HemoCue仪和临床血液分析仪测定血红蛋白结果的可比性研究

Study for comparability of HemoCue apparatus and clinical hemotology analyzer for estimating hemoglobin

目的:建立快速便捷的疾控机构现场血红蛋白测定和人群缺铁性贫血状况评价方法。方法:以校正合格的Beckman-coulter LH780血液分析仪(氰化高铁血红蛋白法)为参考仪器,和HemoCue仪(叠氮高铁血红蛋白法)同步测定33名慢性肝病患者血液,21名慢性肾病患者血液,34名高血压患者血液,19名血小板减少症患者血液和17名胃癌术后患者血液血红蛋白含量,同时测定了质控品血样;以校正合格的Sysmex XE-2100血液分析仪(十二烷基磺酸钠法)和HemoCue仪同步测定400名门诊患者血红蛋白含量,对结果进行配对比较研究。结果:HemoCue仪法测定血红蛋白含量结果较氰化高铁血红蛋白法和十二烷基磺酸法高,各不同病例中,慢性肾病患者组差距最大,平均偏高4.19 g/L,两者偏差为3.74%,其余顺次是胃癌术后组、血小板减少症组、慢性肝病组和高血压组,偏差分别为2.65%、2.20%、1.86%、1.86%。门诊病例组偏差为2.6%。差异均具有显著性(P<0.05);回归分析的调整确定系数r2(Adjusted R Square)在0.984～0.994之间,HemoCue仪法测定结果能够解释氰化高铁血红蛋白法结果的总变化98.4%以上,回归方程的拟合效果好。用本研究获得的回归方程y^=-1.586+0.990x,对2009年我省20岁～59岁妇女血红蛋白水平调查的1635个数据(用HemoCue仪法测定)进行校正,其贫血率校正前为28.3%(WHO贫血判定标准),校正后为36.6%(2002年中国居民营养与健康状况调查浙江省18岁～59岁妇女贫血率为38.86%)。结论:HemoCue仪法测定血红蛋白含量快速便捷,测定结果较临床血细胞分析仪呈系统性偏高,两者具有良好的相关性和可比性,适合疾控机构现场血红蛋白监测,数据经校正后可用于评论人群缺铁性贫血状况,结果满意。

Objective：To establish a quick and convenient method for detecting hemoglobin on the spot and evaluating the status of iron deficiency anemia by CDCs.Methods：We used respectively the blood cell analyzer i.e Beckman-coulter LH780（hemiglobincyanide method,Hicn） as a reference analyser and HemoCue apparatus（Azide methaemoglobin method） at the same time to detect hemoglobin in blood samples from 33 patients with chronic liver disease,21 patients with chronic kidney disease,34 patients with hupertension,19 patients with theombocytopenia and 17 patients operated gastric cancer,a serial of control material were measured also.Besides,we used respectively the analyzer with syemex XE-2100（Sodium laurylsulfonate method,SDS-Hb） and HemoCue apparatus at one time to measure hemoglobin of 400 outpatients,then the results were studyed by Statistics method.Results：The results from HemoCue method were higher than the cyanmethemoglobin method,and also higher than Sodium laurylsulfonate method.the deviation of hemoglobin is maximum in samples patients with chronic kidney disease,and the result from HemoCue method was hagher 4.19 g/L than cyanmethemoglobin method,and deviation of 3.74% between the two methods;and the deviation between the two method is respective 2.65% in patients operated gastric cancer,2.20% in patients with theombocytopenia,1.86% in patients with chronic liver disease and patients with hupertension samples.in addition,the deviation in the outpatients samples is 2.60% between the two methods.there were all signicantly differences between the two methods for these deviation above（P〈0.05）.the adjusted R square of regression analysis was at a point with 0.984～0.994,The regression equation（y=-1.586＋0.990x） fitted better-performing,and the measure result from HemoCue method had a good explain for morethan 98.4% total change of measure result from cyanmethemoglobin method.then we used the regression equation to adjust these hemoglobin data measured by HemoCue method from 1635 20-59 years old womem investigated in 2009 in zhejiang province,the anemia rate was 28.3%（WHO standard）before adjusted,and was 36.6%（the anemia rate of 18～59 years old womem in zhejiang province in 2002 was 38.86% from the result of a survey on the nutrition and health status of residents in china） after adjusted.Conclusion：The results from HemoCue method were higher than the clinical blood cell analyzer method,but the two methods had good corelationships and comparability in estimating hemoglobin and after adjusted,it also can be used to evaluate the Iron deficiency anemia status of residents,Moreover,HemoCue method has been found to be easy in operation,less in training and portable size,it is be suited to filedwork of CDCs.