血气分析仪与血细胞分析仪测定儿童血红蛋白和红细胞比积对比研究

Comparison of hemoglobin and hematocrit level measured by blood gas analyzer and blood cell analyzer in children

目的对比血气分析仪与血细胞分析仪测量外科术后患儿血红蛋白和血细胞比积水平的一致性。方法连续收集200例2019-09—2021-05收治于首都医科大学附属北京天坛医院重症医学科且术后需同时进行血气分析和血细胞分析仪测量血红蛋白和红细胞比积的患儿,应用Pearson相关和Bland-Altman分析法评价两种方法的一致性和相关性。结果血气分析仪和血细胞分析仪测量的血红蛋白和血细胞比积呈正相关,相关系数分别为0.771和0.768;二者测量血红蛋白水平差值的均值(95%可信区间)为4.1(29.1~37.3)g/L,血细胞比积的差值为2.2%(7.9%~12.4%),2组比较差异有统计学意义(P=0.002和P<0.001)。但根据血红蛋白水平将患儿分为正常组、轻度贫血组和中度贫血组进行亚组分析发现,血气分析仪和血细胞分析仪测量的血红蛋白在仅在正常组差异有统计学意义[(129.7±10.7)g/L vs(137.4±24.8)g/L,P=0.016],在轻度贫血组[(102.0±7.1)g/L vs(105.3±19.4)g/L,P=0.082]和中度贫血组[(80.7±6.1)g/L vs(84.2±11.7)g/L,P=0.054]无明显差异。结论血气分析仪与血细胞分析仪测量的血红蛋白和血细胞比积呈明显正相关,但二者之间仍存在一定差异,无法完全互相替代,但对于贫血的患者,血气分析仪测量的血红蛋白具有一定参考价值。

Objective To compare the agreement of hemoglobin and hematocrit level measured by blood gas analyzer and blood cell analyzer in children after surgery.Methods Two hundred children after surgery admitted in Beijing Tiantan Hospital of Capital Medical University from September 2019 to May 2021 who need perform blood gas analyzer and blood cell analyzer to mea⁃sure hemoglobin and hematocrit level were collected.Pearson correlation and Bland-Altman analysis were used to evaluate the correla⁃tion and agreement of the two methods.Results The level of hemoglobin and hematocrit measured by blood gas analyzer and blood cell analyzer showed a significant positive correlation(r=0.771 and r=0.768).The difference of hemoglobin level(95%confidence in⁃terval)between the two methods was 4.1(29.1-37.3)g/L,and the difference of hematocrit level was 2.2%(7.9%-12.4%),there was significant difference between the two groups(P=0.002 and P<0.001).The subgroup analysis,the children were divided into nor⁃mal,mild and moderate anemia group according to the hemoglobin level,shown that the hemoglobin measured by blood gas analyzer and blood cell analyzer only had statistical difference in the normal group((129.7±10.7)g/L vs(137.4±24.8)g/L,P=0.016),the mild anemia group((102±7.1)g/L vs(105.3±19.4)g/L,P=0.082)and moderate anemia group((80.7±6.1)g/L vs(84.2±11.7)g/L,P=0.054)had no statistical difference.Conclusion The level of hemoglobin and hematocrit measured by blood gas analyzer and blood cell analyzer showed a positive correlation,but there are still significantly different that can not completely replace each other,but for patients with anemia,the hemoglobin measured by blood gas analyzer has reference value.