JPH0366616B2 - - Google Patents

Description

[Detailed Description of the Invention] The present invention relates to an automatic method and device for measuring erythrocyte sedimentation rate (hereinafter abbreviated as blood sedimentation rate), which enables accurate measurement even when the properties of blood are significantly abnormal due to the patient's medical condition. It is something that makes you familiar.

Blood sedimentation is measured by forming a blood column in a blood sedimentation measurement tube (hereinafter simply referred to as blood sedimentation tube), standing it vertically, and measuring the sedimentation length of red blood cells over a predetermined period of time, usually visually. . By the way, hospitals of medium or larger size handle a large number of specimens every day, and visually reading the sedimentation distance of these many specimens is a great burden in terms of time, physical, and mental burden. Several blood sedimentation measuring devices have been announced to reduce this burden.

Most of these measurement methods optically detect the upper end surface of red blood cell columns. For example, as shown in FIG. 1, a light source 1 and a photodetector 2 are provided facing each other, with a blood sedimentation tube 3 interposed between them, and the light from the light source is blocked by red blood cell columns 4. The upper end surface of the red blood cell column is detected by detecting that the light entering the photodetector is blocked. Figure 1 uses a combination of a relatively small light source and a small photodetector, and moves this set of photodetection systems vertically along a blood sedimentation tube to a position where its incidence on the photodetector is blocked. The blood sedimentation value is determined by detecting the blood sedimentation value. In Fig. 2, a long light source 1 is used to irradiate the entire necessary part of the blood sedimentation tube 3 with light, and a long photodetector 7 is used to detect the red blood cell column. The light-blocking position is detected without vertically moving the photodetection system (a combination of a light source and a photodetector), and the blood sedimentation value is determined. In addition, in FIG. 3, a long light source 1 is used, but a small photodetector such as an image sensor 8 is used, and a lens 5 is used to detect brightness and darkness depending on the amount of light transmitted through the blood sedimentation tube 3 on the light-receiving surface of the image sensor. The blood sedimentation value is determined by focusing the image on top.

The following methods are available for automatically measuring the blood sediment values of a large number of specimens using these methods.

In the method shown in Figure 1, one set of photodetection system is provided for each blood sedimentation tube, the blood sedimentation tubes are arranged horizontally in a row, and one
A method in which a set of photodetection systems is moved laterally and vertically at the position of the blood sedimentation tube, and multiple measuring tubes are vertically attached to multiple blood sedimentation tube attachment parts provided circumferentially on a rotating body. Attach and move the blood sedimentation tube to the measurement position by rotating the rotating body at the appropriate time.
After stopping, the photodetection system is extended to sandwich the blood sedimentation tube, and then lowered vertically to detect the upper end surface of the red blood cell column (Japanese Patent Application Laid-Open No. 56-46461,
JP-A No. 56-46462). Among these methods, the drawback is that they are expensive because they require the same number of light sources and photodetectors as blood sedimentation tubes, and that they are mechanically complex because they require rotational movement and vertical movement of the photodetection system. There is.

On the other hand, the method shown in FIG. 3 has recently received attention as an excellent method that solves the above-mentioned drawbacks. A specific example of the configuration of an automatic blood sedimentation measuring device using this method will be described below. FIG. 4 and FIG. 5 are an external tube view and a front view of one example, and numeral 101 is a blood sedimentation tube mounting base, which is attached to the blood sedimentation tube mounting base 10.
2 are arranged circumferentially. Blood sediment mounting stand 102
An appropriate number of columns 103 are vertically fixed at appropriate intervals around the column, and a disk-shaped blood sedimentation tube fixing plate 1 is placed on top of the columns 103.
04 is provided. A blood sedimentation tube fixture is provided on this fixing plate in correspondence with the blood sedimentation tube mounting base 101, the lower end of the blood sedimentation tube 105 is pressed against the mounting base 101, and the upper part of the blood sedimentation tube is set in the corresponding blood sedimentation tube fixture. This allows the specimen to be held vertically without leaking from the lower end of the blood sedimentation tube, and to be subjected to blood sedimentation measurement. A light source box 106 houses a light source lamp having a long linear filament. 107 is a light receiver box in which an image sensor is housed as a light receiver. The use of this image sensor made it possible for the first time to measure blood sedimentation without vertically moving the light source and photodetector along the blood sedimentation tube.
It is possible to measure a large number of samples with simple operating functions while using only one photodetection system, and has therefore attracted a lot of attention as an automatic blood sedimentation measuring device that is inexpensive and difficult to break down.

