Young DS. Effects of disease on Clinical Lab. Tests, 4th ed AACC 2001.
PROCEDURE 4. Burtis A et al. Tietz Textbook of Clinical Chemistry, 3rd ed AACC 1999.
1. Assay conditions: 5. Tietz N W et al. Clinical Guide to Laboratory Tests, 3rd ed AACC 1995.
Wavelength: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .340 nm
Cuvette: . . . . . . . . . . . . . . . . . . . . .. . . . . . . .. . . . . . . .1 cm. light path PACKAGING
Constant temperature: . . . . . . . . . . . . . . . . . . . . . . 25C /30C / 37C
Ref: 1001160 R1: 20 x 2 mL , R2: 20 2 mL
2. Adjust the instrument to zero with distilled water or air.
Cont.
3. Pipette into a cuvette: Ref: 1001161 R1: 1 x 150 mL, R2: 10 15 mL
Ref: 1001162 R1: 10 x 50 mL, R2: 10 50 mL
WR (mL) 1,0
Sample (L) 100
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GOT (AST)
GOT (AST)
NADH. Cintique UV. IFCC rec.
Dtermination quantitative daspartate amino transfrase 5. Lire labsorbation (A) initiale de lchantillon, mettre en route le chronomtre et
GOT (AST) lire labsorbation chaque minute pendant 3 minutes.
6. Calculer la moyenne de laugmentation dabsorbation par minute ( A/min).
IVD
CALCULS
Conserver 2-8C
A/min x 1750 = U/L de AST
PRINCIPE DE LA METHODE Units: Lunit internationale (UI) correspond la quantit denzymes qui converti
Laspartate amino transfrase (AST), initialement appele transaminase 1 mol de substrats par minute, dans des conditions standard. La concentration
glutamate oxaloactique (GOT) catalyse le transfert rversible dun groupe est exprime en unit/litre (U/L).
animique de laspartate vers lalpha-ctoglutarate formation de glutamate Facteurs de conversion de tempratures
et doxalactate. Loxalactate produit est rduit en malate en prsence de Les rsultats peuvent se transformer dautres tempratures, en multipliant par:
dshydrognes (MDH) et NADH: Temprature Facteur de conversion
AST de mesure 25C 30C 37C
Aspartate+ -Ctoglutarate Glutamate + Oxalactate
MDH 25C 1,00 1,37 2,08
Oxalactate + NADH + H Malate + NAD+
+
30C 0,73 1,00 1,54
La vitesse de rduction de la concentration en NADH au centre, dtermine 37C 0,48 0,65 1,00
photo numriquement, est proportionnelle la concentration catalytique
dAST dans lchantillon1. CONTROLE DE QUALITE
Il est conseill danalyser conjointement les chantillons de srum dont les valeurs
SIGNIFICATION CLINIQUE ont t contrles: SPINTROL H Normal et pathologique (Rf. 1002120 et
LAST est une enzyme intracellulaire, qui se trouve en grandes quantits 1002210).
dans les muscles du cur, les cellules du foie, les cellules du muscle Si les valeurs se trouvent en dehors des valeurs tolres, analyser linstrument,
squelettique et en plus faibles quantits dans les autres tissus. les ractifs et le calibreur.
Bien quun niveau lev dAST dans le srum ne soit pas caractristique Chaque laboratoire doit disposer de son propre contrle de qualit et dterminer
dune maladie hpatique, elle semploie principalement pour les diagnostics les mesures correctives mettre en place dans le cas o les vrifications ne
et le suivi, avec dautres enzymes telles que lALT et lALP. Elle sutilise correspondraient pas aux attentes.
galement dans le cadre du contrle post-infarctus, chez les patients
souffrant de troubles musculaires du squelette et dans certains autres cas1, VALEURS DE REFERENCE1
4,5
. 25C 30C 37C
Le diagnostic clinique doit tre ralis en prenant en compte les donnes Hommes Jusqu 19 U/L 26 U/L 38 U/L
cliniques et les donnes de laboratoire. Femmes Jusqu 16 U/L 22 U/L 31 U/L
Ces valeurs sont donnes titre dinformation. Il est conseill chaque laboratoire
REACTIFS de dfinir ses propres valeurs de rfrence.
R1 TRIS pH 7,8 80 mmol/L CARACTERISTIQUES DE LA METHODE
Tampon L-aspartate 200 mmol/L
Gamme de mesures: Depuis la limite de dtection 0 U/L jusqu la limite de
NADH 0,18 mmol/L linarit 360 U/L.
R2 Lactate dshydrogn (LDH) 800 U/L Si la concentration de lchantillon est suprieure la limite de linarit diluer 1/10
Substrats Malate dshydrognis (MDH) 600 U/L avec du ClNa 9 g/L et multiplier le rsultat final par 10.
-ctoglutarate 12 mmol/L Prcision:
Intra-srie (n= 20) Inter-srie (n= 20)
PREPARATION
Moyenne (U/L) 55,5 165 55,0 162
Ractif de travail (RT):
Rf: 1001160 Dissoudre ( ) une tablette de substrats R2 dans une dose SD 1,30 3,44 0,92 2,52
CV (%) 2,35 2,07 1,68 1,55
(ampoule) R1.
Rf: 1001161 Dissoudre ( ) une tablette de substrats R2 dans 15 mL de Sensibilit analytique: 1 U/L = 0,00051 A/min.
R1. Exactitude: Les ractifs SPINREACT (y) ne montrent pas de diffrences
Rf: 1001162 Dissoudre ( ) une tablette de substrats de R2 dans 50 mL systmatiques significatives lorsquon les compare dautres ractifs
de R1. commerciaux (x).
Refermer et mlanger doucement, jusqu ce que le contenu soit Les rsultats obtenus avec 50 chantillons ont t les suivants:
totalement dissout. Coefficient de corrlation (r)2: 0,98277.
Stabilit: 21 jours 2-8C ou 72 heures temprature ambiante (15-25C). Equation de la Coubre de rgression: y= 0,9259x - 5,1685.
Les caractristiques de la mthode peuvent varier suivant lanalyseur employ.
CONSERVATION ET STABILITE
Tous les composants du kit sont stables jusqu la date de premption INTERFERENCES
indique sur ltiquette, et si les flacons sont maintenus hermtiquement Les anticoagulants utilisation courante tels que lhparine, lEDTA oxalate ou le
ferms 2-8C, labri de la lumire et des sources de contamination. fluorure nont aucune incidence sur les rsultats. Lhmolyse interfre avec les
Ne pas utiliser les ractifs en dehors de la date indique. rsultats1.
Ne pas utiliser les tablettes si elles sont fragmentes. Diffrentes drogues ont t dcrites ainsi que dautres substances qui interfrent
Indices de dtrioration des ractifs:
dans la dtermination de lAST2, 3.
- Prsence de particules et turbidit.
- Absorbation du blanc 340 nm < 1,00.
REMARQUES
MATERIEL SUPPLEMENTAIRE SPINREACT dispose de consignes dtailles pour lapplication de ce ractif
- Spectrophotomtre ou analyseur pour les lectures 340 nm. dans diffrents analyseurs.
- Bain thermostable 25C, 30C 37C ( 0,1C)
- Cuvettes de 1,0 cm dclairage. BIBLIOGRAPHIE
- Equipement classique de laboratoire. 1. Murray R. Aspartate aminotransferase. Kaplan A et al. Clin Chem The C.V. Mosby
Co. St Louis. Toronto. Princeton 1984; 1112-116.
ECHANTILLONS
2. Young DS. Effects of drugs on Clinical Lab. Tests, 4th ed AACC Press, 1995.
Srum ou plasma1. Stabilit de lchantillon: 7 jours 2-8C. 3. Young DS. Effects of disease on Clinical Lab. Tests, 4th ed AACC 2001.
PROCEDURE 4. Burtis A et al. Tietz Textbook of Clinical Chemistry, 3rd ed AACC 1999.
1. Conditions de test: 5. Tietz N W et al. Clinical Guide to Laboratory Tests, 3rd ed AACC 1995.
Longueur dondes: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .340 nm PRESENTATION
Cuvette:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 cm dclairage
Temprature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25C/30C/37C Ref: 1001160 R1: 20 x 2 mL , R2: 20 2 mL
2. Rgler le spectrophotomtre sur zro en fonction de leau distille ou Ref: 1001161 Cont. R1: 1 x 150 mL, R2: 10 15 mL
air. Ref: 1001162 R1: 10 x 50 mL, R2: 10 50 mL
3. Pipetter dans une cuvette:
RT (mL) 1,0
Echantillon (L) 100
4. Mlanger et incuber pendant 1 minute
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GOT (AST)
GOT (AST)
NADH. Cintico UV. IFCC rec.
Determinao quantitativa de aspartato aminotransferase GOT 5. Ler a absorvncia (A) inicial da amostra, pr o cronmetro a funcionar e ler a
(AST) absorvancia a cada minuto durante 3 minutos.
IVD 6. Calcular a mdia do aumento da absorvncia por minuto ( A/min).
Conservar a 2-8C
CLCULOS
PRINCIPIO DO MTODO
A aspartato aminotransferase (AST) inicialmente chamada de A/min x 1750 = U/L de AST
transaminase glutamato oxaloactica (GOT) cataliza a transferncia
reversvel de um grupo amino do aspartato a -cetoglutarato com formao Unidades: A unidade internacional (UI) a quantidade de enzima que converte 1
de glutamato e oxalacetato. O oxalacetato produzido reduzido a malato mol de substrato por minuto, em condies standardizadas. A concentrao
na presena de malato desidrogenase (MDH) e NADH: expressa em unidades por litro (U/L).
AST
Aspartato + -Cetoglutarato Glutamato + Oxalacetato Factores de converso de temperaturas
MDH Os resultados podem ser transformados a outras temperaturas multiplicando por:
Oxalacetato + NADH + H+ Malato + NAD+
Temperatura Factor para converter a
A velocidade de diminuio da concentracin de NADH em mdia, de medio 25C 30C 37C
determinada fotomtricamente, proporcional concentrao cataltica de 25C 1,00 1,37 2,08
AST na amostra testada1. 30C 0,73 1,00 1,54
37C 0,48 0,65 1,00
SIGNIFICADO CLNICO
A AST una enzima intracelular, que se encontra em nveis elevados no CONTROLO DE QUALIDADE
msculo do corao, nas clulas do fgado, nas clulas do msculo conveniente analisar juntamente com as amostras, os soros controlo
esqueltico e em menor quantidade noutros tecidos. valorizados: SPINTROL H Normal e Patolgico (Ref. 1002120 e 1002210).
Embora um nivel elevado de AST no soro no seja especfico de patologia Se os valores determinados estiverem fora do intervalo de tolerncia, verificar o
heptica, utiliza-se principalmente para seu diagnstico e seguimento, equipamento, os reagentes e o calibrador.
juntamente com outras enzimas como a ALT e ALP. Tambm se utiliza no Cada laboratrio deve dispor do seu prprio Controlo de Qualidade e estabelecer
controlo aps-enfarte, em pacientes com patologias do msculo correces caso os controles no cumpram com as tolerncias.
esqueltico, e noutras patologias1,4,5.
