高海拔环境下不同近红外光谱无创血红蛋白仪检测成功率的比较

Comparison of detection success rate of different kinds of near-infrared spectrum non-invasive hemoglobin monitors in high-altitude environments

目的:比较高海拔环境下不同近红外光谱无创血红蛋白仪的检测成功率。方法:健康志愿者144名,性别不限,年龄18~50岁。采用随机数字表法分为3组:模拟海拔3500 m组(n=35)、4000 m组(n=55)和4500 m组(n=54)。分别在平原环境和模拟不同海拔高度环境中,采用Radical-7、NW-9002SHM、A5和TensorTip MTX型血红蛋白仪检测血红蛋白,比较检测成功率,采用logistic回归分析法筛选影响仪器检测成功率的因素,并通过ROC曲线和约登指数确定阈值。结果:在模拟3500、4000和4500 m高海拔环境中,TensorTip MTX检测成功率高于Radical-7、NW-9002SHM和A5(P<0.001),Radical-7、NW-9002SHM和A5检测成功率差异无统计学意义(P>0.05)。低SpO_(2)是影响Radical-7、NW-9002SHM和A5型血红蛋白仪高海拔检测成功率的主要因素(P<0.001),判断其检测成功的SpO_(2)临界值分别为88.5%、87.5%和89.5%;TensorTip MTX检测成功率不受低SpO_(2)影响。结论:TensorTip MTX型近红外光谱无创血红蛋白仪检测成功率受高海拔环境影响最小,在不具备吸氧条件下可优先选用;Radical-7、NW-9002SHM和A5型近红外光谱无创血红蛋白仪在高海拔环境中应用时需提高氧饱和度才能保证仪器有较高的检测成功率。

Objective To compare the detection success rates(DSRs)of different kinds of near-infrared spectrum non-invasive hemoglobin monitors in high-altitude environments.Methods One hundred and forty-four healthy volunteers of either sex,aged 18-50 yr,were assigned to one of 3 groups using a random number table method:simulated high-altitude 3500 meter group(n=35),4000 meter group(n=55)and 4500 meter group(n=54).Hemoglobin was detected by Radical-7,NW-9002SHM,A5 and TensorTip MTX type hemoglobin monitors in plain environment and simulated environment at different altitudes,and the DSRs were compared.Logistic regression analysis was conducted to identify the risk factors affecting the success rate of instrument detection,and the cut-off value was determined by ROC curve and the Youden index.Results In the simulated high-altitude environment of 3500,4000 and 4500 m,the DSR of TensorTip MTX was significantly higher than that of Radical-7,NW-9002SHM and A5(P<0.001),and there was no significant difference in the DSR among Radical-7,NW-9002SHM and A5(P>0.05).Low SpO_(2) was the main factor affecting the DSRs of the Radical-7,NW-9002SHM and A5 type hemoglobin monitor in high-altitude environment(P<0.001),and the cut-off value of SpO_(2) in determining the success of detection was 88.5%,87.5%and 89.5%,respectively.The DSR of TensorTip MTX was not affected by low SpO_(2).Conclusions The DSR of TensorTip MTX hemoglobin monitor is minimally affected by the high-altitude environment and can be preferred in the absence of oxygen supply;when Radical-7,NW-9002SHM or A5 hemoglobin monitor applied in high-altitude environments,oxygen saturation needs to be increased to ensure a high DSR.