I HC QUC GIA THNH PH H CH MINH

TRNG I HC BCH KHOA TP.H CH MINH

KHOA KHOA HC NG DNG

BO CO

QUANG HC K THUT V NG DNG

MY XT NGHIM SINH HA
GVHD: TS. Phm Th Hi Min

Thnh vin thc hin:

Hunh Th Hong Vy

K1304947

Dng Ngc Minh

K1302328

L Hunh Nhi

K1302779

MC LC
1. Gii thiu.2
2. Thng s xt nghim v cng dng chun on bnh....3
3. Phn loi.11
4. C s l thuyt...12
5. Cu to v nguyn l hot ng.....19
6. Ti liu tham kho..24

1. Gii thiu
Ngy nay, khi x hi tr nn tin b, sc khe con ngi lun c t
ln hng u. Nh c s pht trin vt bc ca khoa hc k thut gip cho y
hc c nhng bc tin quan trng trong pht hin v iu tr bnh. Mc d c
nhiu phng php chun on pht hin bnh hiu qu bng hnh nh nh MRI,
CT, X quang ta ch c th xem xt hot ng bn trong c th mt cch gin
tip. Nhng bit r qu trnh hot ng chuyn ha thng qua nng cc cht
bn trong c th con ngi, th xt nghim l mt phng php da vo s xut
hin cc cht d thng, tng gim cc cht thng thng, ta c th chun on
nhiu bnh lin quan n cc c quan bn trong c th con ngi trc khi chng
biu hin ra ngoi. T ta s c phng php iu tr sm, t hiu qu cao.
Trong xt nghim sinh ha c dng ph bin nht ti cc bnh vin v phng
khm nh chnh xc cao, gi thnh hp l v thi gian thc hin ngn. y l
thit b cn lm sng khng th thiu, gip ta pht hin sm ung th cng nh
nhiu loi bnh v gan, mt, thn, ty, phi, tim Ni tm li xt nghim l
phng php chun on rt cn thit v quan trng trong y hc v l i tng
cn c nghin cu, pht trin hn na.

2. Thng s xt nghim v cng dng chun on bnh

2.1Ure mu
Ch nh: Cc bnh l v thn, kim tra chc nng thn trc phu thut,
can thip, kim tra sc kho nh k
Tr s bnh thng: 2,5 7,5 mmol/l
Ure tng cao trong cc trng hp: Suy thn, thiu niu, v niu, tc nghn
ng niu, ch n nhiu protein
Ure thp trong cc trng hp: Suy gan lm gim tng hp ure, ch n
ngho protein, truyn nhiu dich
Cch ly mu: Mu mu ly vo bui sng, lc i: 3ml mu khng chng
ng hoc chng ng bng lithiheparin.
2.2 Creatinin mu
Ch nh: Cc bnh l v thn, cc bnh l c, kim tra trc phu thut,
can thipNhm mc ch nh gi chc nng thn, mc suy thn.
Tr s bnh thng:
Nam: 62-120 Mmol/l
N: 53-100 Mmol/l
Creatinin tng cao trong cc trng hp: suy thn cp v mn, b tiu tin,
bnh to u ngn, tng bch cu, cng gip, Goutte
Creatinin gim gp trong cc trng hp: c thai, dng thuc chng ng
kinh, bnh teo c cp v mn tnh
Mu mu: Mu mu ly vo bui sng, lc i: 3ml mu khng chng ng
hoc chng ng bng lithiheparin
2.3 ng mu
Ch nh: Nghi ng tiu ng, kim tra trc phu thut,can thip, ang
iu tr cocticoid, nh gi hiu qu v iu chnh liu thuc bnh nhn ang
iu tr tiu ng, kim tra sc kho nh k
Tr s bnh thng: 3,9- 6,4 mmol/l
3