Now, the operations and functions of the blood sedimentation automatic measuring device of this configuration example are as follows. The light source box 106 and the light receiving box 107 are connected by a coupling device 108, and the light receiving box 107 is
It is held by drive shafts 109, 109'. This support/drive shaft 109 is connected to a motor 110, and the rotation of the motor 110 rotates the light receiving box 107 and the light source box 106 connected thereto. At that time, light source box 1
06 and the light-receiving box 107, it is configured to rotate so that a blood sedimentation tube is sandwiched therebetween. In other words, the light source box 106 and the light receiving box 107 are arranged opposite to each other on both sides of the measuring tube, and are configured to rotate. Light is irradiated onto the measurement tube from a light source in the light source box, and the transmitted light from the measurement tube is transmitted through a lens and then detected by an image sensor. The area above the top surface of the sedimented red blood cells is transparent plasma, so the irradiated light passes through and reaches the light receiving area, but the area below the top surface of the sedimented red blood cells is opaque, so the light irradiated to this area does not pass through. .
Utilizing this phenomenon, it is possible to observe the boundary between light transmission and non-transmission using the side light on the image sensor, and by measuring the difference between this and the initial blood column height position, the blood sedimentation value can be calculated. can be measured. By driving the motor 110, the light source box 106 and the light receiving unit box 10 are
7, and the measurement tubes are successively passed between the two, so that the blood sediment values of a large number of specimens set can be automatically measured. Since blood sedimentation values usually need to be recorded only after 30 minutes, 1 hour, or 2 hours have passed, the rotation speed may be slow (for example, 1 rotation per minute).

In addition to the above-mentioned parts, the light source box and light receiving box contain light sources 119 and 120 for determining whether or not a blood sedimentation tube is attached, a light source 121 and a light receiver 122 for reading a blood sedimentation tube attachment position number. As a method for reading the position number, for example, a position number discrimination hole 123 is provided in a part of the blood sedimentation tube fixing plate 104.
There is a method in which the light source 121 and the light receiver 122 are provided with the position number discrimination hole sandwiched between the light source 121 and the light receiver 122 during operation. For example, as shown in FIG. 6, it is possible to discriminate up to 63 positions by combining the methods of drilling holes at 6 positions.
Reference numeral 124 is a measurement position number indicator light, and the number of indicators is at least equal to the number of blood sedimentation tubes that can be attached. 125
The printer prints the blood sedimentation value measurement results together with the measurement position number. Reference numerals 126 and 127 indicate operation switches such as a power switch and a measurement time selection switch. Although not shown in the diagram, it will be equipped with a timing device, microcomputer, etc. with the necessary specifications.

Next, the measurement operation and functions of the above-mentioned device example will be described.

1. Collect a predetermined amount of blood sample into a blood sedimentation tube, and set an appropriate number of blood samples on the blood sedimentation tube mount 102.

2 Turn on the switch (you may turn on the switch first and then perform step 1 above).

3 The photodetection systems 106 and 107 rotate, and the light source 119 and light receiver 120 detect whether or not a blood sedimentation tube is attached.
(at the location where the blood sedimentation tube is installed, the incident light to the light receiver 120 is blocked, so discrimination is possible), and the position number is read by the light source 121 and the light receiver 122 and stored in memory. and starts timing for that position number. At the same time, the corresponding number lamp of the measurement position number display light 124 is lit in red to indicate that "measurement is in progress".

