Srivuthana K, Yee H Y, Bhambhani K, Elton R M, Simpson P M, Kauffman R E
Department of Pediatrics, Children's Hospital of Michigan, Detroit, USA.
Arch Pediatr Adolesc Med. 1996 May;150(5):498-502. doi: 10.1001/archpedi.1996.02170300052010.
To develop and evaluate a new filter paper method to determine capillary blood lead levels accurately in children.
Paired comparison of lead levels determined in capillary whole blood dried on filter paper with lead levels in venous whole blood samples determined by a reference method.
Children's Hospital of Michigan clinics, Detroit.
One hundred children aged 9 months to 6 years.
Lead concentrations determined in capillary whole blood samples dried on filter paper were compared with concentrations measured in paired venous whole blood samples by a reference method.
Comparability of the two lead assay methods was assessed with the concordance coefficient. The sensitivity, specificity, and positive predictivity of the capillary filter paper method relative to the reference method were determined at three intervention decision concentrations of blood lead defined by the Centers for Disease Control and Prevention.
There was high agreement between the two assay methods, with a concordance coefficient of O.96. The capillary filter paper assay had a sensitivity of 90% and specificity of 90% for differentiating blood lead levels of 0.48 mumol/L (10 micrograms/dL) or more. Blood lead levels of 0.72 mumol/L (15 micrograms/dL) or more and 0.96 mumol/L (20 micrograms/dL) or more were identified with 98% and 94% sensitivity and 98% and 99% specificity, respectively. Positive predictivity was 93%, 98%, and 97%, respectively, at the three blood lead concentration decision points.
The capillary filter paper method for blood lead analysis described herein provides a convenient, sensitive, accurate, and inexpensive method to examine children for elevated blood lead levels.
开发并评估一种能准确测定儿童毛细血管血铅水平的新型滤纸法。
将滤纸上干燥的毛细血管全血中测定的铅水平与参考方法测定的静脉全血样本中的铅水平进行配对比较。
底特律密歇根儿童医院诊所。
100名9个月至6岁的儿童。
将滤纸上干燥的毛细血管全血样本中测定的铅浓度与配对的静脉全血样本中通过参考方法测定的浓度进行比较。
用一致性系数评估两种铅检测方法的可比性。在疾病控制与预防中心定义的三个血铅干预决策浓度下，确定毛细血管滤纸法相对于参考方法的敏感性、特异性和阳性预测值。
两种检测方法高度一致，一致性系数为0.96。毛细血管滤纸检测法区分血铅水平为0.48微摩尔/升（10微克/分升）或更高时，敏感性为90%，特异性为90%。区分血铅水平为0.72微摩尔/升（15微克/分升）或更高以及0.96微摩尔/升（20微克/分升）或更高时，敏感性分别为98%和94%，特异性分别为98%和99%。在三个血铅浓度决策点，阳性预测值分别为93%、98%和97%。
本文所述的用于血铅分析的毛细血管滤纸法提供了一种方便、灵敏、准确且廉价的方法来检测儿童血铅水平升高情况。