ng mu tng cao gp trong cc trng hp: Tiu ng do tu, cng

gip, cng tuyn yn, iu tr cocticoid, bnh gan, gim kali mu
ng mu gim gp trong cc trng hp: h ng huyt do ch n,
do s dng thuc h ng huyt qu liu, suy v thng thn, suy gip, nhc
nng tuyn yn, bnh gan nng, nghin ru, bnh Addison
Mu mu: Mu mu ly vo bui sng, lc i: 3ml mu khng chng ng
hoc chng ng bng lithiheparin.
Ch : Ly mu lc i v chuyn mu xung khoa xt nghim chm nht
l 30 pht sau khi ly mu.
2.4 HbA1-C
ngha v ch nh: Nng HbA1 C phn nh tnh trng ng mu trong
khong 2-3 thng trc khi ly mu xt nghim (xt nghim nh lng Glucose
mu ch ni ln c hm lng ng ti thi im ly mu lm xt nghim). V
vy HbA1C c coi l thng s c gi tr chn on v theo di iu tr tiu
ng.
Ch nh: Nghi ng tiu ng, nhng trng hp cn kim sot ng
mu, nht l nhng bnh nhn tiu ng kh kim sot.
Tr s bnh thng: 4-6%
HbA1C tng trong cc trng hp: bnh tiu ng, bnh tiu ng kh
kim sot,.
HbA1C tng gi to trong cc trng hp: ure mu cao, thalassemia.
HbA1C gim gi to trong cc trng hp: Thiu mu, huyt tn, mt mu
Mu mu: Mu mu ly vo bui sng, lc i: 1ml mu tnh mch chng
ng EDTA
2.5 Acid Uric mu
Ch nh: Nghi ng bnh Goutte, bnh thn, bnh khp, theo di hiu qa
iu tr bnh Goutte
Tr s bnh thng:
4

Nam: 180-420 Mmol/l

N: 150-360 Mmol/l
Acid uric tng cao trong nhiu trng hp: thng gp nht l trong bnh
Goutte, leucemie, a hng cu, suy thn, ung th, tng bch cu n nhn, nhim
trng nng, bnh vy nn
Acid uric gim gp trong cc trng hp: c thai, bnh wilsson, hi chng
Fanconi
Mu mu: Mu mu ly vo bui sng, lc i: 3ml mu khng chng ng
hoc chng ng bng lithiheparin
2.6 SGOT (ALAT)
ngha: SGOT l men xc tc phn ng trao i nhm amin. GOT khng
nhng bo tng (khong 30%) m n cn c mt ty th ca t bo (khong
70%). Nng men SGOT phn nh tnh trng tn thng t bo gan, c tim.
Ch nh: Vim gan, nhi mu c tim, vim c, tai bin mch mu no
Tr s bnh thng 40 U/l
SGOT tng cao trong cc trng hp: Vim gan cp do virus hoc do thuc,
tan mu, vim gan do ru, nhi mu c tim, vim c
Lu trong cc trng hp t bo hng cu b v th SGOT tng rt cao
Mu mu: Mu mu ly vo bui sng, lc i: 3ml mu khng chng ng
hoc chng ng bng lithiheparin
2.7 SGPT (ASAT)
ngha: SGPT l men ch c trong bo tng ca t bo gan. Nng
SGPT phn nh tnh trng tn thng t bo gan do vim.
Ch nh: Vim gan (cp, mn), nhn no
Tr s bnh thng 40 U/l
SGPT tng cao gp trong cc trng hp vim gan, nhn no.
Nu SGPT>>>SGOT: Chng t c tn thng nng, cp tnh trn din rng
ca t bo gan
5

Nu SGOT>>>SGPT chng t tn thng su n lp di t bo (ty th)