VALORES DE REFERENCIA1
O diagnstico clnico deve realizar-se tendo em conta todos os dados
25C 30C 37C
clnicos elaboratoriais.
Homens At 19 U/L 26 U/L 38 U/L
REAGENTES Mulheres At 16 U/L 22 U/L 31 U/L
TRIS pH 7,8 Estes valores so orientativos. recomendvel que cada laboratrio estabelea
R1 80 mmol/L
os seus prprios valores de referncia.
Tampo L-Aspartato 200 mmol/L
NADH 0,18 mmol/L CARACTERISTICAS DO METODO
R2 Lactato desidrogenase (LDH) 800 U/L Intervalo de medida: Desde o limite de deteco 0 U/L at ao limite de linearidade
Substrato Malato desidrogenase (MDH) 600 U/L 360 U/L.
-Cetoglutarato 12 mmol/L Se a concentrao da amostra for superior do limite de linearidade, diluir 1/10
com NaCl 9 g/L e multiplicar o resultado final por 10.
PREPARAO Preciso:
Reagente de trabalho (RT): Intrasrie (n= 20) Intersrie (n= 20)
Dissolver um comprimido de R2 Substrato num frasco de R1 tampo. Mdia (U/L) 55,5 165 55,0 162
Ref: 1001160 Dissolver ( ) um comprimido de R2 Substrato num frasco DP 1,30 3,44 0,92 2,52
de R1. CV (%) 2,35 2,07 1,68 1,55
Ref: 1001161 Dissolver ( ) um comprimido de R2 Substrato em 15 mL Sensibilidade analtica: 1 U/L = 0,00051 A/min.
de R1. Exactido: Os reagentes SPINREACT (y) no amostram diferenas sistemticas
Ref: 1001162 Disolver ( ) um comprimido de R2 Substrato em 50 mL de significativas quando se comparam com outros reagentes comerciais (x).
R1. Os resultados obtidos com 50 amostras foram os seguintes:
Tapar e misturar suavemente at dissoluo do seu contedo. Coeficiente de regresso (r)2: 0,98277.
Estabilidade: 21 dias a 2-8C ou 72 horas a temperatura ambiente Equao da recta de regresso: y= 0,9259x - 5,1685.
(15-25C). As caractersticas do mtodo podem variar segundo o equipamento utilizado.
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ALP-LQ
MUESTRAS NOTAS
Suero o plasma heparinizado1. Usar suero libre de hemlisis, separado de SPINREACT dispone de instrucciones detalladas para la aplicacin de este
los hemates lo antes posible. reactivo en distintos analizadores.
Estabilidad: 3 das a 2-8C.
BIBLIOGRAFA
PROCEDIMIENTO 1. Wenger C. et al. Alkaline phosphatase. Kaplan A et al. Clin Chem The C.V.
1. Condiciones del ensayo: Mosby Co. St Louis. Toronto. Princeton 1984; 1094-1098.
Longitud de onda: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 405 nm 2. Rosalki S et al. Clin Chem 1993; 39/4: 648-652.
Cubeta:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 cm paso de luz 3. Young DS. Effects of drugs on Clinical Lab. Tests, 4th ed AACC Press, 1995.
Temperatura constante: . . . . . . . . . . . . . . . . . . . . . . . 25C / 30C / 37C 4. Young DS. Effects of disease on Clinical Lab. Tests, 4th ed AACC 2001.
2. Ajustar el espectrofotmetro a cero frente a agua destilada o aire. 5. Burtis A et al. Tietz Textbook of Clinical Chemistry, 3rd ed AACC 1999.
3. Pipetear en una cubeta: 6. Tietz N W et al. Clinical Guide to Laboratory Tests, 3rd ed AACC 1995.
RT (mL) 1,2
Muestra ( L) 20 PRESENTACIN
4. Mezclar, incubar 1 minuto. R1: 1 x 60 mL
Ref: 41240 R2: 1 x 15 mL
5. Leer la absorbancia (A) inicial de la muestra, poner en marcha el
cronmetro y leer la absorbancia cada minuto durante 3 minutos. R1: 1 x 240 mL
6. Calcular el promedio de la diferencia de absorbancia por minuto Ref: 41242 Cont.
R2: 1 x 60 mL
( A/min). R1: 1 x 480 mL
Ref: 41243
R2: 1 x 120 mL
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ALP-LQ
SAMPLES BIBLIOGRAPHY
Serum or heparinzed plasma1. Use unhemolyzed serum, separated from 1. Wenger C. et al. Alkaline phosphatase. Kaplan A et al. Clin Chem The C.V.
the clot as soon as possible. Stability: 3 days at 2-8C. Mosby Co. St Louis. Toronto. Princeton 1984; 1094-1098.
2. Rosalki S et al. Clin Chem 1993; 39/4: 648-652.
PROCEDURE 3. Young DS. Effects of drugs on Clinical Lab. Tests, 4th ed AACC Press, 1995.
1. Assay conditions: 4. Young DS. Effects of disease on Clinical Lab. Tests, 4th ed AACC 2001.
Wavelength: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 405 nm 5. Burtis A et al. Tietz Textbook of Clinical Chemistry, 3rd ed AACC 1999.
Cuvette: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 cm light path 6. Tietz N W et al. Clinical Guide to Laboratory Tests, 3rd ed AACC 1995.
Constant temperature: . . . . . . . . . . . . . . . . . . . . . . . 25C / 30C / 37C
2. Adjust the instrument to zero with distilled water or air. PACKAGING
3. Pipette into a cuvette:
R1: 1 x 60 mL
WR (mL) 1,2 Ref: 41240 R2: 1 x 15 mL
Sample ( L) 20
4. Mix, incubate for 1 minute. Cont. R1: 1 x 240 mL
Ref: 41242
5. Read initial absorbance (A) of the sample, start the stopwatch and read R2: 1 x 60 mL
absorbances at 1 min intervals thereafter for 3 min. R1: 1 x 480 mL
6. Calculate the difference between absorbances and the average Ref: 41243
R2: 1 x 120 mL
absorbance differences per minute ( A/min).
CALCULATIONS
A/min x 3300 = U/L de ALP
Units: One international unit (IU) is the amount of enzyme that transforms
1 mol of substrate per minute, in standard conditions. The concentration is
expressed in units per litre of sample (U/L).
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ALP-LQ
SIGNIFICATION CLINIQUE
Les phosphatases alcalines sont des enzymes, qui sont prsentes dans presque VALEURS DE RFRENCE 1
tous les tissus de l'organisme, avec une teneur particulirement leve dans les os, 25C 30C 37C
le foie, le placenta, les intestins et les reins. Enfants (1-14 ans) < 400 U/L < 480 U/L < 645 U/L
Par consquent, leur augmentation ou diminution dans le plasma est Adultes 60 -170 U/L 73 - 207 U/L 98 - 279 U/L
particulirement importante cliniquement parlant. Les facteurs qui peuvent affecter les valeurs de rfrence sont: l'exercice, les
Causes les plus probables d'augmentation du niveau de FAL : priodes de croissance chez les enfants et la grossesse.
Maladie osseuse de Paget, obstructions du foie, hpatite, hpatotoxicit cause de Ces valeurs sont approximatives. Il est recommand que chaque laboratoire
mdicaments et ostomalacie. tablisse ses propres valeurs de rfrence.
Causes les plus probables de diminution du niveau de FAL :
Crtinisme et carence en vitamine C1,5,6. CARACTRISTIQUES DE LA MTHODE
Le diagnostic clinique doit tre ralis en tenant compte de toutes les donnes Gamme de mesure: de la limite de la dtection de 0,6845 U/L la limite de linarit
cliniques et de laboratoire. de 1200 U/L.
Si les rsultats obtenus sont plus levs que la limite de linarit, il faut diluer 1/10
RACTIFS avec ClNa 9 g/l et multiplier le rsultat par 10.
R1 Dithanolamine (DEA) pH 10,4 1 mmol/L Prcision:
Tampon Chlorure de magnsium 0,5 mmol/L Intra-essai n=20) Inter-essai (n=20)
R2 Moyenne (mmol/L) 174 443 175 434
p-nitrophnylphospate (pNPP) 10 mmol/L SD 0,72 1,56 6,88 11,93
Substrat
CV (%) 0,41 0,35 3,93 2,75
PRPARATION Sensibilit analytique: 1 U/L = 0,0003 A/min.
Ractif de travail (RT) : Exactitude: les rsultats obtenus en utilisant les ractifs SPINREACT nont pas
Mlanger : 4 vol. de (R1) tampon + 1 vol. de (R2) substrat. prsent de diffrences systmatiques en comparaison avec dautres ractifs
commerciaux (x).
Stabilit : 1 mois 2-8C ou 10 jours temprature ambiante (15-25C). Les rsultats obtenus sur 50 chantillons ont t les suivants :
Coefficient de rgression (r)2: 0,99938.
CONSERVATION ET STABILIT quation de la droite de rgression : y=1,025x 1,105.
Toutes les composantes du kit sont stables jusqu lexpiration de la date mentionne Les caractristiques de la mthode peuvent varier en fonction de l'analyseur utilis.
sur ltiquette en cas de conservation hermtique sous 2-8C et de protection contre
la lumire et les contaminations vites lors de leur utilisation. INTERFRENCES
Indicateurs de dtrioration des ractifs :
Le fluorure, l'oxalate, le citrate et l'EDTA inhibent l'activit de la phosphatase alcaline,
- Prsence de particules et turbidit.
- Absorbances du tmoin 405 nm 1,50. ils ne doivent donc pas tre utiliss comme anticoagulants.
L'hmolyse interfre en raison de la forte teneur en phosphatase alcaline des
QUIPEMENTS SUPPLMENTAIRES hmaties1,2. Plusieurs drogues et autres substances, interfrant dans la
- Spectrophotomtre ou colorimtre mesurant 405 nm. dtermination de la phosphatase alcaline3,4 ont t dcrites.
- Bain thermostable 25C, 30C ou 37 C ( 0,1C)
- Cuves apparies de 1,0 cm dclairage. NOTES
- quipement dusage gnral pour laboratoire.
SPINREACT dispose d'instructions dtailles pour l'application de ce ractif
CHANTILLONS dans diffrents analyseurs.
Srum ou plasma hparinis1. Utiliser du srum exempt d'hmolyse, spar des
hmaties le plus tt possible. BIBLIOGRAPHIE
Stabilit : 3 jours 2-8C. 1. Wenger C. et al. Alkaline phosphatase. Kaplan A et al. Clin Chem The C.V.
Mosby Co. St Louis. Toronto. Princeton 1984; 1094-1098.
