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急性胃肠炎患儿毛细血管全血细胞计数的可靠性

Reliability of Capillary Complete Blood Count in Children With Acute Gastroenteritis.

作者信息

Wielińska-Wiśniewska Hanna, Nowak Jan K, Da Browski Michał, Szydłowska Paula, Szczepanik Mariusz, Cichocka Katarzyna, Krzyżanowska-Jankowska Patrycja, Walkowiak Jarosław

机构信息

Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland.

出版信息

Front Pediatr. 2021 Aug 10;9:715576. doi: 10.3389/fped.2021.715576. eCollection 2021.

Abstract

To assess the reliability of complete blood count (CBC) in the capillary blood of children with acute gastroenteritis (AGE), with a focus on leukocytes. This was a retrospective cross-sectional study. Complete blood count was compared between the capillary and venous blood in children admitted to a pediatric gastroenterology department with primary diagnosis of AGE (ICD-10 A09, A08.0, A08.2). Capillary blood was obtained in the emergency room and venous blood was sampled in the ward shortly thereafter during peripheral intravenous line placement. One hundred and forty children were included. The mean (±SD) age and weight of patients were 3.0 ± 2.9 years and 16 ± 9 kg; 26% had leukocytosis. The mean difference between obtaining results of capillary and venous blood tests was 2 ± 1 h. Area under the receiver operating characteristic curve (AUC) for the identification of leukocytosis using the capillary blood was 0.98 (95% CI 0.96-1.0). The sensitivity and specificity were 86 and 98%, respectively (accuracy 95%). The positive and negative predictive values were 94 and 95%, respectively. The intraclass correlation coefficient revealed high concordance between capillary and venous CBC measurements (leukocyte count 0.94, hemoglobin 0.88, erythrocyte count 0.77, hematocrit 0.79, platelet count 0.90). Matched pairs comparisons revealed marginally higher erythrocytes (difference of medians: 0.2 T/L), hemoglobin (0.3 g/dL), hematocrit (1.0%), and platelets (9 G/L) in the capillary blood. Capillary CBC is useful in detecting leukocytosis in children with AGE.

摘要

为评估急性胃肠炎(AGE)患儿毛细血管血全血细胞计数(CBC)的可靠性,重点关注白细胞。这是一项回顾性横断面研究。对以AGE为主要诊断(国际疾病分类第十版A09、A08.0、A08.2)入住儿科胃肠病科的患儿,比较其毛细血管血和静脉血的全血细胞计数。在急诊室采集毛细血管血,随后不久在病房外周静脉置管时采集静脉血。共纳入140名患儿。患者的平均(±标准差)年龄和体重分别为3.0±2.9岁和16±9千克;26%的患儿有白细胞增多症。获得毛细血管血和静脉血检测结果的平均时间差为2±1小时。使用毛细血管血识别白细胞增多症的受试者工作特征曲线下面积(AUC)为0.98(95%置信区间0.96 - 1.0)。敏感性和特异性分别为86%和98%(准确率95%)。阳性和阴性预测值分别为94%和95%。组内相关系数显示毛细血管血和静脉血CBC测量值之间具有高度一致性(白细胞计数0.94,血红蛋白0.88,红细胞计数0.77,血细胞比容0.79,血小板计数0.90)。配对比较显示毛细血管血中的红细胞(中位数差异:0.2 T/L)、血红蛋白(0.3 g/dL)、血细胞比容(1.0%)和血小板(9 G/L)略高。毛细血管血CBC有助于检测AGE患儿的白细胞增多症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d59d/8384108/2149a0899b6b/fped-09-715576-g0001.jpg

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