Mu mu: Mu mu ly vo bui sng, lc i: 3ml mu khng chng ng
hoc chng ng bng lithiheparin.
2.8 GGT (Gama Glutamyl Transferase)
Ch nh: Cc bnh l gan mt.
Tr s bnh thng:
Nam 45 U/l
N 30 U/l
GGT tng cao trong cc trng hp: Nghin ru, vim gan do ru, ung
th lan to, x gan, tc mt
GGT tng nh trong cc trng hp: Vim tu, bo ph, do dng thuc
Mu mu: Mu mu ly vo bui sng, lc i: 2ml mu khng chng ng
hoc chng ng bng lithiheparin.
2.9 ALP ( phosphatase kim)
Ch nh: Bnh xng, bnh gan mt.
Tr s bnh thng: 90-280 U/l
ALP tng rt cao trong cc trng hp: Tc mt, ung th gan lan to.
ALP cng tng trong cc trng hp: Vim xng, bnh Paget (vim xng
bin dng), ung th xng to ct bo, nhuyn xng, ci xng. Vng da tc
mt, vim gan th pht( sau tng bch cu n nhn nhim khun, bnh Hodgkin,
dng thuc tiu ng, thuc iu tr huyt p)
ALP gim trong cc trng hp: Thiu mu c tnh, suy cn gip, thiu
vitaminC, dng thuc gim m mu
Mu mu: 2ml mu khng chng ng hoc chng ng bng lithiheparin
2.10

Protein ton phn

Ch nh: a u tu xng, bnh gan (x gan, vim gan), bnh thn (hi
chng thn h nhim m, vim cu thn), suy kit, kim tra sc kho nh k
Tr s bnh thng: 65-82g/l
6

Protein tng trong cc bnh l: a u tu (Kahler), bnhWaldenstrom, thiu

nng v thng thn Ngoi ra c th gp protein mu tng trong cc trng hp
c c mu: st ko di, a chy nng, nn nhiu
Protein gim trong cc trng hp: thn h nhim m, x gan, u nng gip
nhim c, suy dinh dng ngoi ra, c th gp gim protein mu do pha long
mu (nhim c nc, truyn dch qu nhiu)
Mu mu: Mu mu ly vo bui sng, lc i: 3ml mu khng chng ng
hoc chng ng bng lithiheparin.
2.11

Albumin mu

Ch nh: a u tu xng, bnh gan (x gan, vim gan), bnh thn (hi
chng thn h nhim m, vim cu thn), suy kit
Tr s bnh thng: 35-55 g/l
Albumin tng thng t gp: Shock, mt nc
Albumin gim thng gp trong cc trng hp: X gan, suy dinh dng,
hi chng thn h, vim cu thn, a u tu ( Kahler), Waldenstrom
Mu mu: Mu mu ly vo bui sng, lc i: 3ml mu khng chng ng
hoc chng ng bng lithiheparin.
2.12

Ch s A/G

Ch nh: a u tu, x gan, vim thn cp, thn h nhim m

Tr s bnh thng: 1,2 2,2
A/G < 1 do tng globulin, do gim Albumin hoc phi hp c 2:
- Gim albumin: do thiu dinh dng, ung th, lao, suy gan
- Tng globulin: a u tu xng, Bnh collagen, nhim khun
- ng thi gim albumin v tng globulin: X gan, vim thn cp, thn h
nhim m, au tu xng
Mu mu: Mu mu ly vo bui sng, lc i: 3ml mu khng chng ng
hoc chng ng bng lithiheparin.
2.13

nh lng B2M (B2 Microglobulin)

7

 ngha: B 2 M do cc t bo lympho, tng bo sn sinh v c trn b mt

cc t bo ny. nh lng B2M gp phn phn loi, tin lng, theo di hiu qu
iu tr bnh a u tu xng, u lympho.
Ch nh: bnh a u tu xng, u lympho
Tr s bnh thng: 0,8 -2,2 mg/l
B2M tng trong cc trng hp nhim trng mn tnh, suy gim chc nng
thn, cc bnh c tnh. c bit, B2M tng cao bnh nhn a u tu xng, u
lympho.
Mu mu: Mu mu ly vo bui sng, lc i: 3ml mu khng chng ng
hoc chng ng bng lithiheparin.
2.14

Cholesterol ton phn

Ch nh: Ri lon m mu, va x ng mch, tng huyt p, hi chng

thn h, kim tra sc kho nh k cho nhng ngi trn 40 tui, nhng ngi bo
ph
Tr s bnh thng: 3,9-5,2 mmol/l
Cholesterol tng trong cc trng hp: ri lon lipid mu nguyn pht hoc
th pht, va x ng mch, hi chng thn h, vng da tc mt ngoi gan, bnh
vy nn
Cholesterol gim trong cc trng hp: hp thu km, suy kit, ung th,
bing n
Mu mu: Mu mu ly vo bui sng, lc i: 3ml mu khng chng ng
hoc chng ng bng lithiheparin.
2.15