PROCDURE 2. Rosalki S et al. Clin Chem 1993; 39/4: 648-652.
1. Conditions dessai: 3. Young DS. Effects of drugs on Clinical Lab. Tests, 4th ed AACC Press, 1995.
Longueur donde: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 405 nm 4. Young DS. Effects of disease on Clinical Lab. Tests, 4th ed AACC 2001.
Cuvette: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 cm. dclairage 5. Burtis A et al. Tietz Textbook of Clinical Chemistry, 3rd ed AACC 1999.
Temprature constante: . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25C / 30C / 37C 6. Tietz N W et al. Clinical Guide to Laboratory Tests, 3rd ed AACC 1995.
2. Rgler linstrument zro dans leau distille ou air.
3. Pipette dans une cuvette:
PRSENTATION
RT (mL) 1,2
R1: 1 x 60 ml
chantillon ( L) 20 Rf : 41240 R2: 1 x 15 ml
4. Mlanger et incuber pendant 1 minute.
5. Lire l'absorbance (A) initiale de l'chantillon, mettre en marche le chronomtre R1: 1 x 240 ml
Rf : 41242 Cont.
et lire l'absorbance chaque minute pendant 3 minutes. R2: 1 x 60 ml
6. Calculer la moyenne de la diffrence d'absorbance par minute ( A/min). R1: 1 x 480 ml
Rf : 41243
R2: 1 x 120 ml
CALCULS
A/min x 3300 = U/L de FAL
Units : L'unit internationale (UI) est la quantit d'enzyme qui convertit 1 mol de
substrat par minute, en conditions standard. La concentration est exprime en units
par litre (U/l).
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ALP-LQ
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TOTAL PROTEIN
Protenas Totales
Biuret. Colorimtrico
Determinacin cuantitativa de protenas totales 4. Mezclar e incubar 5 minutos a 37C o 10 minutos a T ambiente.
IVD 5. Leer la absorbancia (A) del Patrn y la muestra, frente al Blanco de
reactivo. El color es estable como mnimo 30 minutos.
Conservar a 2-8C
CLCULOS
PRINCIPIO DEL MTODO
En medio alcalino, las protenas dan un intenso color violeta azulado (A) Muestra - (A) Blanco
x 7 (Conc. Patrn) = g/dL de protenas totales
en presencia de sales de cobre; contiene yoduro como antioxidante. (A) Patrn - (A) Blanco
La intensidad del color formado es proporcional a la concentracin de
1,4
protena total en la muestra ensayada . CONTROL DE CALIDAD
Es conveniente analizar junto con las muestras sueros control valorados:
SIGNIFICADO CLNICO SPINTROL H Normal y Patolgico (Ref. 1002120 y 1002210).
Las protenas son compuestos orgnicos macromoleculares, Si los valores hallados se encuentran fuera del rango de tolerancia, revisar
ampliamente distribuidos en el organismo. Actan como elementos el instrumento, los reactivos y el calibrador.
estructurales y de transporte. Se dividen en dos fracciones, albmina Cada laboratorio debe disponer su propio Control de Calidad y establecer
y globulinas. correcciones en el caso de que los controles no cumplan con las
Su determinacin es til en la deteccin de: tolerancias.
- Hiperproteinemia producida por hemoconcentracin, deshidra-
tacin o aumento en la concentracin de protenas especificas. VALORES DE REFERENCIA1
-Hipoproteinemia por hemodilucin debida a un defecto en la sntesis Adultos: 6,6 8,3 g/dL
proteica, perdidas excesivas (hemorragias) o catabolismo proteico
4,5 Recin nacidos: 5,2 9,1 g/dL
excesivo .
Estos valores son orientativos. Es recomendable que cada laboratorio
El diagnstico clnico debe realizarse teniendo en cuenta todos los establezca sus propios valores de referencia.
datos clnicos y de laboratorio.
caducidad indicada en la etiqueta, cuando se mantienen los frascos Se han descrito varias drogas y otras substancias que interfieren en la
bien cerrados a 2-8C, protegidos de la luz y se evita su 2,3
determinacin de las proteinas .
contaminacin.
No usar reactivos fuera de la fecha indicada. NOTAS
Indicadores de deterioro de los reactivos: 1. T PROTEIN CAL: Debido a la naturaleza del producto, es aconsejable
- Presencia de partculas y turbidez. tratarlo con sumo cuidado ya que se puede contaminar con facilidad.
- Absorbancia (A) del blanco a 540 nm 0,22. 2. La calibracin con el Patrn acuoso puede dar lugar a errores
sistemticos en mtodos automticos. En este caso, se recomienda
MATERIAL ADICIONAL utilizar calibradores sricos.
- Espectrofotmetro analizador para lecturas a 540 nm. 3. Usar puntas de pipeta desechables limpias para su dispensacin.
- Cubetas de 1,0 cm de paso de luz. 4. SPINREACT dispone de instrucciones detalladas para la aplicacin
- Equipamiento habitual de laboratorio. de este reactivo en distintos analizadores.
MUESTRAS BIBLIOGRAFA
1
Suero o plasma heparinizado . 1. Koller A. Total serum protein. Kaplan A et al. Clin Chem The C.V.
Estabilidad de la muestra: 1 mes en nevera a (2-8C). Mosby Co. St Louis. Toronto. Princeton 1984; 1316-1324 and 418.
2. Young DS. Effects of drugs on Clinical Lab. Tests, 4th ed AACC Press,
PROCEDIMIENTO 1995.
1. Condiciones del ensayo: 3. Young DS. Effects of disease on Clinical Lab. Tests, 4th ed AACC
Longitud de onda: . . . . . . . . . . . . . . . . . . . . . 540 (530-550) nm 2001.
Cubeta: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 cm paso de luz 4. Burtis A et al. Tietz Textbook of Clinical Chemistry, 3rd ed AACC 1999.
Temperatura: . . . . . . . . . . . . . . . . . . . . . . . . . . 37C / 15-25C 5. Tietz N W et al. Clinical Guide to Laboratory Tests, 3rd ed AACC 1995.
2. Ajustar el espectrofotmetro a cero frente a agua destilada.
3. Pipetear en una cubeta (Nota 3): PRESENTACIN
Blanco Patrn Muestra Ref: 1001290 R: 2 x 50 mL, CAL: 1 x 2 mL
R (mL) 1,0 1,0 1,0 Ref: 1001291 Cont. R: 2 x 250 mL, CAL: 1 x 5 mL
Patrn (Nota 1, 2) (L) -- 25 -- Ref: 1001292 R: 1 x 1000 mL, CAL: 1 x 5 mL
Muestra (L) -- -- 25
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TOTAL PROTEIN
Total protein
Biuret. Colorimetric
Quantitative determination of total protein 4. Mix and incubate 5 min at 37C or 10 min at room temperature.
IVD 5. Read the absorbance (A) of the samples and Standard, against the
Blank. The colour is stable for at least 30 minutes.
Store at 2-8C
CALCULATIONS
PRINCIPLE OF THE METHOD (A) Sample - (A) Blank
x 7 (Standard conc.) = g/dL of total protein in the sample
Proteins give an intensive violet-blue complex with copper salts in an (A) Standard - (A) Blank
alkaline medium. Iodide is included as an antioxidant.
The intensity of the color formed is proportional to the total protein QUALITY CONTROL
1,4
concentration in the sample . Control sera are recommended to monitor the performance of assay
procedures: SPINTROL H Normal and Pathologic (Ref. 1002120 and
CLINICAL SIGNIFICANCE 1002210).
The proteins are macromolecular organic compounds, widely If control values are found outside the defined range, check the instrument,
distributed in the organism. They act like structural and transport reagents and calibrator for problems.
elements. The proteins of the serum are divide in two fractions, Each laboratory should establish its own Quality Control scheme and
albumin and globulins corrective actions if controls do not meet the acceptable tolerances.
The determination of total proteins is useful in the detection of:
- High protein levels caused by hemoconcentration like in the REFERENCE VALUES1
dehydrations or increase in the concentration of specific proteins. Adults: 6,6 8,3 g/dL
- Low protein level caused by hemodilution by an impared synthesis Newborn: 5,2 9,1 g/dL
4,5
or loss (as by hemorrhage) or excessive protein catabolism . These values are for orientation purpose; each laboratory should establish
Clinical diagnosis should not be made on a single test result; it should its own reference range.
integrate clinical and other laboratory data.
PERFORMANCE CHARACTERISTICS
REAGENTS
Measuring range: From detection limit of 0,007 g/dL to linearity limit of 14
Sodium potassium tartrate 15 mmol/L g/dL.
R Sodium iodide 100 mmol/L If the results obtained were greater than linearity limit, dilute the sample 1/2
Potassium iodide 5 mmol/L with NaCI 9 g/L and multiply the reslut by 2.
Biuret Precision:
Copper (II) sulphate 5 mmol/L
Sodium hydroxide 1000 mmol/L Intra-assay (n=20) Inter-assay (n=20)
Mean (g/dL) 6,53 4,89 6,77 5,08
T PROTEIN CAL Bovine albumin primary standard 7 g/dL SD 0,01 0,01 0,07 0,05
CV (%) 0,21 0,24 1,05 0,94
PRECAUTIONS Sensitivity: 1 g/dL = 0,0825 A.
R: H314-Causes severe skin burns and eye damage. H412-Harmful to Accuracy: Results obtained using SPINREACT reagents (y) did not show
aquatic life with long lasting effects. systematic differences when compared with other commercial reagents (x).
Follow the precautionary statements given in MSDS and label of the The results obtained using 50 samples were the following:
product. 2
Correlation coefficient (r) : 0,97002
Regression equation y= 0,954x +0,511.
PREPARATION The results of the performance characteristics depend on the analyzer used.
The reagents are ready to use.
INTERFERENCES
1,4
STORAGE AND STABILITY Hemoglobin and lipemia .
All the components of the kit are stable until the expiration date on the A list of drugs and other interfering substances with total protein
2,3
label when stored tightly closed at 2-8C protected from light and determination has been reported .
contaminations prevented during their use.
Do not use reagents over the expiration date. NOTES
Signs of reagent deterioration: 1. T PROTEIN CAL: Proceed carefully with this product because due its
- Presence of particles and turbidity. nature it can get contamined easily.
- Blank absorbance (A) at 540 nm 0,22. 2. Calibration with the aqueous standard may cause a systematic error in
automatic procedures. In these cases, it is recommended to use a
ADDITIONAL EQUIPMENT serum Calibrator.
- Spectrophotometer or colorimeter measuring at 540 nm. 3. Use clean disposable pipette tips for its dispensation.
- Matched cuvettes 1,0 cm light path. 4. SPINREACT has instruction sheets for several automatic
- General laboratory equipment. analyzers. Instructions for many of them are available on request.
SAMPLES BIBLIOGRAPHY
Serum or heparinized plasma :
1
1. Koller A. Total serum protein. Kaplan A et al. Clin Chem The C.V.
Stability of the sample: 1 month at refrigerator (2-8C). Mosby Co. St Louis. Toronto. Princeton 1984; 1316-1324 and 418.
