Jones L A, Gonzalez E R, Venitz J, Edinboro L E, Poklis A
Department of Pharmacy, Medical College of Virginia, Richmond.
Ann Emerg Med. 1992 Jul;21(7):777-81. doi: 10.1016/s0196-0644(05)81020-0.
To determine whether the use of fingerstick blood samples or venipuncture blood samples affect the accuracy and the precision of the Vision Theophylline I assay and the Vision Theophylline II assay in the emergency department setting.
Prospective clinical trial.
ED in a university teaching hospital.
SUBJECTS/INTERVENTIONS: Simultaneous fingerstick and venipuncture blood samples were obtained from adult patients who required baseline theophylline levels in the ED.
The Vision system was used in the ED to measure theophylline concentrations from fingerstick and venipuncture samples. Vision samples were drawn and analyzed by one of three pharmacists rounding within the ED between March and October 1990. These pharmacists were instructed by laboratory personnel concerning pertinent operating procedures. The vision Theophylline I and Theophylline II assays are enzyme-inhibitor immunoassays contained within a multi-chamber test packet. The high-performance liquid chromatography (HPLC) theophylline assay was used as the reference method.
Linear regression of theophylline concentrations determined by the Vision Theophylline I assay versus HPLC revealed a significant correlation for fingerstick samples (r = .9440; P less than .05) and for venipuncture samples (r = .9750; P less than .05). The accuracy values for Vision Theophylline I assay venipuncture and fingerstick samples versus HPLC were -0.63 +/- 1.2 mg/l and 0.22 +/- 1.8 mg/L, respectively. The precision for Vision Theophylline I assay venipuncture and fingerstick samples versus HPLC were 0.27 and 0.38, respectively. Linear regression of theophylline concentrations determined by the Vision Theophylline II assay versus HPLC revealed a significant correlation for fingerstick samples (r = .9804; P less than .05) and for venipuncture samples (r = .9875; P less than .05). Accuracy values for Vision Theophylline II fingerstick and venipuncture samples versus HPLC were -0.53 +/- 1.4 mg/L and -0.65 +/- 1.3 mg/L, respectively. Precision values for Vision Theophylline II fingerstick and venipuncture samples versus HPLC were 0.34 and 0.29, respectively.
There is a strong correlation between theophylline concentrations measured by Vision Theophylline assay versus HPLC, regardless of whether the Vision Theophylline assay is performed on a fingerstick or venipuncture sample. Vision fingerstick samples were more accurate than Vision venipuncture samples for both Vision Theophylline I and II assays. Theophylline concentrations measured by the Vision system using venipuncture samples were slightly more precise than those using fingerstick samples when compared with HPLC analysis. These differences in accuracy and precision were not clinically relevant.
确定在急诊科环境中，使用指尖血样本或静脉穿刺血样本是否会影响“视觉茶碱 I 检测法”和“视觉茶碱 II 检测法”的准确性和精密度。
前瞻性临床试验。
一所大学教学医院的急诊科。
研究对象/干预措施：从急诊科需要测定茶碱基线水平的成年患者中同时采集指尖血和静脉穿刺血样本。
在急诊科使用视觉系统测量指尖血和静脉穿刺血样本中的茶碱浓度。1990 年 3 月至 10 月期间，由三名在急诊科巡视的药剂师之一采集并分析视觉样本。实验室人员就相关操作程序对这些药剂师进行了指导。视觉茶碱 I 和视觉茶碱 II 检测法是多腔测试包中的酶抑制免疫检测法。采用高效液相色谱（HPLC）茶碱检测法作为参考方法。
视觉茶碱 I 检测法测定的茶碱浓度与 HPLC 测定结果的线性回归显示，指尖血样本（r = 0.9440；P < 0.05）和静脉穿刺血样本（r = 0.9750；P < 0.05）均具有显著相关性。视觉茶碱 I 检测法的静脉穿刺样本和指尖血样本与 HPLC 相比的准确度值分别为 -0.63 ± 1.2 mg/l 和 0.22 ± 1.8 mg/L。视觉茶碱 I 检测法的静脉穿刺样本和指尖血样本与 HPLC 相比的精密度分别为 0.27 和 0.38。视觉茶碱 II 检测法测定的茶碱浓度与 HPLC 测定结果的线性回归显示，指尖血样本（r = 0.9804；P < 0.05）和静脉穿刺血样本（r = 0.9875；P < 0.05）均具有显著相关性。视觉茶碱 II 检测法的指尖血样本和静脉穿刺血样本与 HPLC 相比的准确度值分别为 -0.