4 The photodetection systems 106 and 107 continue to rotate, measuring and storing blood sedimentation values each time they pass through each blood sedimentation tube, and for a certain period of time (for example, 30
minutes, one hour), the blood sedimentation value is printed on the printer 125 along with the measurement position number and the like.

5 Continue the measurement and print the blood sedimentation value together with the position number on the printer 125 for the blood sedimentation tube that has reached the selected measurement time (usually 1 hour or 2 hours; select either one using the measurement time selection switch 127). . At the same time, the corresponding number of the measurement position number display light 124 is switched to a green light to indicate that the measurement has been completed. A blood sedimentation tube whose position number is lit in green indicates that it can be removed and replaced with a blood sedimentation tube containing the next new blood sample. When the blood sedimentation tube is removed after the measurement is completed, the measurement position number indicator light turns off, and when a new blood sedimentation tube is attached, it lights red.

6. For blood sedimentation tubes that are newly installed in empty seats after the start of measurement, and for blood sedimentation tubes that are replaced with new blood sedimentation tubes after measurement ends, the operations from step 3 above are performed each time.

7 In the event of an accident, for example, when a blood sedimentation tube is accidentally removed during measurement.

When the power is cut off due to a power outage, etc., and measurements cannot be taken at the specified time.

When the light source lamp of the light detection system burns out.

When the optical detection system stops rotating due to a failure.

etc., in the event of an accident, an alarm is sounded, the type of accident is printed on the printer 125, and the blood sedimentation tube immediately before the accident occurs is printed even outside of the specified time,
The burden of re-examination is becoming lighter by making use of previous measurement results.

8. When all measurements are completed, the rotation of the photodetection system is automatically stopped. Alternatively, the device is configured to automatically turn off the power.

With the advent of automatic blood sedimentation meters as described above,
It has become possible to significantly reduce the heavy burden of the past, and it has become widely used.

However, the pathological conditions of patients vary widely, and accordingly, the properties of blood also vary widely. For example, bilirubin increases in the blood of patients with liver disease, and as a result, plasma (the portion above the top of the red blood cell layer when red blood cells sediment), which should normally be colorless and transparent, turns yellow. Furthermore, the blood of anemic patients or patients undergoing artificial dialysis is dilute, and when blood sedimentation is measured, the boundary of the upper surface of red blood cells becomes unclear. In such cases where the red color is unclear, it has traditionally been prescribed to read the position where it is thought that the red color will not become any darker.

By the way, in the conventional method of measuring the erythrocyte sedimentation rate by irradiating a blood sedimentation measurement tube containing a blood sample with light and measuring the red blood cells by detecting the transmitted light at a predetermined time, infrared light is used as the irradiation light. However, when the present inventors collected measurement data using such long wavelength light on a large number of specimens, it was found that a large number of specimens with the above-mentioned tendency were detected. Discrepancies with visual values (values obtained by measuring with the human eye using conventional methods) were observed at a rate of . Note that the conventional method of optically measuring blood sedimentation levels using long wavelength light such as infrared rays is extremely common sense and an idea that can be arrived at naturally.

This is because the yellow color exhibited by the plasma of patients with a high bilirubin content allows long-wavelength red light to pass through easily, and due to anemia, the density of red blood cells is low and they are dispersed over a certain range without showing a clear red blood cell sedimentation interface. This is because it is thought that for such a specimen, light with a longer wavelength passes through the dispersed red blood cell particles and reaches the photodetector, and becomes opaque only in areas where the red blood cell sedimentation density is high.

However, the discrepancy between the actual measurement results and the visually observed values is as described above. Therefore, the inventor of the present invention searched for a method to obtain a good agreement between visual values and optically measured values, which had been carried out for many years, and found that it is better to use short-wavelength green or blue light than red. We have reached a conclusion that cannot be reached from the conventional wisdom mentioned above, that a good agreement can be obtained. For example, when a large number of samples were automatically measured using the automatic hematology analyzer using a filter with a transmission center wavelength of around 500 nm and compared with visually observed values, the percentage of "unmatched samples" showing a discrepancy of 3 mm or more was approximately It decreased to 4%. This is a significant performance improvement compared to the mismatch rate of about 13% when using red or near-infrared light.