2. Young DS. Effects of drugs on Clinical Lab. Tests, 4th ed AACC Press,
PROCEDURE 1995.
1. Assay conditions: 3. Young DS. Effects of disease on Clinical Lab. Tests, 4th ed AACC
Wavelength: . . . . . . . . . . . . . . . . . . . . . . . . . 540 (530-550) nm 2001.
Cuvette: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 cm. light path 4. Burtis A et al. Tietz Textbook of Clinical Chemistry, 3rd ed AACC 1999.
Temperature: . . . . . . . . . . . . . . . . . . . . . . . . . . 37C / 15-25C 5. Tietz N W et al. Clinical Guide to Laboratory Tests, 3rd ed AACC 1995.
2. Adjust the instrument to zero with distilled water.
3. Pipette into a cuvette (Note 3): PACKAGING
Blank Standard Sample Ref: 1001290 R: 2 x 50 mL, CAL: 1 x 2 mL
Ref: 1001291 Cont. R: 2 x 250 mL, CAL: 1 x 5 mL
R (mL) 1,0 1,0 1,0
Ref: 1001292 R: 1 x 1000 mL, CAL: 1 x 5 mL
Standard (Note 1, 2) (L) -- 25 --
Sample (L) -- -- 25
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TOTAL PROTEIN
Protines totales
Biuret. Colorimtrique
Dtermination quantitative de protines totales 5. Lire labsorbation (A) du patron et lchantillon, en comparaison avec le
IVD blanc du ractif. La couleur reste stable pendant au moins 30 minutes.
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TOTAL PROTEIN
Protenas Totais
Biuret. Colorimtrico
Determinao quantitativa de protenas totais 5. Ler a absorvncia (A) do Padro e da amostra, frente ao Branco de
IVD reagente. A colorao estvel como mnimo 30 minutos.
Conservar a 2-8C
CLCULOS
PRINCPIO DO MTODO (A) Amostra - (A) Branco
x 7 (Conc. Padro) = g/dL de protenas totais
Em meio alcalino, as protenas do uma colorao violeta azulada (A) Padro - (A) Branco
intensa, na presena de sais de cobre; contm iodeto como
antioxidante. CONTROLO DE QUALIDADE
A intensidade da colorao formada proporcional da conveniente analisar juntamente com as amostras, os soros controlo
1,4
concentrao de protena total na amostra testada . valorizados: SPINTROL H Normal e Patolgico (Ref. 1002120 e 1002210).
Se os valores determinados estiverem fora do intervalo de tolerncia,
SIGNIFICADO CLNICO
verificar o equipamento, os reagentes e o calibrador.
As protenas so compostos orgnicos macromoleculares,
Cada laboratrio deve dispor do seu prprio Controlo de Qualidade e
amplamente distribudos no organismo. Actuam como elementos
estabelecer correces caso os controles no cumpram com as tolerncias.
estruturais e de transporte. Dividem-se em duas fraces, albumina e
globulinas. 1
A sua determinao til na deteco de: VALORES DE REFERNCIA
- Hiperproteinmia produzida por hemoconcentrao, desidratao ou Adultos: 6,6 8,3 g/dL
aumento na concentrao de protenas especificas. Recm- nascidos: 5,2 9,1 g/dL
-Hipoproteinmia por hemodiluio devida a um defeito na sntese Estes valores so orientativos. recomendvel que cada laboratrio
proteica, perdas excessivas (hemorragias) ou catabolismo proteico estabelea os seus prprios valores de referncia.
4,5
excessivo .
O diagnstico clnico deve realizar-se tendo em conta todos os dados CARACTERISTICAS DO METODO
clnicos e de laboratrio. Intervalo de medida: Desde o limite de deteco de 0,007 g/dL at ao limite
de linearidade de 14 g/dL.
REAGENTES Se a concentrao for superior ao limite de linearidade, diluir a amostra 1/2
Potassio sdio tartarato 15 mmol/L com CINa 9 g/L e multiplicar o resultado final por 2.
R Iodeto sdico 100 mmol/L Preciso:
Biuret Iodeto de potssio 5 mmol/L Intrasrie (n=20) Intersrie (n=20)
Sulfato de cobre (II) 5 mmol/L Mdia (g/dL) 6,53 4,89 6,77 5,08
Hidrxido de sdio 1000 mmol/L SD 0,01 0,01 0,07 0,05
T PROTEIN CAL Padro primrio de Albumina Bovina 7 g/dL CV (%) 0,21 0,24 1,05 0,94
Sensibilidade analitica: 1 g/dL = 0,0825 A.
PRECAUO Exactitude: Os reagentes SPINREACT (Y) no mostram diferenas
R: H314-Provoca queimaduras na pele e leses oculares graves. sistematicas significativas quando comparados com outros reagentes
H412-Nocivo para os organismos aquticos, com efeitos duradouros. comerciais (x).
Seguir os conselhos de prudncia dados em SDS e etiqueta. Os resultados obtidos com 50 amostras foram os seguintes:
Coeficiente de correlao (r)2: 0,97002.
PREPARAO Equao da recta de regresso: y=0,954x+0,511.
Os reagentes esto prontos a ser utilizados. As caracteristicas do metodo podem variar segundo o equipamento
utilizado.
CONSERVAO E ESTABILIDADE
Todos os componentes do kit so estveis, at ao final do prazo de INTERFERNCIAS:
1,4
validade indicado no rtulo, quando mantidos nos frascos bem Hemoglobina e lipmia .
fechados, a 2-8C, protegidos da luz e evitando a sua contaminao. Uma listagem de vrios frmacos e outras substncias que interferem com
2,3
No usar reagentes fora de prazo. a determinao das proteinas encontra-se descrita .
Indicadores de deteriorao dos reagentes:
- Presena de partculas e turvao. NOTAS
- Absorvncia (A) do branco a 540 nm 0,22. 1. T PROTEIN CAL: Devido naturaza do produto, aconselhvel manuse-lo
com extremo cuidado j que se pode contaminar com muita facilidade.
MATERIAL ADICIONAL 2. A calibrao com o Padro aquoso pode dar lugar a erros sistemticos
- Espectrofotmetro ou equipamento para leituras a 540 nm. em mtodos automticos. Neste caso, recomenda-se a utilizao de
- Cuvetes de 1,0 cm de passo de luz. calibradores sricos.
- Equipamento habitual de laboratrio. 3. Usar pontas de pipetas descartveis e limpas para a sua dispensao.
4. SPINREACT dispe de instrues detalhadas para a aplicao deste
AMOSTRAS reagente em diferentes equipamentos.
1
Soro ou plasma heparinizado .
Estabilidade da amostra: 1 ms no frigorfico (2-8C).
BIBLIOGRAFIA
PROCEDIMENTO 1. Koller A. Total serum protein. Kaplan A et al. Clin Chem The C.V. Mosby
Co. St Louis. Toronto. Princeton 1984; 1316-1324 and 418.
1. Condies do ensaio:
2. Young DS. Effects of drugs on Clinical Lab. Tests, 4th ed AACC Press,
Comprimento de onda: . . . . . . . . . . . . . . . . . . . 540 (530-550) nm
1995.
Cuvete: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 cm passo de luz 3. Young DS. Effects of disease on Clinical Lab. Tests, 4th ed AACC 2001.
Temperatura: . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37C / 15-25C 4. Burtis A et al. Tietz Textbook of Clinical Chemistry, 3rd ed AACC 1999.
2. Ajustar o espectrofotmetro a zero frente a agua destilada. 5. Tietz N W et al. Clinical Guide to Laboratory Tests, 3rd ed AACC 1995.
3. Pipetar para uma cuvete (Nota 3):
Branco Padro Amostra APRESENTAO
R (mL) 1,0 1,0 1,0 Ref: 1001290 R: 2 x 50 mL, CAL: 1 x 2 mL
Padro (Nota 1, 2) (L) -- 25 -- Ref: 1001291 Cont. R: 2 x 250 mL, CAL: 1 x 5 mL
Amostra (L) -- -- 25 Ref: 1001292 R: 1 x 1000 mL, CAL: 1 x 5 mL
4. Agitar e incubar 5 minutos a 37C ou 10 minutos temperatura
ambiente.
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CREATININE TRINDER
Creatinine-TR
Enzymatic
Quantitative determination of creatinine 8. Read the absorbance (A2) of the standard and the samples, at 545nm
IVD against the blank.
Store at 2-8C
CALCULATIONS
PRINCIPLE OF THE METHOD A Sample x k - ABlank x k
Creatinine= xC = mg/dL of Creatinine in the sample
In the first reaction, creatinase and sarcosine oxidase were used in the A Standard x k - ABlank x k
enzymatic hydrolysis of endogenous creatine to produce hydrogen K= 0,754= 460 L/610 L
peroxide, that is eliminated by catalase. In the second reaction, the catalase C= Concentration of the standard
is inhibitred by sodium azide, and creatinase and 4- aminoantipyrine (4-AA) A= A2 - A1
were added, and only the creatine generated from creatinine by creatininase
was hydrolyzed sequentially by creatinase and sarcosine oxidase to QUALITY CONTROL
produce hydrogen peroxide. This newly-formed hydrogen peroxide was Control sera are recommended to monitor the performance of assay procedures:
measured in a coupled reaction catalyzed by peroxidase, with N-ethyl-n- SPINTROL H Normal and Pathologic (Ref. 1002120 y 1002210).
sulphopropyl-mtoluidine (TOPS)/4-AA as a chromogen. If control values are found outside the defined range, check the instrument,
reagents and calibrator for problems.
CLINICAL SIGNIFICANCE Each laboratory should establish its own Quality Control scheme and corrective
Creatinine is the result of the degradation of the creatine, component of actions if controls do not meet the acceptable tolerances.
muscles, it can be transformed into ATP, that is a source of high energy for
the cells. The creatinine production depends on the modification of the REFERENCE VALUES1
muscular mass, and it varies little and the levels usually are very stable. Serum or plasma:
Is excreted by the kidneys. With progressive renal insufficiency there is Men 0,9 - 1,3 mg/dL
retention in blood of urea, creatinine and uric acid. Women 0,6 - 1,1 mg/dL
Elevate creatinine level may be indicative of renal insufficiency2. Urine:
Clinical diagnosis should not be made on a single test result; it should Men 14 - 26 mg/Kg/24 h
integrate clinical and other laboratory data. Women 11 -20 mg/Kg/24 h
These values are for orientation purpose; each laboratory should establish its own
REAGENTS reference range.
R1 MOPS 25 mmol/L, TOPS 0,5 mmol/L, Creatinase
10 KU/L, Sarcosine Oxidase 5 KU/L Catalase 3 PERFORMANCE CHARACTERISTICS
KU/L, EDTA 1mmol/L, pH 7,5. Measuring range: From detection limit of 0,00 mg/dL to linearity limit of 180
mg/dL.
