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血淸內 生化學的 成分의 時間的 變動에 關한 實驗的 硏究
徐載鶴,金春元 한양대학교 의과대학 1984 한양의대 학술지 Vol.4 No.1
In interpreting the significance of a changes in the value of a serum constitutents over time, the clinician is often faced with the problem of diciding whether the difference between two measured values reflect a change in the patient's conditions or could be explained on the basis of the expected biological fluctuations occuring in healthy subjects. To make this decision, one must be equipped with knoweledge of the usual biologic variation. This study made it possible to seperate the analytical (procedural) from biological (time, subject) sources of variation. Author evaluated the biological variation (time, subject) of serum consituents in a group of 7 healthy young men. Fourteen constituents (albumin, total protein, cholesterol, triglyceride, creatinine, blood urea nitrogen, glucose, hydroxybutyrate dehydrogenase, gammaglutamyl transpeptidase, creatine phosphokinase, lactic dehydrogenase, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, were assayed at the same time. All of them were performed on the "MCA (Microcentrifugal Analyzer Multi Ⅲ)" analyzer. The twenty one venipunctures were performed: 6:30 A.M. breakfast. Group A (7,8,9,10,11, A.M.), 11:30 A.M. lunch. Group B (12 A.M. 1,2,3,4, P.M.), 4:30 P.M. dinner. Group C (5,6,7,8,9, P.M.), 10:00 P.M. sleeping group D (01,11,12, P.M., next morning 4,5 A.M.), group E (12 A.M. 5 P.M.), and extra 6 A.M. A groups were standing time, B groups were sitting time, C groups were resting time, D groups were sleeping time, E group were after eating time. The statistical significance (t-test) was calculated on the basis of the comparision of 5 group's values and grand mean, and calculated coefficiency variation of all time, in order to compare the intra individual variation (subject variation). The results were as following: 1. The significant changes (P<0.05) in group A were seen for increased albumin, blood urea nitrogen, aspartate aminotransferase, and decreased glucose, alanine aminotransferase. 2. The significant changes (P<0.05) in group B were seen for decreased choloesterol, and increased albumin and glucose. 3. The significant changes (P<0.05) in group C were seen for decreased triglyceride. 4. The significant changes (P<0.05) in group D were seen for descreased albumin, total protein, triglyceride, blood urea nitrogen, and glucose. 5. The significant changes (P<0.05) in group E were seen for decreased total protein, cholesterol, and increased glucose. 6. The intra individual variation of albumin, total protein, and glucose were very low (mean CV: 10%). 7. The intra individual variation of cholesterol, creatinine, blood urea nitrogen, hydroxybutyrate dehydrogenase, lactic dehydrogenase aspartate aminotransferase, and alkaline phosphatase were medium(10% mean CV: 20%). 8. The intra individual variation of triglyceride, gamma-glutarmyl transpeptidase, creatine phosphokinase and alanine aminotransferase were higher (mean CV: 20%).