Triglycerid

Ch nh: Ri lon m mu, va x ng mch, tng huyt p, hi chng

thn h, u vng, vim tu, kim tra sc kho nh k cho nhng ngi trn 40
tui, nhng ngi bo ph
Tr s bnh thng: 0,5- 2,29 mmol/l
8

Triglycerid tng trong cc trng hp: Va x ng mch, ri lon lipid

mu, hi chng thn h, bnh bo ph, i tho ng
Triglycerid gim trong cc trng hp: x gan, hi chng km hp thu, suy
kit, cng tuyn gip
Mu mu: Mu mu ly vo bui sng, lc i: 3ml mu khng chng ng
hoc chng ng bng lithiheparin.
2.16

HDL-C

Ch inh: Ri lon m mu, va x ng mch, tng huyt p, kim tra sc

kho nh k cho nhng ngi trn 40 tui
Tr s bnh thng: 0,9mmol/l
HDL-C tng: t nguy c gy va x ng mch
HDL-C gim: d c nguy c gy va x ng mch, hay gp trong cc
trng hp ri lon m mu, va x ng mch, tng huyt p, cn au tht
ngc
Ngi ta thng ch ti t s CHOLESTEROL TON PHN / HDL-C.
T s ny tt nht l <4, t s ny cng cao th kh nng va x ng mch cng
nhiu.
Mu mu: Mu mu ly vo bui sng, lc i: 3ml mu khng chng ng
hoc chng ng bng lithiheparin.
2.17

LDL-C

Ch inh: Ri lon m mu, va x ng mch, tng huyt p, bnh mch

vnh, i tho ng
Tr s bnh thng: <=3,4mmol/l
LDL-C cng cao, nguy c b va x ng mch cng ln.
LDL-C tng trong cc trng hp: Va x ng mch, ri lon lipid mu,
bnh bo ph
LDL-C gim trong cc trng hp: x gan, hi chng km hp thu, suy kit,
cng tuyn gip
9

Mu mu: Mu mu ly vo bui sng, lc i: 3ml mu khng chng ng

hoc chng ng bng lithiheparin.
2.18

Canxi ton phn

Ch inh: a u tu, long xng, ci xng, dng thuc li tiu Diazit ko

di
Tr s bnh thng: 2,2-2,7 mmol/l
Can xi ton phn tng trong cc trng hp: long xng, a u tu, cng
ph gip trng, bnh Paget, cng gip, dng li tiu Diazit
Can xi ton phn gim trong cc trng hp: Thiu vitamin D, ci xng,
thiu nng gip, suy thn, mt s trng hp khng p ng vi vitamin D, hi
chng thn h, cc trng hp gim Albumin mu, tan mu, vim tu cp, thai
nghn
Mu mu: Mu mu ly vo bui sng, lc i: 3ml mu khng chng ng
hoc chng ng bng lithiheparin.
2.19

Ca++ mu

Ch inh: a u tu, long xng, suy thn

Tr s bnh thng: 1,17-1,29 mmol/l
Ca++ tng trong cc trng hp: a u tu, long xng, vim phi, gim
phosphat mu, nhim c vitamin D, cng cn gip tin pht hoc th pht
Ca++ gim trong cc trng hp: Thiu nng cn gip, suy thn, bnh
Tetanie, ci xng, cc bnh c gim Albumin mu
Mu mu: Mu mu ly vo bui sng, lc i: 3ml mu khng chng ng
hoc chng ng bng lithiheparin.
2.20

St trong mu

Ch inh: Cc trng hp thiu mu, mt mu do chy mu, tr, giun mc,

thai nghn, nhim c st, tan mu
Tr s bnh thng:
Nam: 11-27 Mmol/l
10

N: 7-26 Mmol/l
St tng trong cc trng hp: tan mu, suy tu, x tu, ri lon sinh tu, x
gan, nhim c st, truyn mu nhiu ln
St gim trong cc trng hp: Thiu mu thiu st, vim nhim mn tnh,
chy mu ko di, n king, gim hp thu st (ct on rut, d dy)
Mu mu: Mu mu ly vo bui sng, lc i: 3ml mu khng chng ng
hoc chng ng bng lithiheparin.

