Biochemistry Department, Clínica Universidad de Navarra, Pamplona, Spain.
Hematology Department, Clínica Universidad de Navarra, Pamplona, Spain.
Diagnosis (Berl). 2023 Mar 7;10(3):281-297. doi: 10.1515/dx-2022-0126. eCollection 2023 Aug 1.
Remote self-collected capillary blood samples have been proposed as alternative to venous blood samples as an aid in telemedicine. The aim of this work is to compare the preanalytical and analytical performance of these two types of samples and to study the stability of common measurands in capillary blood.
Capillary and venous blood samples were collected in parallel from 296 patients in serum tubes to analyze 22 common biochemistry magnitudes after centrifugation and in EDTA tubes to analyze 15 hematologic magnitudes. Quality of the preanalytical process was assessed applying the model of quality indicator. 24 h stability at room temperature was studied by obtaining paired capillary samples. A questionnaire of assessment was conducted.
Mean hemolysis index was higher in capillary samples compared to venous blood samples (p<0.001). Regression analysis and difference analysis showed no bias for all studied biochemistry parameters and hematologic parameters, except mean corpuscular volume (MCV), between capillary and venous blood samples. Regarding sample stability, percentage deviation was higher than the corresponding minimum analytical performance specification for ferritin, vitamin D, hematocrit, MCV, mean corpuscular hemoglobin concentration, platelets distribution wide, mean platelet volume and basophils. Finger pricking was perceived as less painful (p<0.05) than venipuncture in participants who undergo more than one blood test per year.
Capillary blood can be used as an alternative to venous blood for the studied parameters in automated common clinical analyzers. Cautious should be taken if samples are not analyzed within 24 h from the collection.
远程采集的毛细血管血样已被提议作为静脉血样的替代物，以辅助远程医疗。本研究的目的是比较这两种类型样本的分析前和分析性能，并研究常见测量值在毛细血管血中的稳定性。
从 296 例患者中同时采集毛细血管血和静脉血于血清管中，离心后分析 22 项常见生化指标，于 EDTA 管中分析 15 项血液学指标。采用质量指标模型评估分析前过程的质量。通过获得配对的毛细血管样本，研究 24 小时室温稳定性。进行评估问卷。
与静脉血相比，毛细血管血的平均溶血指数更高（p<0.001）。回归分析和差异分析显示，除平均红细胞体积（MCV）外，所有研究的生化参数和血液学参数在毛细血管血和静脉血之间均无偏差。关于样本稳定性，铁蛋白、维生素 D、红细胞压积、MCV、平均红细胞血红蛋白浓度、血小板分布宽度、血小板平均体积和嗜碱性粒细胞的百分比偏差均高于相应的最低分析性能规格。每年接受多次血液检测的参与者认为指尖采血比静脉穿刺疼痛程度更低（p<0.05）。
在自动常规临床分析仪中，毛细血管血可替代静脉血用于研究参数。如果样本在采集后 24 小时内未进行分析，则应谨慎对待。
