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两种经皮数字测量设备无创测定血红蛋白浓度的有效性和一致性

Validity and correspondence of non-invasively determined hemoglobin concentrations by two trans-cutaneous digital measuring devices.

作者信息

Crowley Caitlin, Montenegro-Bethancourt Gabriela, Solomons Noel W, Schűmann Klaus

机构信息

Center for Studies of Sensory Impairment, Aging and Metabolism, Guatemala City, Guatemala.

出版信息

Asia Pac J Clin Nutr. 2012;21(2):191-200.

Abstract

Hemoglobin (Hb) concentration is the central diagnostic indicator for anemia, including nutritional anemia. The objective of this study was to compare the Hb values determined by two portable, non-invasive devices across a wide Hb spectrum against formal laboratory measurements, and with each other. Eighty Guatemalan adults (40 highland men, 40 lowland pregnant women) provided venous blood for formal Hb colorimetric determination. Hb was also registered sequentially on the Rad-87™ pulse CO-Oximeter with Rainbow Set technology (Masimo) and Haemospect® (MBR Optical Systems) by non-invasive skin-probe contact procedures as per manufacturers' instructions. Whole blood Hb concentrations ranged from 7.8 to 18.5 g/dL (mean, 12.9±2.3 g/dL and median, 13.3 g/dL). Corresponding descriptive statistics were: range, 9.6 to 16.2 g/dL; mean, 12.1±1.5 g/dL; and median, 11.9 g/L, respectively, with the Rad-87™ (nail bed). They were: range, 8.7 to 15.8 g/dL; mean, 12.7±1.8 g/dL; and median13.0 g/dL for the Hemospect® for forearm contact. They were: range, 9.1 to 17.5 g/dL; mean, 13.2±2.1 g/dL; and median, 13.4 g/dL for palm contact. The Pearson correlation coefficient of venous blood Hb with the former device's Hb values was r=0.59 (p<0.001), and r=0.94 (p<0.001) and r=0.90 (p<0.001) with those of the latter device at the palm and forearm, respectively. The inter-site Lin coefficient was r=0.84. Sensitivity and specificity were variable across devices, depending on Hb cut-off and measurement procedures. With Hb cut-off values of <12.0 g/dL for adult (non-pregnant women and <13.0 g/dL for adult men), the Haemospect device's performance here would provide adequate potential for screening purposes.

摘要

血红蛋白(Hb)浓度是贫血(包括营养性贫血)的核心诊断指标。本研究的目的是比较两种便携式非侵入性设备在较宽Hb范围内测定的Hb值与正规实验室测量值之间的差异,以及这两种设备之间的差异。80名危地马拉成年人(40名高地男性、40名低地孕妇)提供静脉血用于正规的Hb比色测定。按照制造商的说明,通过非侵入性皮肤探头接触程序,还使用具有彩虹技术的Rad-87™脉搏血氧饱和度仪(Masimo公司)和Haemospect®(MBR光学系统公司)依次记录Hb值。全血Hb浓度范围为7.8至18.5 g/dL(均值为12.9±2.3 g/dL,中位数为13.3 g/dL)。使用Rad-87™(甲床)时相应的描述性统计数据分别为:范围9.6至16.2 g/dL;均值12.1±1.5 g/dL;中位数11.9 g/L。对于前臂接触的Haemospect®,数据分别为:范围8.7至15.8 g/dL;均值12.7±1.8 g/dL;中位数13.0 g/dL。对于手掌接触,数据分别为:范围9.1至17.5 g/dL;均值13.2±2.1 g/dL;中位数13.4 g/dL。静脉血Hb与前一种设备的Hb值的Pearson相关系数为r = 0.59(p<0.001),与后一种设备在手掌和前臂处的Hb值的相关系数分别为r = 0.94(p<0.001)和r = 0.90(p<0.001)。不同部位间的Lin系数为r = 0.84。不同设备的敏感性和特异性各不相同,这取决于Hb临界值和测量程序。对于成年人(非孕妇Hb临界值<12.0 g/dL,成年男性Hb临界值<13.0 g/dL),此处Haemospect设备的性能可为筛查目的提供足够的潜力。

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