11

3. Phn loi
Da vo mc t ng ca my m ta chia lm 2 loi l my xt
nghim sinh ha t ng v bn t ng. C 2 loi my ny u pha mu theo nh
lut Elisa v c nguyn l hot ng ging nhau, nhng my t ng s t ng
pha mu cn i vi my bn t ng, ngi s dng phi pha mu th cng.
So snh my xt nghim sinh ha t ng v bn t ng : my xt
nghim sinh ha t ng c nhng u im vt tri so vi my bn t ng, nh
cho ra kt qu nhanh, nng xut cao, tit km mu th, v c bit l hon ton t
ng t vic pha ch mu n v sinh cuvet. Tuy nghin gi thnh ca my xt
nghim sinh ha t ng cao hn rt nhiu so vi my bn t ng, v l do ny
nn ti cc trm y t c quy m nh, s lng mu cn xt nghim khng nhiu,
th my bn t ng vn c s dng ph bin.

12

4. C s l thuyt
4.1 C s ha sinh: xt nghim sinh ho s dng ph-ng php o mu
quang in, o hp th ca cc cht trong bnh phm, ng-i ta khng th
o trc tip cc cht v bn thn cc cht trong dung dch l trong sut.
Mt khc, trong cc dung dch xt nghim c rt nhiu cc cht khc nhau nn
cng kh khn trong vic o c v tnh ton. V vy, lm vic vi mt loi
cht cn nghin cu trong dung dch xt nghim, ng-i ta s dng ph-ng php
nh du mu. Bng cch s dng tch cht ho hc ca cc cht cn nghin
cu, ng-i ta s dng cht cho tc dng vi mt cht hay mt s cht no ,
trong qu trnh phn ng, cht s to ra mt sn phm hp th nh sng
mt b-c sng no l mnh nht. S hp th mnh hay yu s t l vi nng
ca cht trong dung dch. T ta c th tnh ton d dng c -c
cc thng s mong mun. Phn ny s trnh by cc nguyn tc to cc sn
phm c tnh cht hp th trn o mt s thng s xt nghim in hnh.
nh lut Elisa:
Theo nguyn l c bn ca min dch hc, mi mt khng nguyn
(antigen) c nhiu yu t khng nguyn (epitope), mi mt epitope c kh nng
kt hp vi mt khng th (antibody) tng ng vi n. Hu ht cc khng
nguyn u c mt hoc vi epitope c trng cho n, da trn m ngi ta
c th xc nh c khng nguyn. Bn cnh , s xut hin ca khng
nguyn trong c th trong mt s trng hp c kh nng kch thch c th to
ra khng th n dng c hiu chng li khng nguyn . Thng qua vic
xc nh khng th ny ngi ta cng c th gin tip xc nh khng nguyn
trong c th.
Da trn c s , k thut ELISA c thit lp nhm chn on s hin
din ca mt khng nguyn hay khng th. xc nh mt yu t cn chn
on (khng nguyn/khng th) ngi ta s dng mt hoc nhiu yu t pht
hin (khng th/khng nguyn/b th) c phn ng min dch c hiu vi yu
13

t cn chn on. Cc yu t pht hin ny c nh du bng enzyme sao cho

phn ng min dch vi yu t cn chn on s to nn s thay i c th nhn
bit c bng mt thng hay thm ch nh lng c bng cc cng c so
mu khc khi cho c cht ca enzyme nh du vo.
V d : phn ng to mu ca glucose

Rq l dung dch , c o bc sng 492 n 550 nm, tt nht l

500nm
4.2 C s vt l
4.2.1

Cc nh lut o mu

4.2.1.1

S hp th nh sng ca dung dch:

