指尖血红蛋白分析仪在维持性血液透析患者中应用的准确性

Accuracy of portable hemoglobinometer in maintenance hemodialysis patients

该文回顾性分析了中山大学附属第三医院岭南医院维持性血液透析(maintenance hemodialysis,MHD)患者的静脉血红蛋白(hemoglobulin,Hb)与指尖毛细血管血红蛋白(digital capillary hemoglobulin,DHb,Hemocue Hb 201+血红蛋白仪检测)数据,评价DHb与Hb的相关性、差异性及DHb对贫血诊断的准确性,旨在评价指尖血红蛋白分析仪在MHD患者中应用的准确性以及其对贫血的诊断价值。研究共纳入105例患者,其配对的DHb与Hb差异无统计学意义[(109±21)g/L比(108±20)g/L,t=-1.284,P=0.202]。Pearson相关分析结果显示,DHb与Hb存在显著正相关(r=0.929,P<0.001);线性回归分析结果显示,DHb与Hb满足回归方程Hb=0.88×DHb+12.23,回归系数检验P<0.001。Bland-Altman分析结果显示,DHb与Hb差值为(1.0±7.8)g/L,一致性界限为(-14.2,16.2)g/L;DHb与Hb差值与Hb的百分比均值为1%,一致性界限为(-13.7%,15.7%)。DHb对MHD患者贫血控制达标(Hb>110 g/L)的诊断灵敏度为0.90,特异度0.83,阳性预测值为0.84,阴性预测值为0.90。本研究提示,Hemocue Hb 201+血红蛋白仪在MHD患者中应用的准确性较好,可在一定程度上满足贫血治疗效果的检测及达标的筛查。

This study aims to evaluate the accuracy of portable hemoglobinometer(Hemocue Hb 201+hemoglobin analyzer)in patients with maintenance hemodialysis(MHD)and its diagnostic value for anemia.The data of venous hemoglobulin(Hb)and fingertip capillary hemoglobulin(DHb)in MHD patients from Lingnan Hospital,the Third Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed,and the correlation and difference between DHb and Hb and the accuracy of DHb in the diagnosis of anemia were evaluated.A total of 105 patients were included in the study.There was no significant difference between the paired DHb and Hb[(109±21)g/L vs.(108±20)g/L,t=-1.284,P=0.202].Pearson correlation analysis showed that DHb was positively correlated with Hb(r=0.929,P<0.001).Linear regression analysis showed that DHb and Hb met the regression equation Hb=0.88×DHb+12.23,and P<0.001.Bland-Altman analysis showed that the differences between the paired DHb and Hb was(1.0±7.8)g/L with the limit of agreement as(-14.2,16.2)g/L.The mean percentage of the differences in Hb was 1%with limit of agreement as(-13.7%,15.7%).A DHb of>110 g/L was 0.90 sensitive and 0.83 specific to identify patients with an Hb>110 g/L and its positive and negative predictive values were 0.84 and 0.90,respectively.It suggests that,in MHD patients,Hemocue Hb 201+analyzer shows good accuracy,and can be used to monitor the Hb trend and serve as a screen method for those reaching target Hb.