R2 MOPS 90 mmol/L, Creatininase 30 KU/L, If the results obtained were greater than linearity limit, dilute the sample 1/2 with
peroxidase KU/L, pH 7,5. Azida sdica 0,5 g/L. NaCl 9 g/L and multiply the result by 2.
Precision:
CREATININE CAL Creatinine aqueous primary standard 2 mg/dL.
Intra-assay (n=20) Inter-assay (n=20)
Mean (mg/dL) 0,87 3,82 0,87 3,75
PRECAUTIONS SD 0,01 0,06 0,02 0,06
CAL: H290-May be corrosive to metals. CV (%) 1,63 1,44 2,31 1,72
Follow the precautionary statements given in MSDS and label of the
Sensitivity: 1 mg/dL = 0,0226 (A)
product.
Accuracy: Results obtained using SPINREACT these reagents did not show
PREPARATION systematic differences when compared with other commercial reagents or with
HPLC method.
R1 and R2 are ready to use.
The results obtained using 50 samples were the following:
Correlation coefficient (r)2: 0,9730
STORAGE AND STABILITY
Regression equation: y= 1,066x - 0,020.
All the components of the kit are stable until the expiration date on the label
The results of the performance characteristics depend on the analyzer used.
when stored tightly closed at 2-8C, protected from light and contaminations
prevented during their use.
INTERFERENCES
R1 and R2 are stable 8 weeks after opening bottle.
No interferences were observed with haemoglobin until 5 g/dL, bilirubin 40 mg/dL.
ADDITIONAL EQUIPMENT Other drugs and substances may interfere3,4.
- Spectrophotometer o photometer measuring at 54520 nm
- Cell holder thermostable at 37C NOTES
- General laboratory equipment. 1. CREATININE CAL: Proceed carefully with this product because due its
nature it can get contamined easily.
SAMPLES 2. Calibration with the aqueous Standard may cause a systematic error in
- Serum or plasma1. automatic procedures. In these cases, it is recommended to use a serum
- Urine (24 h)1: Dilute fresh urine 1/50 with disitlled water. Calibrator.
Multiply the result by 50 (sample dilution factor). 3. Use clean disposable pipette tips for its dispensation.
Creatinine is stable 1 day at 2-8C. 4. SPINREACT has instruction sheets for several automatic analyzers.
PROCEDURE BIBLIOGRAPHY
1. Assay conditions: 1. Fossati et al. Clin Chem 1983;29:1494-1496.
Wavelength: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 545 nm (525-565) 2. Tietz Textbook of Clinical Chemistry, 3rd edition. Burtis CA, Ashwood ER.
Cuvette: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 cm light path WB Saunders Co.,1999.
Temperature: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37C (0,1C) 3. Young DS. Effects of drugs on Clinical Lab. Tests, 4th ed AACC Press, 1995.
2. Adjust the instrument to zero with distilled water. 4. Young DS. Effects of disease on Clinical Lab. Tests, 4th ed AACC 2001.
3. Pipette into a cuvette (Note 3):
Blank Standard (Note 1,2) Sample PACKAGING
R1 (L) 450 450 450 Ref.: 1001115 R1: 1 x 30 mL, R2:1 x 10 mL, CAL: 1 x 5 mL
Cont.
Sample (L) 10 10 10 Ref.: 1001117 R1: 1 x 240 mL, R2:1 x 80 mL, CAL: 1 x 5 mL
4. Mix and incubate 5 minutes.
5. Read the absorbance (A1) of the standard and the samples, at
545nm against the blank.
6. Add:
Blank Standard Sample
R2 (L) 150 150 150
7. Mix and incubate 5 minutes.
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CREATININE TRINDER
Creatinina-TR
Enzimtico
Determinacin cuantitativa de creatinina 8. Leer la absorbancia (A2) a 545nm, del patrn y de las muestras frente al
IVD blanco.
Conservar a 2-8C CLCULOS
A Muestra x k - ABlancox k
PRINCIPIO DEL MTODO Creatinina= xC = mg/dL de Creatinina en la muestra
En la primera reaccin, se usa creatinasa y sarcosina oxidasa en la A Patrn x k - ABlancox k
hidrlisis enzimtica de la creatina endgena para producir perxido de K= 0,754= 460 L/610 L
hidrgeno, el cual es eliminado por catalasa. En la segunda reaccin, la C= Concentracin del patrn
catalasa es inhibida por la azida sdica, se aaden creatininasa y 4- A= A2 - A1
aminoantipirina (4-AA), y nicamente la creatina generada a partir de la CONTROL DE CALIDAD
creatinina por la creatininasa se hidroliza secuencialmente por la creatinasa Es conveniente analizar junto con las muestras sueros control valorados:
y sarcosina oxidasa, para producir perxido de hidrgeno. Este nuevo SPINTROL H Normal y Patolgico (Ref. 1002120 y 1002210).
perxido de hidrgeno formado se mide en una reaccin acoplada Si los valores hallados se encuentran fuera del rango de tolerancia, revisar el
catalizada por la peroxidasa, con N-etil-n-sulfopropil-mtoluidina (TOPS)/4- instrumento, los reactivos y el calibrador.
AA como cromgeno. Cada laboratorio debe disponer su propio Control de Calidad y establecer
SIGNIFICADO CLNICO correcciones en el caso de que los controles no cumplan con las tolerancias.
La creatinina es el resultado de la degradacin de la creatina, componente VALORES DE REFERENCIA1
de los msculos y puede ser transformada en ATP, fuente de energa para Suero o plasma:
las clulas. Hombres 0,9 - 1,3 mg/dL
La produccin de creatinina depende de la modificacin de la masa Mujeres 0,6 - 1,1 mg/dL
muscular. Vara poco y los niveles suelen ser muy estables. Orina:
Se elimina a travs del rin. En una insuficiencia renal progresiva hay una Hombres 14 - 26 mg/Kg/24 h
retencin en sangre de urea, creatinina y cido rico. Mujeres 11 -20 mg/Kg/24 h
Niveles altos de creatinina son indicativos de patologa renal2. Estos valores son orientativos. Es recomendable que cada laboratorio establezca
El diagnstico clnico debe realizarse teniendo en cuenta todos los datos sus propios valores de referencia.
clnicos y de laboratorio.
CARACTERSTICAS DEL MTODO
REACTIVOS Rango de medida: Desde el lmite de deteccin de 0,00 mg/dL hasta el lmite de
R1 MOPS 25 mmol/L, TOPS 0,5 mmol/L, linealidad de 180 mg/dL.
Creatinasa 10 KU/L, Sarcosina Oxidasa 5 KU/L Si la concentracin es superior al lmite de linealidad, diluir la muestra 1/2 con
Catalasa 3 KU/L, EDTA 1mmol/L, pH 7,5. ClNa 9 g/L y multiplicar el resultado final por 2.
R2 MOPS 90 mmol/L, Creatinasa 30 KU/L, Precisin:
peroxidasa KU/L, pH 7,5. Azida sdica 0,5 g/L. Intraserie (n=20) Interserie (n=20)
Media (mg/dL) 0,87 3,82 0,87 3,75
CREATININE CAL Patrn primario acuoso de Creatinina 2 mg/dL. SD 0,01 0,06 0,02 0,06
CV (%) 1,63 1,44 2,31 1,72
PRECAUCIONES
CAL: H290-Puede ser corrosivo para los metales. Sensibilidad analtica: 1 mg/dL = 0,0226 (A)
Seguir los consejos de prudencia indicados en la FDS y etiqueta del Exactitud: Los reactivos de SPINREACT (y) no muestran diferencias sistemticas
producto. significativas cuando se comparan con otros reactivos comerciales (x) o con el
mtodo HPLC.
PREPARACIN Los resultados obtenidos con 50 muestras fueron los siguientes:
R1 y R2 estn listos para su uso. Coeficiente de correlacin (r)2: 0,9730.
Ecuacin de la recta de regresin: y= 1,066x - 0,020.
CONSERVACIN Y ESTABILIDAD Las caractersticas del mtodo pueden variar segn el analizador utilizado.
Todos los componentes del kit son estables, hasta la fecha de caducidad
indicada en la etiqueta, cuando se mantienen los frascos bien cerrados a 2- INTERFERENCIAS
8C, protegidos de la luz y se evita su contaminacin. No usar reactivos No se observan interferencias con Hemoglobina hasta 5g/L, bilirrubina 40 mg/dL.
fuera de la fecha indicada. Se han descrito varias drogas y otras substancias que interfieren en la
R1 y R2 son estables durante 8 semanas despus de la apertura del bote. determinacin de la creatinina3,4.
MATERIAL ADICIONAL NOTAS
- Espectrofotmetro o fotmetro para lecturas a 54520 nm 1. CREATININE CAL: Debido a la naturaleza del producto, es aconsejable
- Cubeta termostatizada a 37C tratarlo con sumo cuidado ya que se puede contaminar con facilidad.
- Equipamiento habitual de laboratorio. 2. La calibracin con el Patrn acuoso puede dar lugar a errores sistemticos en
MUESTRAS mtodos automticos. En este caso, se recomienda utilizar calibradores
- Suero o plasma heparinizado1. sricos.
- Orina (24 h) 1: Diluir la muestra al 1/50 con agua destilada. Multiplicar el 3. Usar puntas de pipeta desechables limpias para su dispensacin.
resultado por 50 (factor de dilucin de la muestra). 4. SPINREACT dispone de instrucciones detalladas para la aplicacin de
Estabilidad de la creatinina: al menos 24 horas a 2-8C. este reactivo en distintos analizadores.
PROCEDIMIENTO BIBLIOGRAFA
1. Condiciones del ensayo: 1. Fossati et al. Clin Chem 1983;29:1494-1496.
Longitud de onda: . . . . . . . . . . . . . . . . . . . . . . . . . . . 545 nm (525-565) 2. Tietz Textbook of Clinical Chemistry, 3rd edition. Burtis CA, Ashwood ER.
Cubeta: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 cm paso de luz WB Saunders Co.,1999.
Temperatura: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37C (0,1C) 3. Young DS. Effects of drugs on Clinical Lab. Tests, 4th ed AACC Press, 1995.
2. Ajustar el espectrofotmetro a cero frente a agua destilada. 4. Young DS. Effects of disease on Clinical Lab. Tests, 4th ed AACC 2001.
3. Pipetear en una cubeta (Nota 3):
Blanco Patrn (Nota 1,2) Muestra
PRESENTACIN
R1 (L) 450 450 450
Ref.: 1001115 R1: 1 x 30 mL, R2:1 x 10 mL, CAL: 1 x 5 mL
Muestra (L) 10 10 10 Cont.
Ref.: 1001117 R1: 1 x 240 mL, R2:1 x 80 mL, CAL: 1 x 5 mL
4. Mezclar e incubar durante 5 minutos.
5. Leer la absorbancia (A1) a 545nm, del patrn y de las muestras
frente al blanco.