Nu ri mt chm sng c c-ng I0 vo mt cuvt ng mt dung dch

no th mt phn Ir b phn x trn b mt ca cuvt, mt phn khc Ia b dung
dch hp th, phn cn li It i qua cuvt ra ngoi, gia cc i l-ng c-ng nh
sng ny c cc h thc sau:
I0=Ir+Ia+It
Trn thc t, khi phn tch ta ch ding mt loi cuvt nn I r th-ng khng
i. Mt khc, Ir rt nh do b mt cuvt rt phng. Ta c h thc n gin sau:
I0=Ia+It
Ir
Ia

It

I0

Hnh 1. M t -ng truyn ca nh sng qua cuvt cha dung dch

14

4.2.1.2

nh lut Bouguer Lambert Beer:

Khi nghin cu s hp th nh sng ca dung dch, Beer thit lp -c

mi lin h gia h s tt K vi nng ca cht hp th nh sng nh- sau:
K = .C
Trong :
C : nng cht tan trong dung dch
: h s khng ph thuc vo nng
nh lut Beer cng t-ng t nh- nh lut Bouguer Lambert. Nh-ng nu
nh lut Bouguer Lambert kho st s thay i hp th nh sng vi dung
dch c nng xc nh khi thay i chiu dy ca lp dung dch hp th, cn
nh lut Beer li kho st s thay i hp th nh sng ca dung dch vi s
thay i nng ca mt lp dung dch c chiu dy khng i. Kt hp hai nh
lut ny, ta c nh lut Bouguer Lambert Beer:
hp th c-ng nh sng ca mt lp dung dch ph thuc vo bn
cht, nng v b dy ca lp dung dch c nh sng ri qua
V mt ton hc, nh lut -c biu din bng ph-ng trnh:

I x I 0 .10 .C.L
Trong :
C : l nng cht tan
L : chiu dy lp dung dch
: h s tt khng i, ch ph thuc vo bn cht ca cht tan v b-c sng
ca nh sng ri vo dung dch.
Trong xt nghim, chng ta th-ng s dng mt s cc thng s gin tip t
nh lut Bouguer Lambert Beer
T s gia c-ng chm sng sau khi qua dung dch I x vi c-ng chm
sng chiu ti I0 -c gi truyn qua, k hiu l T
T
15

Ix
I0

4.2.2

Cc nh lut quang in:

- nh lut quang in th nht ( nh lut v gii hn quang in) :

i vi mi kim loi dng lm catt c mt b-c sng gii hn 0 xc nh
gi l gii hn quang in ca kim loi , hin t-ng quang in ch sy ra khi
b-c sng ca nh sng kch thch nh hoc bng gii hn quang in (0)
V d: gii hn quang in ca mt s kim loi
Bc 260nm, ng 300nm, km 350nm, nhm 360nm, canxi 450nm, kali
550nm, xi 660nm. V vy, trong xt nghim cn phi chn loi c u thu quang
c gii hn quang in ln.
- nh lut quang in th hai ( nh lut v dng quang in)
i vi mt nh sng thch hp, c-ng dng quang in bo ho t l
thun vi c-ng ca chm sng kch thch.
iu ny -c Anhstanh gii thch l do s electron quang in b bt ra
khi mt catt trong mt n v thi gian t l vi s phtn n p vo mt catt
trong thi gian . Mt khc s phtn ny li t l vi c-ng chm sng chiu
ti. y l mt tnh cht ht sc quan trng, m nh c th ch to -c my
o mu quang in.
4.3 Phng php o
4.3.1 Phng php im cui (Endpoint)
- Phng php ny ch o hp th ca hn hp phn ng mt ln, l
lc phn ng to mu sy ra hon ton, v nng cc cht trong dung dch sau
phn ng n nh. C th o hp th mt bc sng (monochromatic)
hoc hai bc sng (bichromatic). S dng dung dch chun (Standard) dng
ng chun hay h s ci t trc.
Chia theo s dung dch chun s dng khi o ta c 3 loi:
Php o ch s dng mt dung dch chun: nng ca mu cng c
tnh theo cng thc:

16

 Php o s dng nhiu dung dch chun (multistandard): nng ca

mu c xc nh t ng cong chun. ng cong ny dng c t cc dung
dch chun bit trc nng v hp th o c:
(Astandard Ablank).TR
TR l chiu ca phn ng :

