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一种廉价的袖珍红外扫描仪对人血和牛血中碳氧血红蛋白和高铁血红蛋白检测的准确性。

Accuracy of detection of carboxyhemoglobin and methemoglobin in human and bovine blood with an inexpensive, pocket-size infrared scanner.

机构信息

Department of Anesthesia and Perioperative Care, Hypoxia Research Laboratory, University of California, San Francisco, California, United States of America.

出版信息

PLoS One. 2018 Mar 7;13(3):e0193891. doi: 10.1371/journal.pone.0193891. eCollection 2018.

Abstract

Detecting life-threatening common dyshemoglobins such as carboxyhemoglobin (COHb, resulting from carbon monoxide poisoning) or methemoglobin (MetHb, caused by exposure to nitrates) typically requires a laboratory CO-oximeter. Because of cost, these spectrophotometer-based instrument are often inaccessible in resource-poor settings. The aim of this study was to determine if an inexpensive pocket infrared spectrometer and smartphone (SCiO®Pocket Molecular Sensor, Consumer Physics Ltd., Israel) accurately detects COHb and MetHb in single drops of blood. COHb was created by adding carbon monoxide gas to syringes of heparinized blood human or cow blood. In separate syringes, MetHb was produced by addition of sodium nitrite solution. After incubation and mixing, fractional concentrations of COHb or MetHb were measured using a Radiometer ABL-90 Flex® CO-oximeter. Fifty microliters of the sample were then placed on a microscope slide, a cover slip applied and scanned with the SCiO spectrometer. The spectrograms were used to create simple linear models predicting [COHb] or [MetHb] based on spectrogram maxima, minima and isobestic wavelengths. Our model predicted clinically significant carbon monoxide poisoning (COHb ≥15%) with a sensitivity of 93% and specificity of 88% (regression r2 = 0.63, slope P<0.0001), with a mean bias of 0.11% and an RMS error of 21%. Methemoglobinemia severe enough to cause symptoms (>20% MetHb) was detected with a sensitivity of 100% and specificity of 71% (regression r2 = 0.92, slope P<0.001) mean bias 2.7% and RMS error 21%. Although not as precise as a laboratory CO-oximeter, an inexpensive pocket-sized infrared scanner/smartphone detects >15% COHb or >20% MetHb on a single drop of blood with enough accuracy to be useful as an initial clinical screening. The SCiO and similar relatively low cost spectrometers could be developed as inexpensive diagnostic tools for developing countries.

摘要

检测危及生命的常见变性血红蛋白,如一氧化碳中毒引起的碳氧血红蛋白(COHb)或暴露于硝酸盐引起的高铁血红蛋白(MetHb),通常需要实验室 CO 分光光度计。由于成本原因,这些基于分光光度法的仪器在资源匮乏的环境中往往无法获得。本研究旨在确定一种廉价的口袋式红外分光光度计和智能手机(SCiO®Pocket Molecular Sensor,Consumer Physics Ltd.,以色列)是否能准确检测一滴血液中的 COHb 和 MetHb。COHb 是通过向肝素化人或牛血液的注射器中添加一氧化碳气体产生的。在单独的注射器中,通过添加亚硝酸钠溶液产生 MetHb。孵育和混合后,使用 Radiometer ABL-90 Flex® CO 分光光度计测量 COHb 或 MetHb 的分数浓度。然后将 50 微升样品置于显微镜载玻片上,盖上盖玻片,用 SCiO 分光光度计进行扫描。光谱图用于创建基于光谱图最大值、最小值和等色波长预测 [COHb] 或 [MetHb] 的简单线性模型。我们的模型预测临床上显著的一氧化碳中毒(COHb≥15%)的敏感性为 93%,特异性为 88%(回归 r2=0.63,斜率 P<0.0001),平均偏差为 0.11%,均方根误差为 21%。足以引起症状的高铁血红蛋白血症(>20% MetHb)的检测灵敏度为 100%,特异性为 71%(回归 r2=0.92,斜率 P<0.001),平均偏差为 2.7%,均方根误差为 21%。虽然不如实验室 CO 分光光度计精确,但一种廉价的袖珍式红外扫描仪/智能手机可以在一滴血液上检测到超过 15% 的 COHb 或超过 20% 的 MetHb,其准确性足以作为初始临床筛查。SCiO 和类似的相对低成本光谱仪可以开发为发展中国家的廉价诊断工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd4a/5841812/ae3724a64c82/pone.0193891.g001.jpg

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