Papadea C, Eckman J R, Kuehnert R S, Platt A F
Public Health Laboratory, Georgia Department of Human Resources, Atlanta.
Pediatrics. 1994 Mar;93(3):427-32.
To compare laboratory and programmatic issues in neonatal hemoglobin screening in two systems using either liquid cord blood or heel puncture blood dried on filter paper (DB) to determine the accuracy of hemoglobin phenotype; the collection rate of cord blood versus DB; and the types of and reasons for errors.
Cord blood samples for 6904 newborns were analyzed by electrophoresis in a large hospital laboratory. DB samples on the same cohort were analyzed by isoelectric focusing in a state public health laboratory.
Interlaboratory concordance was 99.4% for 6904 matched specimen pairs, which included 27 disease and 596 carrier phenotypes. In 42 pairs, discordances for potential disease phenotypes occurred with cord blood samples. Errors involving carrier phenotypes occurred in 15 cord blood samples and 14 DB samples. Inconclusive results requiring repeat testing occurred more often in the cord blood testing system (92) than in the DB system (23). Clerical transcriptions and limitations of the techniques accounted for most laboratory errors. Noncompliance in sample collection occurred more frequently with cord blood (181) than DB (86).
Both systems are subject to errors, but are equally reliable for neonatal hemoglobinopathy screening.
比较两个系统在新生儿血红蛋白筛查中的实验室及程序相关问题，这两个系统分别使用液体脐带血或滤纸（DB）上的足跟穿刺干血来确定血红蛋白表型的准确性；脐带血与DB的采集率；以及错误的类型和原因。
在一家大型医院实验室中，通过电泳对6904例新生儿的脐带血样本进行分析。在州公共卫生实验室中，通过等电聚焦对同一队列的DB样本进行分析。
6904对匹配样本的实验室间一致性为99.4%，其中包括27种疾病和596种携带者表型。在42对样本中，脐带血样本出现了潜在疾病表型的不一致情况。15份脐带血样本和14份DB样本出现了涉及携带者表型的错误。需要重复检测的不确定结果在脐带血检测系统（92例）中比在DB系统（23例）中更常见。大多数实验室错误是由文书转录和技术局限性导致的。脐带血样本采集的不依从情况（181例）比DB样本（86例）更频繁。
两个系统都存在错误，但在新生儿血红蛋白病筛查中同样可靠。