+ 1 nu chiu phn ng tng

-1 nu chiu phn ng gim

Nng ca mu c ni suy t ng cong chun :

(Asample Ablank).TR
Php o s dng h s:
Khi o khng s dng cc dung dch chun m s dng mt h s cho trc
tnh ra nng ca dung dch. Nng mu c tnh theo cng thc :
Csample = (Asample Ablank).F
Vi F l h s cho trc
Chia theo s bc sng s dng khi o ta c 2 loi:
Php o mt bc sng: o hp th ca dung dch Trng, Chun v
Mu ti mt bc sng.
Php o hai bc sng: o hp th ca Trng (Blank), Chun v mu
(Sample) ti hai bc sng, mt bc sng chnh v mt bc sng ph, hp
th ca cc dung dch c tnh theo cng thc sau:
Asample, Astandard, Ablank = Almain Alref
A : hp th
lmain : Bc sng chnh
lref : Bc sng ph
4.3.2. Phng php ng hc (Kinetic)
Phng php ng hc c s dng o hot ng ca enzym. c
im ca phng php ny l o ngay khi bt u phn ng, sau mt khong thi
gian tr (Delay time) no , khng c thi gian i phn ng n nh.
hp th ca hn hp phn ng c o n ln trong thi gian phn ng t
(Reaction time), khong cch gia n ln o l t/n giy v tnh gi tr chnh lch ca
cc hp th gia php o sau vi php o trc, kt qu cui cng l tnh c
gi tr chnh lch trung bnh/pht (DA/min)
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 hot ng ca enzym c tnh theo cng thc:

hot ng ca Enzym =DA/min.K.
Trong , K l h s thng c cho trc vi tng loi ho cht.
- n v o hot ng enzym l U/L, ngoi ra cn s dng n v mi l
kat (katal) l lng men xc tc s bin i 1 mol c cht trong 1 giy.
4.3.3 Phng php o thi gian c nh (Fixed Time):
Cng tng t nh php o ng hc, nhng ch khc l thi gian gia cc
ln o hp th l c nh.

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5. Cu to v nguyn l hot ng :
5.1 S khi my xt nghim sinh ha

Hnh 2. S khi my xt nghim sinh ha

5.2 Cu to chi tit
5.2.1

Ngun sng

Ngun sng c nhim v pht ra nh sng trng c cng mnh. L

do dng ngun sng trng y nh phn c s ho sinh ta bit, chnh l do
mi mt xt nghim khi phn ng s cho mt mu c trng ca xt nghim , v
n s hp th mnh nht mt di bc sng tng ng, v vy khi o s hp th ta
ch dng mt bc sng c bn. Vi nhiu xt nghim ta s dng nhiu bc sng
khc nhau v ngun sng trng s cp y cc bc sng ny cho tt c cc xt
nghim.
Trong thc t ngi ta c th d dng to ra ngun sng trng. Ngun sng
trng ph bin nht trong cc my xt nghim sinh ha l n halogen. Nng
lng ca n halogen gim v pha UVA nhng n vn mnh cp nng
lng cho b pht hin quang bc sng gn 350nm. tng cng nh sng
n di vng cc tm, ngi ta s dng mt n Tungsten - halogen . n ny gm
mt dy tc tungsten t trong v thch anh cha halogen nh it hoc Brom.
Hnh bn di m t dy ph pht x ca mt s n Tungsten halogen.
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Hnh 3. Ph ca n Tungsten - Halogen

5.2.2

B chn bc sng

B lc bc sng dng chn ly mt bc sng yu cu cho tng xt

nghim. S d ngi ta dng ngun sng trng v cc b lc m khng dng cc
linh kin pht ra cc bc sng c nh l do dng b lc c th d dng thm cc
b lc theo yu cu xt nghim tc l c tnh m i vi xt nghim hn l dng
linh kin pht ra bc sng c nh. Trong cc my xt nghim sinh ho hin nay,
b lc thng l mt bnh xe trn c gn mt s knh lc , s knh lc trn bnh xe
ny tu thuc vo loi my. Cc b lc ny l cc cch t, knh lc, lng knh kt
hp vi cc thu knh thu c mt di rt hp bc sng: 340nm, 405nm,
505nm, 546nm, 570nm, 600nm, 650nm, 700nm
5.2.3

Cuvet

Cuvet c dng ng mu o trong my xt nghim, cuvet phi c cc

tnh cht sau :
- Cho qua tt c cc bc sng dng trong th nghim
- C b mt quang hc m bo song song v phng tuyt i trnh s
phn x ca nh sng chiu ti.
- Phi c bn ha hc, khng b cc ha cht lm hng.