6. Aadir:
Blanco Patrn Muestra
R2 (L) 150 150 150
7. Mezclar e incubar durante 5 minutos.
BSIS77-E 13/05/16 SPINREACT, S.A./S.A.U Ctra.Santa Coloma, 7 E-17176 SANT ESTEVE DE BAS (GI) SPAIN
Tel. +34 972 69 08 00 Fax +34 972 69 00 99. e-mail: spinreact@spinreact.com
CREATININE TRINDER
Cratinine-TR
Enzymatique
Dtermination quantitative de cratinine 8. Lire labsorption (A2) 545nm, du patron et des chantillons par rapport au
IVD blanc.
Conserver 2 - 8C. CALCULS
A Muestra x k - ABlanco x k
PRINCIPE DE LA MTHODE xC
A Patrn x k - ABlanco x k
Dans la premire raction, nous utilisons de la cratinase oxydase dans Cratinine= = mg/dL de Cratinine dans lchantillon
l'hydrolyse enzymatique de la cratine endogne pour produire du peroxyde K= 0,754= 460L/610L
dhydrogne, qui est limin par catalase. Dans la seconde raction, la C = Concentration du patron
catalase est inhibe par lazoture de sodium, on ajoute de la cratinase et A= A2 - A1
4-aminoantipyrine (4-AA), et seulement la cratine gnre partir de la
CONTRLE DE QUALIT
cratinine par la cratinase on hydrolyse squentiellement par la cratinase
Il convient danalyser avec les chantillons de srums de contrle valus :
y sarcosine oxydase, pour produire du peroxyde dhydrogne. Ce nouveau
SPINTROL H Normal et pathologique (Rf. 1002120 et 1002210).
peroxyde dhydrogne form est mesur dans une raction accouple
Si les valeurs trouves sont en dehors de la gamme de tolrance, il faut vrifier
catalyse par la peroxydase, avec N-thyle-n-sulfopropyle-m-toluidine
linstrument, les ractifs et le calibreur.
(TOPS)/4-AA comme chromogne.
Chaque laboratoire doit disposer de son propre Contrle de qualit et tablir des
SIGNIFICATION CLINIQUE corrections dans le cas o les contrles ne sont pas conformes aux tolrances
La cratinine est le rsultat de la dgradation de la cratine, composant des exiges.
muscles et elle peut tre transforme en ATP source dnergie pour les
VALEURS DE RFRENCE1
cellules.
Srum ou plasma :
La production de cratinine dpend de la modification de la masse
Hommes 0,9 - 1,3 mg/dL
musculaire. Elle varie peu et les niveaux sont gnralement trs stables.
Femmes 0,6 - 1,1 mg/dL
Elle slimine par les reins. Dans une insuffisance rnale progressive il y a
Urine :
une rtention dure, de cratinine et dacide urique dans le sang.
Hommes 14 - 26 mg/Kg/24 h
Des niveaux levs de cratinine sont indicatifs de pathologie rnale2.
Femmes 11 -20 mg/Kg/24 h
Le diagnostic clinique doit tre ralis en prenant en compte toutes les
Ces valeurs sont indicatives. Il est conseill que chaque laboratoire tablisse ses
donnes cliniques et de laboratoire.
propres valeurs de rfrence.
RACTIFS
CARACTRISTIQUES DE LA MTHODE
R1 MOPS 25 mmol/L, TOPS 0,5 mmol/L, Gamme de mesure : depuis la limite de dtection de 0,00mg/dL jusqu la limite
Cratinase 10 KU/L, Sarcosine Oxydase 5 KU/L de linarit de 180 mg/dL.
Catalase 3 KU/L, EDTA 1mmol/L, pH7,5. Si la concentration de lchantillon est suprieure la limite de linarit, diluer
R2 MOPS 90 mmol/L, Cratinase 30 KU/L, lchantillon 1/2 avec ClNa 9 g/L et multiplier le rsultat final par 2.
Peroxydase KU/L, pH 7,5. Azoture de sodium 0,5 Prcision :
g/L. Intra-srie (n= 20) Inter-srie (n= 20)
CRATININE CAL Patron primaire aqueux de Cratinine 2 mg/dL. Moyenne (mgl/L) 0,87 3,82 0,87 3,75
SD 0,01 0,06 0,02 0,06
PRCAUTIONS CV (%) 1,63 1,44 2,31 1,72
CAL : H290-Peut tre corrosif pour les mtaux.
Suivre les conseils de prudence indiqus sur la FDS et sur ltiquette du Sensibilit analytique : 1 mg/dL = 0,0226 (A)
produit. Prcision : Les ractifs SPINREACT (y) ne montrent pas de diffrences
systmatiques significatives quand ils sont compars dautres ractifs
PRPARATION commerciaux (x) ou avec la mthode HPLC.
R1 et R2 sont prts tre utiliss. Les rsultats obtenus avec 50 chantillons ont t les suivants :
Coefficient de corrlation (r)2 : 0,9730.
CONSERVATION ET STABILIT quation de la droite de rgression : y = 1,066x 0,020
Tous les composants du kit sont stables jusqu la date dexpiration indique Les caractristiques de la mthode peuvent varier selon lanalyseur utilis.
sur ltiquette, quand les flacons sont gards bien ferms 2-8C, labri
de la lumire et que leur contamination est vite. Ne pas utiliser des INTERFERENCES
ractifs au-del de la date indique. Aucune interfrence nest observe avec lhmoglobine jusqu 5g/L, bilirubine 40
R1 et R2 sont stables pendant 8 semaines aprs louverture du flacon. mg/dL.
MATRIEL SUPPLMENTAIRE Plusieurs mdicaments ont t dcrits ainsi que dautres substances qui
- Spectrophotomtre ou photomtre pour lectures 54520 nm interfrent dans la dtermination de la cratinine3,4.
- Cuve thermostatise 37C REMARQUES
- quipement habituel de laboratoire. 1. CRATININE CAL : En raison de la nature du produit, il est conseill de le
CHANTILLONS traiter avec beaucoup de prcaution car il peut tre facilement contamin.
- Srum ou plasma hparin1. 2. Ltalonnage avec le patron aqueux peut entraner des erreurs systmatiques
- Urine (24 h) 1: Diluer lchantillon 1/50 avec de leau distille. Multiplier dans des mthodes automatiques. Dans ce cas, il est conseill dutiliser des
le rsultat par 50 (facteur de dilution de lchantillon). calibreurs sriques.
Stabilit de la cratinine : au moins 24 heures 2-8C 3. Utiliser des embouts de pipette jetables propres pour leur diffusion.
4. SPINREACT dispose dinstructions dtailles pour lapplication de ce
PROCDURE ractif dans diffrents analyseurs.
1. Conditions de lessai :
Longueur donde : . . . . . . . . . . . . . . . . . . . . . . . . . . .545nm (525-565) BIBLIOGRAPHIE
Cuve : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 cm passage de lumire 1. Fossati et al. Clin Chem 1983;29:1494-1496.
Temprature : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 37C(0,1C) 2. Tietz Text book of Clinical Chemistry, 3rd edition. Burtis CA, Ashwood ER.
2. Rgler le spectrophotomtre zro par rapport leau distille. WB Saunders Co.,1999.
3. Introduire la pipette dans une cuve(Note 3): 3. Young DS. Effects of drugs on Clinical Lab. Tests, 4th ed AACC Press, 1995.
Blanc Patron (Note 1,2) chantillon 4. Young DS. Effects of disease on Clinical Lab. Tests, 4th ed AACC 2001.
R1 (L) 450 450 450
PRSENTATION
chantillon (L) 10 10 10
4. Mlanger et incuber pendant 5 minutes. Rf : 1001115 Cont. R1 : 1 x30 mL, R2:1 x 10 mL, CAL : 1 x 5 mL
5. Lire labsorption (A1) 545nm, du patron et des chantillons par Rf : 1001117 R1 : 1 x240 mL, R2:1 x 80 mL, CAL : 1 x 5 mL
rapport au blanc.
6. Ajouter :
Blanc Patron chantillon
R2 (L) 150 150 150
7. Mlanger et incuber pendant 5 minutes.
BSIS77-F 26/04/17 SPINREACT, S.A./S.A.U Ctra. Santa Coloma, 7 E-17176 SANT ESTEVE DE BAS (GI) ESPAGNE
Tel. +34 972 69 08 00 Fax +34 972 69 00 99. E-mail : spinreact@spinreact.com
CREATININE TRINDER
Creatinina-TR
Enzimtico
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Tel. +34 972 69 08 00 Fax +34 972 69 00 99. e-mail: spinreact@spinreact.com
BILIRUBIN T- DPD
Total Bilirubin
DPD. Colorimetric
BSIS92-I 24/02/17 SPINREACT,S.A./S.AU. Ctra.Santa Coloma, 7 E-17176 SANT ESTEVE DE BAS (GI) SPAIN
Tel. +34 972 69 08 00 Fax +34 972 69 00 99. e-mail: spinreact@spinreact.com
BILIRUBIN T- DPD
Bilirrubina Total
DPD. Colorimtrico
BSIS92-E 24/02/17 SPINREACT,S.A./S.AU. Ctra.Santa Coloma, 7 E-17176 SANT ESTEVE DE BAS (GI) SPAIN
Tel. +34 972 69 08 00 Fax +34 972 69 00 99. e-mail: spinreact@spinreact.com
BILIRUBINE T- DPD
Bilirubine totale
DPD. Colorimtrique
Dtermination quantitative de bilirubine totale 8. Lire l'absorption (A2) du calibreur et lchantillon par rapport au blanc de
IVD ractif.
9. Calculer l'augmentation d'absorption : A= A2A1
Conserver 2 - 8C. CALCULS
PRINCIPE DE LA MTHODE Avec calibreur :
La bilirubine totale (tant conjugue que non conjugue sunit avec lagent ( A )Muestra
diazo en prsence dun surfactant pour former lazobilirubine. Lintensit de ( A ) Calibrador x Conc. Calibreur =mg/dL de bilirubine dans lchantillon
la couleur forme est proportionnelle la concentration de bilirubine
prsente dans lchantillon test. Laugmentation de labsorption 546 nm
- Avec Facteur :(A) chantillon x Facteur* = mg/dL bilirubine dans lchantillon
est directement proportionnelle la concentration de bilirubine totale.
Concentrac in del Calibrador
SIGNIFICATION CLINIQUE
La bilirubine est cre par la dgradation de lhmoglobine et existe sous *Facteur : ( A ) Calibrador
deux formes. La bilirubine non conjugue est transporte vers le foie, unie Facteur de conversion : mg/dL x 17,1 = mol/L.
par lalbumine, o elle se transforme en conjugue (directe) avec lacide
glucoronique et elle est excrte. Lhyperbilirubinmie est le rsultat dune CONTRLE DE QUALIT
augmentation de la bilirubine dans le plasma. Les causes les plus probables Il est recommand d'utiliser des srums de contrle valus:
de lhyperbilirubinmie : SPINTROL H Normal et pathologique (Rf. 1002120 et 1002210).
