Department of clinical research and education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Neonatal Unit at Sachs' Children and Youth hospital, Stockholm, Sweden.
Sci Rep. 2019 Jun 26;9(1):9301. doi: 10.1038/s41598-019-45606-0.
There is a growing recognition of the importance of point-of-care tests (POCTs) for detecting critical neonatal illnesses to reduce the mortality rate in newborns, especially in low-income countries, which account for 98 percent of reported neonatal deaths. Lactate dehydrogenase (LDH) is a marker of cellular damage as a result of hypoxia-ischemia in affected organs. Here, we describe and test a POC LDH test direct from whole blood to provide early indication of serious illness in the neonate. The sample-in-result-out POC platform is specifically designed to meet the needs at resource-limited settings. Plasma is separated from whole blood on filter paper with dried-down reagents for colorimetric reaction, combined with software for analysis using a smartphone. The method was clinically tested in newborns in two different settings. In a clinical cohort of newborns of Stockholm (n = 62) and Hanoi (n = 26), the value of R using Pearson's correlation test was 0.91 (p < 0.01) and the R = 0.83 between the two methods. The mean LDH (±SD) for the reference method vs. the POC-LDH was 551 (±280) U/L and 552 (±249) U/L respectively, indicating the clinical value of LDH values measured in minutes with the POC was comparable with standardized laboratory analyses.
人们越来越认识到床边检测（POCT）在检测危及生命的新生儿疾病方面的重要性，以降低新生儿的死亡率，特别是在占报告的新生儿死亡 98%的低收入国家。乳酸脱氢酶（LDH）是缺氧缺血导致受影响器官细胞损伤的标志物。在这里，我们描述并测试了一种直接从全血中进行 POCT 的 LDH 检测方法，以提供新生儿严重疾病的早期迹象。这种即时得出结果的 POCT 平台是专门为资源有限的环境而设计的。在滤纸上用干燥的试剂分离全血中的血浆，用于比色反应，并结合智能手机的软件进行分析。该方法在斯德哥尔摩（n=62）和河内（n=26）的两个不同环境中的新生儿临床队列中进行了测试。在斯德哥尔摩和河内的新生儿临床队列中（n=62 和 n=26），使用 Pearson 相关检验的 R 值为 0.91（p<0.01），两种方法之间的 R 值为 0.83。参考方法与 POCT-LDH 的平均 LDH（±SD）分别为 551（±280）U/L 和 552（±249）U/L，表明 POCT 在几分钟内测量的 LDH 值具有临床价值，与标准化实验室分析相当。