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Trong thc t c nhiu loi cuvet ph thuc vo vt liu ch to. Cuvet

thng c lm bng thch anh, thy tinh, nha trong sut, c chiu dy quang
hc chun l 1cm m bo cc tnh cht trn.
5.2.4

B pht hin quang

B pht hin quang c chc nng l bin i tn hiu quang thu c khi
nh sng i qua cuvt thnh tn hiu in. B pht hin quang l mt linh kin
quang- in, trn thc t hin nay thng dng l photo it hay photo tranzito do
kch thc nh, thch hp cho cc my xch tay hoc nhng my c cu trc nh.
ng thi li c nhy cao hn cc linh kin khc.
5.2.5

Hin th

Kt qu o s c hin th ra mn hnh CRT hoc mn hnh tinh th lng

(LCD). Sau khi o c hp th ca cht, my s tin thnh tnh ton theo
chng trnh do ngi dng la chn, v hin th ra hp th, nng cht, sau
ngi dng c th nhp tn bnh nhn, s th t, ngy thng xt nghim
phc v cho vic in ra v lu tr.
Cc dng my hin nay thng c trang b my in nhit, hoc c th kt
ni vi my in ngoi, gip d dng trong vic in kt qu xt nghim.
5.3 My xt nghim sinh ha bn t ng Mindray BA-88A
My xt nghim sinh ha bn t ng
Model : BA 88A
Hng sn xut : Mindray China

Hnh 4. Hnh nh thc t ca my BA 88A

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Hnh 5. S cu to my BA 88A
M t chung
- Cc phng php o : im cui, ng hc, thi gian c nh
- Di bc sng o : 340 670 nm
- C th ci t ln ti 200 chng trnh xt nghim
- Ch test : Flowcell v Cuvette
- Giao din thn thin vi ngi dng
- Cc ch s o c : ALT, AST, ALP, ACP, GGT, _-HBDH, LDH, CK,
AMY.TG.TC, HDL-C, UA, UREA, Cr, Glu, TP, Alb, T-bil, D-Bil, TBA, NH4+ ,
HCO3-, Ca, Mg, Cl , Na, K, apoAI , apoB, Lp ( a ), C3, C4 , lgG, lgA, lgM,
HbA1c, Alcohol, Amphetamines, Barbiturates, Benzodiazepine

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 Thng s k thut
- n halogen tungsten 6V 10W
- B chn bc sng : gm 8 knh lc, cho ra cc bc sng : 340nm,
405nm, 450nm, 510nm, 546nm, 578nm, 630nm, 670nm.
- m sc : < 8 nm
- Ngun: AC 100-240V, 50 / 60Hz.
- Kch thc : 430 x 360 x 170 ( mm), nng 6.8 kg
5.4 Kinh nghim s dng v bo qun
- My bm phi c calibrate mi 1 n 2 thng.
- My khng i km dng c ng cht thi ( mu sau xt nghim ).
- i vi phng php o im cui, my c th thc hin 100 xt nghim
/ gi. i vi phng php o ng hc v thi gian c nh, my c th thc hin
25 30 xt nghim / gi.
- Khi thay n, phi thay c h thng n.
- Tui th ca n l 900 gi, v cn 15 pht n nh trc khi s dng.
- S dng my nhit 25 30 C, m 35 85 %.
- My c th kt chut, bn phm, my in qua cng USB.

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6. Ti liu tham kho

[1] Nguyn Hu T, Quang ph k
[2] Nguyn Th Thu Vn, Phn tch nh lng, nh xut bn i hc quc gia Tp.
H Ch Minh, 2012

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