Bilirubine totale : Augmentation de lhmolyse, altrations gntiques, Si les valeurs trouves sont en dehors de la gamme de tolrance, il faut vrifier
anmie nonatale, altrations rythropotiques, prsence de linstrument, les ractifs et le calibreur.
mdicaments. Chaque laboratoire doit tablir de son propre Contrle de qualit et des corrections
Bilirubine directe : Cholestase hpatique, altrations gntiques et en cas de non-conformit des contrles en termes de tolrances exiges.
altrations hpatiques. VALEURS DE RFRENCE
Le diagnostic clinique doit tre ralis en tenant compte de toutes les
Bilirubine totale 0,2-1,2 mg/dL (3,4-20,5mol/L)
donnes cliniques et de laboratoire.
Ces valeurs sont indicatives. Il est conseill que chaque laboratoire tablisse ses
propres valeurs de rfrence.
RACTIFS
Surfactants CARACTRISTIQUES DE LA MTHODE
R1
Acide chlorhydrique (HCI) 160mM Gamme de mesure :Depuis la limite de quantification de 0,1 mg/dL jusqu la
2,4-DPD 2mM limite de linarit de 30mg/dL.
R2 Si la concentration de lchantillon est suprieure la limite de linarit, diluer 1/2
Acide chlorhydrique (HCI) 120 mM
Surfactant avec ClNa 9 g/L et multiplier le rsultat final par 2.
Prcision :
En option BILIRUBINE CAL Rf :1002013 Inter-srie (n= 40) Intra-srie (n= 80)
Moyenne (mgl/L) 1,169 5,0485 1,1682 5,0485
PRCAUTIONS SD 0,0285 0,0594 0,012 0,046
R1/ R2 : H290- Corrosif pour les mtaux.. H314-Irritation ou corrosion CV (%) 2,4 1,2 1,0 0,9
cutane.
Sensibilit analytique : 1 mg/dL = 0,033Abs.
R1 : contient HCl et Triton X-114. R2 : contient HCly 2,4-DPD.
Exactitude : Les rsultats obtenus en utilisant les ractifs SPINREACT (y) ne
Suivre les conseils de prudence indiqus sur la FDS et sur ltiquette du
montrent pas de diffrences systmatiques significatives quand ils sont compars
produit.
dautres ractifs commerciaux (x).avec lanalyseur de Spinreact, Spintech 240.
PRPARATION Les rsultats obtenus avec 61 chantillons avec des valeurs entre 0,42 19,36
Tous les ractifs sont prts tre utiliss. mg/dL (7,18 a 331,056 mol/L) furent les suivants :
Coefficient de corrlation (r) : 0,996
CONSERVATION ET STABILIT Equation de la droite de rgression : y = 0,9836x +0,1644
Les ractifs sont stables jusqu la date dexpiration indique sur ltiquette, Les caractristiques de la mthode peuvent varier selon lanalyseur utilis.
quand ils sont conservs bien ferms 2-8C, labri de la lumire et que
leur contamination est vite pendant lutilisation. Ne pas utiliser des ractifs INTERFERENCES
au-del de la date indique. Les interfrences dues lhmolyse, lipmie et a. ascorbique ont t values
Indicateurs de dtrioration des ractifs : pour cette mthode de bilirubine totale sur un analyseur Spintech 240. Deux
- La prsence de particules et de turbidit. concentrations de la bilirubine totale ont t values. Aucune interfrence na
t observe pour la lipmie (Intralipid) jusqu 1800 mg/dL, hmoglobine 2000
MATRIEL SUPPLMENTAIRE mg/dL et lacide ascorbique jusqu 40 mg/L.
- Spectrophotomtre ou analyseur capable de mesurer labsorption 546 Une liste de mdicaments et dautres substances qui interfrent dans la bilirubine
nm. a t rapporte par Young et. al4,5.
- Cuvettes de 1.0 cm de passage de lumire. REMARQUES
- quipement habituel de laboratoire. 1. SPINREACT dispose dinstructions dtailles pour lapplication de ce
CHANTILLONS ractif dans diffrents analyseurs.
Srum ou plasma sans hmolyse. Protger de la lumire. BIBLIOGRAPHIE
Stabilit de lchantillon : 4 jours 2-8C ou 2 mois -20C. 1. David G Levitt and Michael D Levitt. Quantitative assessment of the multiple
PROCDURE processes responsible for bilirubin homeostasis in health and disease .Clin Exp
Gastroenterol. 2014; 7: 307-328.
1. Conditions de lessai :
2. Malloy H T. et al. The determination of bilirubin with the photoelectric colorimeter.
Longueur donde : ..546 nm (530-580).
J. Biol Chem 1937; 112, 2; 481-491.
Cuvette :.1cm passage de lumire 3. Martinek R. Improved micro-method for determination of serum bilirubin. Clin Chim
Temprature .........................37C 1966: Acta 13: 61-170.
2. Rgler le spectrophotomtre zro par rapport leau distille. 4. Young DS. Effects of drugs on Clinical Lab. Tests, 4th ed AACC Press, 1995.
3. Introduire la pipette dans une cuvette : 5. Young DS. Effects of disease on Clinical Lab. Tests, 4th ed AACC 2001.
Blanc calibreur Blanc chantillon 6. Burtis A et al. Tietz Text book of Clinical Chemistry, 3rd ed AACC 1999.
R 1 (L) 800 800 7. Tietz N W et al. Clinical Guide to Laboratory Tests, 3rd ed AACC 1995.
Calibreur (L) 40 - PRSENTATION
chantillon (L) - 40
4. Mlanger et incuber 5 minutes exactement 37C Rf : 1001046 Cont. R 1 : 1 x 240 mL
5. Lire l'absorption (A1) du calibreur et lchantillon. R 2 : 1 x 60 mL
6. Ajouter :
Calibreur chantillon
R 2 (L) 200 200
7. Mlanger et incuber 5 minutes exactement 37C
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Tel. +34 972 69 08 00 Fax +34 972 69 00 99. E-mail : spinreact@spinreact.com
BILIRUBIN T- DPD
Bilirrubina Total
DPD. Colorimtrico
BSIS92-P 26/04/17 SPINREACT,S.A./S.AU. Ctra. Santa Coloma, 7 E-17176 SANT ESTEVE DE BAS (GI) SPAIN
Tel. +34 972 69 08 00 Fax +34 972 69 00 99. e-mail: spinreact@spinreact.com
NH3
AMMONIA
Enzymatic-UV
Quantitative determination of Ammonia WR Blank Standard Sample
IVD Sample ---- ---- 0,1 mL
Distilled water 0,1 mL ---- ----
Store at 2-8C Standard ---- 0,1 mL ----
Reagent (R1) 1,0 mL 1,0 mL 1,0 mL
INTENDED USE
4. Mix, and allow to stand for 5 min. Read initial absorbance of sample and
For the quantitative in vitro determination of Ammonia in plasma.
blank (A1).
5. Then add:
PRINCIPLE OF THE METHOD(1, 4, 5)
GLDH (R2) 0,01 mL 0,01 mL 0,01 mL
Ammonia combines with -ketoglutarate and NADPH in the presence of
glutamate dehydrogenase (GLDH) to yield glutamate and NADP+. The 6. Mix, and incubate for 5 min. Read final absorbance of sample and blank (A2).
corresponding decrease in absorbance at 340 nm is proportional to the
plasma ammonia concentration. CALCULATIONS
Ablank = Blank A1 - Blank A2
GLDH
-ketoglutarate + NH3+NADPH glutamate+ NADP+
Asample = Sample A1 - Sample A2
CLINICAL SIGNIFICANCE
The major source of circulating ammonia is the GI tract. Under normal Asample - Ablank
conditions, ammonia is metabolized to urea by liver enzymes. Several Conc. of = x Standard conc
diseases, both inherited and acquired, cause elevated ammonia Ammonia Astandard - Ablank
(hyperammonemia). The inherited deficiencies of urea cycle enzymes are
the major cause of hyperammonemia in infants. The acquired QUALITY CONTROL
hyperammonemia diseases are caused by liver disease, renal failure, and Control sera are recommended to monitor the performance of assay procedures:
Reyes syndrome. Elevated ammonia is toxic to the central nervous system. Ammonia Control 4x2 mL ref. 1002240.Control should be assayed at least once a
day. Values obtained should fall within the specified range.
REAGENTS If control values are found outside the defined range, check the instrument,
R 1a NADPH 0,26 mmol/L reagents and technique for problems.
-ketoglutarate 3,88 mmol/L Each laboratory should establish its own Quality Control scheme and corrective
Reagent
actions if controls do not meet the acceptable tolerances.
R1b 0,15 mol/L
Triethanolamine pH 8,6 REFERENCE VALUES(2)
Buffer
Plasma ammonia: 10 - 47 mol/L
R2 GLDH 1200 U/mL
0.17 - 80 g/dL
0.017 - 0,080 mg/dL
The concentration of Ammonia CAL is stating on These values are for orientation purpose; each laboratory should establish its own
CAL
the vial label. reference range.
OPTIONAL Ammonia Control 4x2 mL ref. 1002240
PERFORMANCE CHARACTERISTICS
PRECAUTIONS Linearity: The method is linear to 1180 mol/L (20 g/mL, 2 mg/dL).
R1b (Sodium hydroxide): Xi, Irritant. R36/38 Irritating to eyes and skin. S26 If the results obtained were greater than linearity limit, dilute the sample 1/2 with
In case of contact with eyes, rinse immediately with plenty of water and seek NaCl 9 g/L and multiply the result by 2.
medical advice. S37/39 Wear suitable gloves and eye/face protection. S45 Sensitivity: The minimum detectable concentration with an acceptable level of
In case of accident or if you feel unwell seek medical advice immediately precision was determined as 23,4 mol/L (0.39 g/mL).
R2, CAL (Sodium azide): Xn, Harmful. R22 Harmful if swallowed. R32: Precision:
Contact with acids liberates very toxic gas. S28: After contact with skin wash Intra-assay (n=43) Inter-assay (n=43)
immediately with plenty of water. S45: In case of accident or if you feel Mean (mol/L) 66,86 162,23 403,26 66,86 162,23 403,26
unwell, seek medical advice immediately (show label where possible). SD 2,86 3,16 4,10 4,72 10,49 11,69
PREPARATION CV (%) 4,3 1,9 1,0 7,1 6,5 2,9
- R1a R1b Reconstitute the contents of one vial R1a with 5 mL Buffer R1b. Accuracy: Results obtained using SPINREACT reagents (y) did not show
- R2 CAL Ready to use. systematic differences when compared with other commercial reagent (x).
