臨床化学

WordNet

the way two individuals relate to each other; "their chemistry was wrong from the beginning -- they hated each other"; "a mysterious alchemy brought them together" (同)interpersonal chemistry, alchemy
the chemical composition and properties of a substance or object; "the chemistry of soil"
the science of matter; the branch of the natural sciences dealing with the composition of substances and their properties and reactions (同)chemical science
a healthcare facility for outpatient care
a medical establishment run by a group of medical specialists
meeting for diagnosis of problems and instruction or remedial work in a particular activity
scientifically detached; unemotional; "he spoke in the clipped clinical monotones typical of police testimony"
relating to a clinic or conducted in or as if in a clinic and depending on direct observation of patients; "clinical observation"; "clinical case study"
a scientist who specializes in chemistry

PrepTutorEJDIC

『化学』 / 化学的性質,化学反応,化学作用
〈U〉(医学の)臨床講義 / 〈C〉《集合的に》臨床講義のクラス / 〈C〉臨床講義室 / 〈C〉(病院・医科大学・社会事業団などに付属した)診療所;《形容詞を判って》医療施設,病院 / 〈C〉(警察・学校・社会事業団などに付属した)相談所
臨床の,臨床講義の / 病床の / 臨床的な,客観的な態度の
『化学者』 / 《英》=pharmacist

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/11/10 14:40:37」(JST)

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Clinical chemistry (also known as chemical pathology, clinical biochemistry or medical biochemistry) is the area of clinical pathology that is generally concerned with analysis of bodily fluids.

The discipline originated in the late 19th century with the use of simple chemical tests for various components of blood and urine. Subsequent to this, other techniques were applied including the use and measurement of enzyme activities, spectrophotometry, electrophoresis, and immunoassay.

Most current laboratories are now highly automated to accommodate the high workload typical of a hospital laboratory. Tests performed are closely monitored and quality controlled.

All biochemical tests come under chemical pathology. These are performed on any kind of body fluid, but mostly on serum or plasma. Serum is the yellow watery part of blood that is left after blood has been allowed to clot and all blood cells have been removed. This is most easily done by centrifugation, which packs the denser blood cells and platelets to the bottom of the centrifuge tube, leaving the liquid serum fraction resting above the packed cells. This initial step before analysis has recently been included in instruments that operate on the "integrated system" principle. Plasma is in essence the same as serum, but is obtained by centrifuging the blood without clotting. Plasma is obtained by centrifugation before clotting occurs. The type of test required dictates what type of sample is used.

A large medical laboratory will accept samples for up to about 700 different kinds of tests. Even the largest of laboratories rarely do all these tests themselves, and some must be referred to other labs.

This large array of tests can be further sub-categorised into sub-specialities of:

General or routine chemistry - commonly ordered blood chemistries (e.g., liver and kidney function tests).
Special chemistry - elaborate techniques such as electrophoresis, and manual testing methods.
Clinical endocrinology - the study of hormones, and diagnosis of endocrine disorders.
Toxicology - the study of drugs of abuse and other chemicals.
Therapeutic Drug Monitoring - measurement of therapeutic medication levels to optimize dosage.
Urinalysis - chemical analysis of urine for a wide array of diseases, along with other fluids such as CSF and effusions
Fecal analysis - mostly for detection of gastrointestinal disorders.

Tests

Common clinical chemistry tests include:

Electrolytes

Sodium
Potassium
Chloride
Bicarbonate

Renal (Kidney) Function Tests

Creatinine
Blood urea nitrogen

Liver Function Tests

Total protein (serum)
- Albumin
- Globulins
- A/G ratio (albumin-globulin)
- Protein electrophoresis
- Urine protein
Bilirubin; direct; indirect; total
Aspartate transaminase (AST)
Alanine transaminase (ALT)
Gamma-glutamyl transpeptidase (GGT)
Alkaline phosphatase (ALP)

Cardiac Markers

Troponin
Myoglobin
CK-MB
B-type natriuretic peptide (BNP)

Minerals

Calcium
Magnesium
Phosphate
Potassium

Blood Disorders

Iron
Transferrin
TIBC
Vitamin B12
Folic acid

Miscellaneous

Glucose
C-reactive protein
Glycated hemoglobin (HbA1c)
Uric acid
Arterial blood gases ([H⁺], P_CO₂, P_O₂)
Adrenocorticotropic hormone (ACTH)
Toxicological screening and forensic toxicology (drugs and toxins)
Neuron-specific enolase (NSE)
fecal occult blood test (FOBT)

Panel tests

A set of commonly ordered tests are combined into a panel:

Basic metabolic panel (BMP) - 8 tests - sodium, potassium, chloride, bicarbonate, blood urea nitrogen (BUN), creatinine, glucose, calcium
Comprehensive metabolic panel (CMP) - 14 tests - above BMP plus total protein, albumin, alkaline phosphatase (ALP), alanine amino transferase (ALT), aspartate amino transferase (AST), bilirubin

Notes and references

Clinical Biochemistry (journal)

Bibliography

Burtis, Carl A.; Ashwood, Edward R.; Bruns, David E. (2006). Tietz textbook of clinical chemistry (4th ed.). Saunders. p. 2448. ISBN 978-0-7216-0189-2. Cite uses deprecated parameters (help)

External links

American Association of Clinical Chemistry
Association for Mass Spectrometry: Applications to the Clinical Lab (MSACL)

UpToDate Contents

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English Journal

Plasma endostatin may improve acute kidney injury risk prediction in critically ill patients.

Mårtensson J1,2, Jonsson N3, Glassford NJ4, Bell M5, Martling CR6, Bellomo R7,8, Larsson A9.
Annals of intensive care.Ann Intensive Care.2016 Dec;6(1):6. doi: 10.1186/s13613-016-0108-x. Epub 2016 Jan 13.
BACKGROUND: Breakdown of renal endothelial, tubular and glomerular matrix collagen plays a major role in acute kidney injury (AKI) development. Such collagen breakdown releases endostatin into the circulation. The aim of this study was to compare the AKI predictive value of plasma endostatin with tw
PMID 26762504

(177)Lu-labelled macrocyclic bisphosphonates for targeting bone metastasis in cancer treatment.

Bergmann R1, Meckel M2, Kubíček V3, Pietzsch J1, Steinbach J1, Hermann P3, Rösch F4.
EJNMMI research.EJNMMI Res.2016 Dec;6(1):5. doi: 10.1186/s13550-016-0161-3. Epub 2016 Jan 16.
BACKGROUND: Metastatic bone lesion is a common syndrome of many cancer diseases in an advanced state. The major symptom is severe pain, spinal cord compression, and pathological fracture, associated with an obvious morbidity. Common treatments including systemic application of bisphosphonate drugs a
PMID 26780082

Carbon dioxide dialysis in a swine model utilizing systemic and regional anticoagulation.

Sharma AS1, Weerwind PW2, Bekers O3, Wouters EM4, Maessen JG2.
Intensive care medicine experimental.Intensive Care Med Exp.2016 Dec;4(1):2. doi: 10.1186/s40635-016-0076-3. Epub 2016 Jan 16.
BACKGROUND: Extracorporeal carbon dioxide removal (ECCO2R) has been gaining interest to potentially facilitate gas transfer and equilibrate mild to moderate hypercapnic acidosis, when standard therapy with non-invasive ventilation is deemed refractory. However, concern regarding the effectiveness of
PMID 26780677