采用Hemocue和参考方法测定静脉血和毛细血管血中的血红蛋白:一项验证研究。
Hemoglobin measured by Hemocue and a reference method in venous and capillary blood: a validation study.
作者信息
Neufeld Lynnette, García-Guerra Armando, Sánchez-Francia Domingo, Newton-Sánchez Oscar, Ramírez-Villalobos María Dolores, Rivera-Dommarco Juan
机构信息
División de Epidemiología de la Nutrición, Centro de Investigaciones en Nutrición y Salud, Instituto Nacional de Salud Pública, Av. Universidad 655, colonia Santa María Ahuacatitlán, 62508 Cuernavaca, Morelos, México.
出版信息
Salud Publica Mex. 2002 May-Jun;44(3):219-27. doi: 10.1590/s0036-36342002000300005.
OBJECTIVE
To assess the comparability of hemoglobin concentration (Hb) in venous and capillary blood measured by Hemocue and an automated spectrophotometer (Celldyn) and to document the influence of type of blood (capillary or venous) and analysis method on anemia prevalence estimates.
MATERIAL AND METHODS
Between February and May 2000, capillary and venous samples were collected from 72 adults and children at Hospital del Niño Morelense (Morelos State Children's Hospital) in Cuernavaca, Morelos, Mexico, and assessed for Hb using the Hemocue and Celldyn methods. Estimated Hb levels were compared using the concordance correlation coefficient and Student's t test for paired data. The sensitivity and specificity for anemia diagnosis were estimated and compared between type of blood and method of assessment.
RESULTS
Capillary blood had higher Hb (+0.5 g/dl) than venous blood in adults and children, as did samples assessed by Celldyn compared to Hemocue (+0.3 g/dl). Specificity to detect anemia was adequate (> 0.90) but sensitivity was low for capillary blood assessed by Hemocue (< 0.80).
CONCLUSIONS
The difference in Hb between venous and capillary blood is likely related to biological variability. Hemoglobin concentration in capillary blood assessed by Hemocue provides an adequate estimation of population anemia prevalence but may result in excess false negative diagnoses among individuals. The results of this study stress the importance of sample collection technique, particularly for children. Method of analysis and sampling site need to be taken into consideration in field studies. The English version of this paper is available too at: http://www.insp.mx/salud/index.html.
目的
评估采用Hemocue和自动分光光度计(Celldyn)测定的静脉血和毛细血管血中血红蛋白浓度(Hb)的可比性,并记录血液类型(毛细血管血或静脉血)和分析方法对贫血患病率估计值的影响。
材料与方法
2000年2月至5月期间,在墨西哥莫雷洛斯州库埃纳瓦卡的莫雷伦塞儿童医院(Hospital del Niño Morelense)采集了72名成人和儿童的毛细血管血和静脉血样本,并使用Hemocue和Celldyn方法评估Hb。采用一致性相关系数和配对数据的Student t检验比较估计的Hb水平。估计并比较贫血诊断的敏感性和特异性在血液类型和评估方法之间的差异。
结果
成人和儿童的毛细血管血Hb水平高于静脉血(高0.5 g/dl),Celldyn评估的样本与Hemocue评估的样本相比也是如此(高0.3 g/dl)。检测贫血的特异性足够(>0.90),但Hemocue评估的毛细血管血敏感性较低(<0.80)。
结论
静脉血和毛细血管血之间Hb的差异可能与生物学变异性有关。Hemocue评估的毛细血管血中的血红蛋白浓度能够充分估计人群贫血患病率,但可能导致个体中出现过多的假阴性诊断。本研究结果强调了样本采集技术的重要性,尤其是对于儿童。在现场研究中需要考虑分析方法和采样部位。本文的英文版也可在以下网址获取:http://www.insp.mx/salud/index.html。