- 20 mL of R1b will be used to dilute R2 in case of using the reagent in The results obtained using 56 samples spanning the range 16.57 to 881 mol/L
automatic analyzers. were the following:
Correlation coefficient (r)2: 1,0.
STORAGE AND STABILITY Regression equation y= 1,02x 7,33.
R1 (reagent reconstituted with buffer) is stable 5 days at 15-25 C or 3 weeks The results of the performance characteristics depend on the analyzer used.
at 2-8 C,stored in the absence of bacterial contamination. The other
components of the kit are stable until the expiration date on the label when INTERFERENCES(3)
stored tightly closed at 2-8C, protected from light and contaminations Haemolysis interferes with the assay.
prevented during their use. Do not use reagents over the expiration date.
ADDITIONAL EQUIPMENT NOTES
- Spectrophotometer or colorimeter measuring at 340 nm. 1. In order to avoid contamination it is recommended to use disposable material.
2. SPINREACT has instruction sheets for several automatic analyzers.
- Thermostatic bath at 37 C ( 0,1C)
Instructions for many of them are available on request.
- Matched cuvettes 1,0 cm light path.
- General laboratory equipment (Note 1).
BIBLIOGRAPHY
SAMPLES (2) 1. Dewan, J.G., Biochem J., 1938; 32: 1378.
Heparinized plasma or EDTA plasma. 2. Mondzac, A., Ehrlich, G.E., Seegmiller, J.E., J Lab Clin. Med., 1965; 66: 526.
Blood is collected from a stasis-free vein and stored in an ice bath. The 3. Howanowitz, J.H., Howanowitz, P.J., Skrodzki, C.A., Iwanski, J.A: Clin.
plasma is then separated within 30 min. Ammonia assay should be carried Chem., 1984; 30:906.
out immediately. The plasma may be stored for 2 hours at 2-8 C. 4. Neely, W.E., Phillipson, J., Clin Chem, 1988; 34:1868.
5. Pesh-Iman, M., Kumar, S., Willis, C.E., Clin. Chem., 1978; 24:2044.
PROCEDURE
1. Assay conditions: PACKAGING
Wavelength: . . . . . . . . . . . . . . . . . . . . . . . . . . . 340nm Ref: 1001410 R1a: 8 5 mL,, R1b: 1 x 60 mL, R2: 1 x 1 mL, CAL:
*Cuvette: . . . . . . . . . . . . . . . . . . . . . . . . 1 cm light path Cont.
Constant temperature . . . . . . . . . . . . . . . . . 25/30/37C 1 x 5.5 mL
* Please try not to use flow cell. Exchangeable cuvettes are suggested
to avoid cargover in manual photometers.
2. Adjust the instrument to zero with distilled water.
3. Pipette into a cuvette:
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NH3
AMONIACO
Enzimtico-UV
Determinacin cuantitativa de Amoniaco 2. Ajustar el espectrofotmetro a cero frente a agua destilada.
IVD 3. Pipetear en la cubeta:
Blanco RT Estndar Muestra
Conservar a 2-8C Muestra ---- ---- 0,1 mL
Agua destilada 0,1 mL ---- ----
USO PREVISTO
Para determinacin cuantitativa in vitro de Amoniaco en plasma. Estndar ---- 0,1 mL ----
Reactivo (R1) 1,0 mL 1,0 mL 1,0 mL
PRINCIPIO DEL METODO(1, 4, 5) 4. Mezclar, y dejar reposar durante 5 min. Leer la absorbancia inicial de la
El amoniaco se combina con -cetoglutarato y NADPH en presencia de muestra y del blanco (A1).
glutamato deshidrogenasa (GLDH) para producir glutamato y NADP+. El 5. Aadir entonces:
correspondiente descenso de absorbancia a 340 nm es porporcional a la GLDH (R2) 0,01 mL 0,01 mL 0,01 mL
concentracin de amoniaco en plasma. 6. Mezclar e incubar durante 5 min. Leer la absorbancia final de la muestra y
GLDH blanco (A2).
-cetoglutarato + NH3+NADPH glutamato+ NADP+
CALCULOS
SIGNIFICADO CLINICO Ablanco = Blanco A1 - Blanco A2
La principal fuente de difusin de amonaco es el tracto gastrointestinal. En Amuestra = Muestra A1 - Muestra A2
condiciones normales, el amoniaco es metabolizado a urea por las enzimas
del hgado. Varias enfermedades, tanto congnitas como adquiridas, Amuestra - Ablanco
causan incrementos de amonaco (hiperamonemia). La causa principal de Conc. de = x Conc. estndar
hiperamonemia en los bebs es la deficiencia hereditaria Amoniaco Aestandar - Ablanco
de enzimas del ciclo de la urea. Las enfermedades de hiperamonemia
adquiridas son causadas por enfermedad heptica, insuficiencia renal, y CONTROL DE CALIDAD
sndorme de Reye. Un nivel alto de amonaco es txico para el sistema Es conveniente analizar junto con las muestras sueros control valorados:
nervioso central. Control de Amoniaco 4x2 mL ref.1002240. Se debe ensayar el control al menos
una vez al da. Si los valores hallados se encuentran fuera del rango de tolerancia,
REACTIVOS
se debe revisar el instrumento, los reactivos y la tcnica.
NADPH 0,26 mmol/L Cada laboratorio debe disponer su propio Control de Calidad y establecer
R 1a
-cetoglutarato 3,88 mmol/L correcciones en el caso de que los controles no cumplan con las tolerancias.
Reactivo
R1b 0,15 mol/L VALORES DE REFERENCIA(2)
Trietanolamina pH 8,6
Tampn Amoniaco en plasma: 10 - 47 mol/L
R2 GLDH 1200 U/mL 0.17 - 80 g/dL
0.017 - 0.080 mg/dL
Estos valores son orientativos. Es recomendable que cada laboratorio establezca
La concentracin del estndar de amoniaco es la
CAL sus propios valores de referencia.
que viene indicada en la etiqueta del vial.
OPCIONAL Control de Amoniaco 4x2 mL ref.1002240 CARACTERISTICAS DEL METODO
Linealidad: El mtodo es lineal hasta 1180 mol/L (20 g/mL, 2 mg/dL).
PRECAUCIONES
Si la concentracin de la muestra es superior al lmite de linealidad, diluir 1/2 con
R1b (Hidrxido de sodio) Xi, Irritante. R36/38: Irrita los ojos y la piel. S26:
ClNa 9 g/L y multiplicar el resultado final por 2.
En caso de contacto con los ojos lvense inmediata y abundantemente
Sensibilidad: La mnima concentracin detectable con un nivel de precisin
con agua y acdase a un mdico. S37/39: sense guantes adecuados y
aceptable, se determin como 23,4 mol/L (0,39 g/mL).
proteccin para los ojos/la cara. S45: En caso de accidente o malestar,
Precisin:
acdase inmediatamente al mdico.
R2, CAL (Azida sdica) Xn,Nocivo. R22: Nocivo por ingestin. R32: En Intraserie (n=43) Interserie (n=43)
contacto con cidos libera gases muy txicos. S28: En caso de contacto Media (mol/L) 66,86 162,23 403,26 66,86 162,23 403,26
con la piel, lvese inmediata y abundantemente con agua.S45: En caso de SD 2,86 3,16 4,10 4,72 10,49 11,69
accidente o malestar, acdase inmediatamente al mdico. CV (%) 4,3 1,9 1,0 7,1 6,5 2,9
Exactitud: Los reactivos SPINREACT (y) no muestran diferencias sistemticas
PREPARACION significativas cuando se comparan con otros reactivos comerciales (x).
- R1a R1b Reconstituir el contenido de un vial de R1a con 5 mL de R1b Los resultados obtenidos con 56 muestras de pacientes con concentraciones de
tampn. 16,57 hasta 881 mol/L fueron los siguientes:
- R2 CAL Listos para su uso. Coeficiente de regresin (r)2: 1,0.
- Para la utilizacin de este reactivo en analizadores automticos, se debe Ecuacin de la recta de regresin: y= 1,02x 7,33.
diluir R2 con 20 mL de R1b. Las caractersticas del mtodo pueden variar segn el analizador utilizado.
CONSERVACION Y ESTABILIDAD
INTERFERENCIAS(3)
R1 (reactivo reconstituido con el tampn) es estable 5 das a 15-25 C o 3
semanas a 2-8 C, conservado en ausencia de contaminacin bacteriana. La hemlisis interfiere en el ensayo.
El resto de componentes del kit son estables hasta la fecha de caducidad
indicada en la etiqueta del vial, cuando se mantienen los frascos bien NOTAS
cerrados a 2-8C, protegidos de la luz y se evita su contaminacin. No usar 1. A fin de evitar contaminaciones se recomienda utilizar material de plstico
reactivos fuera de la fecha indicada. de un solo uso.
2. SPINREACT dispone de instrucciones detalladas para la aplicacin de
MATERIAL ADICIONAL este reactivo en distintos analizadores.
- Espectrofotmetro o analizador para lecturas a 340 nm.
- Bao termostatable a 37C ( 0,1C) BIBLIOGRAFIA
- Cubetas de 1,0 cm de paso de luz. 1. Dewan, J.G., Biochem J., 1938; 32: 1378.
- Equipamiento habitual de laboratorio (Nota 1). 2. Mondzac, A., Ehrlich, G.E., Seegmiller, J.E., J Lab Clin. Med., 1965; 66: 526.
3. Howanowitz, J.H., Howanowitz, P.J., Skrodzki, C.A., Iwanski, J.A: Clin.
MUESTRAS (2) Chem., 1984; 30:906.
Plasma heparinizado o EDTA plasma. 4. Neely, W.E., Phillipson, J., Clin Chem, 1988; 34:1868.
Extraer sangre sin hemlisis y almacenar en bao de hielo. Separar el 5. Pesh-Iman, M., Kumar, S., Willis, C.E., Clin. Chem., 1978; 24:2044.
plasma o suero de los eritrocitos dentro de los 30 minutos despus de la
extraccin. El ensayo de amoniaco se debe realizar inmediatamente. El PRESENTACION
plasma se puede conservar 2 horas a 2-8 C.
Ref: 1001410 R1a: 8 5 mL, R1b: 1 x 60 mL, R2: 1 x 1 mL, CAL:
Cont.
PROCEDIMIENTO 1 x 5.5 mL
1. Condiciones del ensayo:
Longitud de onda: . . . . . . . . . . . . . . . . . . . . . . . . . . 340 nm
*Cubeta: . . . . . . . . . . . . . . . . . . . . . . . . . . .1 cm paso de luz
Temperatura constante: . . . . . . . . . . . . . . . . . . . 25/30/37C
*Se sugiere usar cubetas desechables en lugar de cubetas de flujo, para
evitar posibles contaminaciones en analizadores manuales.
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UREA -37
Urea 37
o-Phthalaldehyde 37C. Colorimetric
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UREA -37
Urea 37
o-Ftalaldehdo 37C. Colorimtrico
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