Serum chloride (Cl)

The total amount of chlorine in the body is about 100g, which is mainly present in the form of chloride ions in tissues and body fluids, which is the anion with the largest amount of extracellular fluid. It is closely related to the content of bicarbonate. Chloride plays an important role in regulating water, osmotic pressure and acid-base balance in the body. Chloride ions in the body are often absorbed and metabolized with sodium ions, and the changes are often consistent. Basic Information Specialist classification: growth and development check classification: biochemical examination Applicable gender: whether men and women apply fasting: fasting Analysis results: Below normal: Found in severe vomiting, high intestinal obstruction, chronic pyloric obstruction. Normal value: Serum chloride (Cl: 98-106mmol/L Above normal: Found in acute and chronic renal failure, renal tubular acidosis, obstructive nephropathy. negative: Positive: Reminder: Each measurement should be measured with a fixed value of quality control serum to ensure the accuracy of the results. Normal value Ion selective electrode method 98 to 106 mmol/L (98 to 106 mEq/L) based on the chloride. It is 100-106 mmol/L (55-376 mg/dl) based on chlorine. Clinical significance 1, increase (1) Reduction in discharge is seen in acute and chronic renal failure, renal tubular acidosis, obstructive nephropathy, and the like. (2) Excessive intake is seen in high-salt diets, and excessive saline is input, especially in chronic renal insufficiency. (3) Respiratory alkalosis. (4) Hypertonic dehydration (dehydration > loss of sodium). (5) bismuth bromide poisoning. 2, lower (1) severe vomiting, high intestinal obstruction, chronic pyloric obstruction and so on. (2) Artificial stomach or intestinal fistula causes a large loss of gastric juice, pancreatic juice, and bile. (3) Chronic adrenal insufficiency. (4) severe diabetes caused by excessive urinary acidosis. (5) Excessive sweating did not make up sodium chloride in time. (6) Heart failure and nephritis long-term salt-free or low-salt diet and a lot of diuretic. Low results may be diseases: chronic adrenal insufficiency results may be high disease: renal tubular acidosis, hyperosmotic dehydration, respiratory alkalosis precautions 1. After the chlorine electrode is used for a long time, black substance (AgCl) will appear on the electrode film head. At this time, the sensitivity of the electrode is lowered, and the black material on the surface of the film is wiped off with a soft cloth, and then gently rubbed several times with fine sandpaper. Just fine. 2. Each measurement should be performed simultaneously with fixed-quality control serum to ensure the accuracy of the results. 3. In the currently widely used electrolyte analyzer, the chlorine electrode is a liquid membrane electrode that selectively responds to chloride ions. It uses a quaternary ammonium salt which has an exchange effect on chloride ions as an active material. Into a special PVC tubular electrode, one side of the membrane is in contact with the sample solution, and the other side is in contact with the internal reference solution. The membrane potential is directly proportional to the activity of the chloride ion in the sample, and the potential difference between the chlorine electrode and the reference electrode It changes as the chloride ion activity in the sample solution changes. 4. The ion selective electrode method (ISE) measures the ion activity in the sample solution, which is different from the ion concentration measured by the flame method. In the flame method, it is assumed that the activity coefficient of water is 100% ideal, but the sample is usually determined to contain protein, cholesterol, triglyceride, etc., and these substances occupy 3% to 7% of the total volume in normal human serum. This factor is caused by the ISE method results are 3% to 7% higher than the flame method results. On the other hand, proteins and other macromolecules will complex a part of the ions, which causes the ISE method to be lower than the flame method. In most cases, the first factor dominates, so the ISE method is 1% to 5% higher than the flame method. Because the ISE method measures the ion activity, it can better reflect the actual situation of the electrolyte in the human body. 5, Bi Ping and other ISE method and α-amylase-glucosidase two-point kinetic method for the determination of chlorine, found that the ISE method precision and anti-interference is significantly better than the enzymatic method, high-fat samples (TG> 7.5mmol / L ) There is a significant negative interference with the determination of serum chlorine by enzymatic method, but no effect on the ISE method. Yan Daliang and other studies have found that sodium azide has a greater impact on the determination of chlorine by ISE, which can make chlorine significantly higher. Therefore, sodium azide should not be used as a preservative for the reagent, nor can a quality control serum containing sodium azide be used. Yu Jianxin also found that the stabilizers and preservatives in the quality control serum have obvious interference with the chlorine electrode of the SLD938 ion analyzer, resulting in high results. Therefore, when selecting quality control serum, pay attention to the use of products that do not interfere with the electrode. 6. When the PVC liquid film electrode is immersed in the aqueous solution for a long time, the electroactive substance therein will be continuously dissolved and lost, and the life of the electrode is shortened. So for the average medium laboratory. Preferably, after measuring the sample every day, the electrode is rinsed with distilled water, and the water in the electrode is drained, dried overnight, and activated for 15 to 30 minutes with the activation solution the next day, and used after calibration. In addition, it should be noted that the standard method and the quality control liquid of the flame method cannot be used to calibrate the electrode. Prevent poisoning damage to the electrode. Inspection process Immediately after venous blood collection, the test is sent. The detection method and procedure are similar to the ISE method for measuring potassium sodium. The chlorine electrode consists of the base of the electrode and the head. The head contains silver-silver chloride particles. When the chloride ions in the solution contact the surface of the electrode head, an electromotive force obeying the Nernst equation is generated. When connected with the reference electrode, the chlorine in the sample can be detected. The concentration of the compound. Not suitable for the crowd A patient with hemophilia and severe clotting factor deficiency. Adverse reactions and risks Infection: Do not touch the dirt after blood collection. Do not wash your hands immediately to avoid infection.