It goes without saying that it may be necessary to change the determination output level of the output of the photodetector as the wavelength used changes.

As described in detail above, by carrying out the present invention, it is possible to automatically measure the blood sedimentation level of samples of all types accurately and with almost no effort. be.

As mentioned above, when using a conventional infrared transmitting filter (a filter that does not transmit light of 600 nm or less, but transmits light of 600 to 3000 nm), not only the discrepancy rate with visual values is large, but also the blood sedimentation value Examples of discrepancies are observed even in the case of small specimens.

However, in the method of the present invention using light with a center wavelength of 500 nm, it was found that the rate of discrepancy with visual values was small, and that the specimens showing discrepancy were limited to cases where the blood sediment value was 80 mm or more. The normal value of blood sedimentation value is
It is considered to be 10 mm or less for men and 15 mm or less for women. For both men and women, up to 25 mm is considered mild promotion, 25 to 50 mm is moderate promotion, and 50 mm or more is considered severe promotion. Therefore 80
mm or more is a significant acceleration, and for such a value, it can be said that it is meaningless to talk about a measurement error of 5 mm or 10 mm.

Therefore, the purpose of automatic blood sedimentation measurement can be sufficiently achieved by using light with a center wavelength of 500 nm, but it will be even more effective if the following mechanism is added.

That is, in carrying out the automatic blood sedimentation measurement method of the present invention, if, for example, one-hour value measurement is selected, if the blood sedimentation value of the sample after one hour is, for example, 80 mm or more, an alarm will be emitted or the measurement position will be changed. The purpose of the present invention can be achieved by configuring the lamp of the corresponding position number among the number display lights 124 to blink, and by visually measuring only the specimen of that number to supplement automatic measurement. It is even more advantageous.

Examples and comparative examples of the present invention are shown below.

Example Using the apparatus shown in FIGS. 3 to 5, an automatic blood sedimentation measurement was carried out by applying a filter with a transmission center wavelength of 500 nm to the light source 1.

As a result, as shown in the chart of FIG. 7, the discrepancy rate between the readings by the automatic blood sedimentation measuring device and the readings visually was 4.2%.

Comparative Example The same procedure as in the example was carried out except that an infrared transmitting filter was used as the filter, and the results shown in FIG. 8 were obtained.

In this case, the mismatch rate was 12.5%, and the improvement effect of the present invention was clearly recognized.

[Brief explanation of drawings]

Figures 1 to 3 are exemplary diagrams showing combinations of light sources and photodetectors in the conventional automatic blood sediment measurement method, and Figures 4 and 5 are automatic blood sediment measurement devices using the method shown in Figure 3. FIG. 6 is an illustrative diagram showing a position reading method in FIGS. 3 and 4;
FIG. 7 is a chart showing the correlation between the readings by the automatic blood sedimentation measuring method according to the embodiment of the present invention and the visual readings, and FIG. 8 is the chart showing the correlation between the readings by the automatic blood sedimentation measuring method and the visual readings according to the comparative example. It is a chart showing the correlation with reading values. 1...Light source, 2...Photodetector, 3...Blood sedimentation tube,
4... Red blood cell column, 5... Lens, 7... Long photodetector, 8... Image sensor.

Claims (1)

[Claims] 1. Irradiating a blood sedimentation measuring tube containing a blood sample with light,
1. An automatic blood sedimentation measurement method for measuring an erythrocyte sedimentation rate by detecting transmitted light over a predetermined period of time and measuring the length of an erythrocyte column, characterized in that the center wavelength of the measurement light is set at around 500 nm. 2. Irradiate the blood sedimentation measurement tube containing the blood sample with light,
An automatic blood sedimentation measurement device for measuring erythrocyte sedimentation rate by detecting transmitted light over a predetermined period of time and measuring red blood cell column length, characterized in that the center wavelength of the measurement light is around 500 nm.