HemoCue Hb 301血红蛋白分析仪在献血者筛查中的适用性分析

目的分析比较HemoCue Hb 301血红蛋白分析仪在献血者筛查中的适用性。方法随机选取街头60例献血者血样本使用HemoCue Hb 301血红蛋白分析仪和全自动血细胞分析仪检测血红蛋白(Hb),以全自动血细胞分析仪结果为参考,进行比较分析;取医院体检人群30个中轻度贫血的标本用HemoCue Hb 301血红蛋白分析仪检测Hb与全自动血细胞分析仪的结果进行比对分析;在街头献血者初筛中试用一段时间与传统的硫酸铜比重目测法进行比较。结果 HemoCue Hb301血红蛋白分析仪检测结果与Sysmex-kx 21N全自动血细胞分析仪比较,无统计学意义。献血者和中轻度贫血的批内精密度为0.74%和1.08%。硫酸铜比重目测法献血者淘汰率为2.05%,HemoCue Hb 301血红蛋白分析仪检测献血者淘汰率为2.39%。结论 HemoCue Hb 301血红蛋白分析仪批内精密度和准确度高,偏倚度可接受,操作轻便、快速、容易标准化,能准确定量献血者的Hb含量,数据可查,更符合血站质量管理规范的要求。很适合于街头献血者的初筛,尤其是以集体献血模式为主的采供血机构。     

BC-5300全自动血细胞分析仪性能评价

目的评价迈瑞BC-5300全自动血细胞分析仪的性能。方法对BC-5300的精密度、携带污染率、线性、重复性进行测定;将100例健康体检标本同时用Sysmex XT-1800i和BC-5300测定白细胞（WBC）、红细胞（RBC）、血红蛋白（Hb）、血小板（PLT）、红细胞比容（HCT）5项指标并进行比对;并将这100例标本的BC-5300分类结果与手工分类结果进行比较。结果 BC-5300的精密度、携带污染率、线性、重复性均在允许范围内（仪器厂家提供）;BC-5300和Sysmex XT-1800i对WBC、RBC、Hb、PLT、HCT的测定结果差异无统计学意义（P〉0.05）;BC-5300分类结果与手工分类结果进行比较,除单核细胞、嗜碱性粒细胞外,相关性较好;对异常细胞检出能力强。结论 BC-5300是一种较理想的全自动血细胞分析仪。     

Bland-Altman 分析法评价 GEM Premier 3000血气分析仪与BC-5800血液细胞分析仪检测血红蛋白及血细胞比容的相关性和一致性

【目的】使用Bland-Altman分析法评价床边血气分析仪检测血红蛋白（Hb）及血细胞比容（HCT ）结果与中心实验室检测结果是否具有相关性及一致性。【方法】对100份动脉血标本分别使用迈瑞BC-5800血液分析仪及GEM Premier 3000血气分析仪行Hb及 HCT检测，并对结果行相关性分析及Bland-Altman分析。【结果】两种方法所测得Hb的相关系数 r ＝0．807，P ＜0．01，回归方程为Y＝24．163＋0．742X ，两组方法所测得 HCT的相关系数 r ＝0．709，P ＜0．01，回归方程为 Y＝8．881＋0．635X ，两组数据均有较好的相关性。但经Bland-Altman法分析，Hb及HCT检测95％的可信区间均在临床可以接受的界限之外，一致性欠佳。【结论】GEM 血气分析仪与BC血液细胞分析仪方法测得指标均有较好的相关性，但一致性欠佳。床边即时检验尚无法完全替代传统检验方法。     

未成熟粒细胞检测的评估及参考范围的建立

目的探讨血液分析仪定量检测不成熟粒细胞（IG）指数的临床应用;建立本实验室应用Sysmex XE-2100全自动血液分析仪进行IG检测的正常参考值范围。方法应用临床标本连续测定20次,观察其批内精密度;用2个水平质控物连续测定20 d,观察其批间精密度;分别应用血液分析仪和流式细胞仪对101例标本进行IG指数测定,对其结果进行相关性回归分析和一致性比较;对883例全血标本分别用血液分析仪进行自动幼稚粒细胞计数和手工推片染色后显微镜检分类,比较血液分析仪检测与显微镜镜检的一致性;以Sysmex XE-2100全自动血液分析仪和配套试剂盒测定766名健康者的IG值,以确立本室检测的参考范围。结果高、中、低值检测的批内精密度结果IG绝对计数的CV值分别为4.78%、5.35%、13.06%,IG百分率的CV值分别为3.82%、6.03%、14.54%;批间精密度2个水平的CV值分别为IG绝对值4.38%、5.13%;IG百分率4.3%、5.1%,均〈15%,在允许范围内。与流式细胞法比较具有良好相关性,相关系数（r）为0.916;与人工镜检比较的r为0.8903;年龄间比较各年龄组IG值间P均〉0.05,即年龄间差异无统计学意义;性别间比较P〈0.05,即性别间差异有统计学意义,分性别不分年龄建立本室IG检测的参考值范围为IG绝对值95%可信区间男（0,0.04×10^9/L）;女（0,0.02×10^9/L）。IG百分率95%可信区间男（0,0.5%）;女（0,0.4%）。结论临床应用血液分析仪定量检测IG方法可行,能为临床疾病的诊断和治疗监测提供实验室数据。各实验室应建立本实验室检测的参考值范围。     

Sysmex XE 2100血细胞分析仪红细胞报警的临床诊断价值

目的评价Sysmex XE 2100全自动血细胞分析仪红细胞报警的临床诊断价值。方法收集我院住院以及门诊患者500例(500份)静脉血标本,用Sysmex XE 2100全自动血细胞分析仪做血常规检测,对400例(份)出现报警信息的标本进行血涂片镜检,评价血细胞分析仪检测红细胞报警的诊断价值。结果血细胞分析仪红细胞报警的特异度为74%,灵敏度为100%,阳性预测值为91.25%,阴性预测值为100%,与金标准镜检的符合率为93%,一致性指标K=0.82,K>0.75。结论 Sysmex XE 2100全自动血细胞分析仪对异常红细胞报警系统的性能良好,特异性好,灵敏度高,符合临床应用要求。     

未成熟粒细胞检测的评估及参考范围的建立

目的探讨血液分析仪定量检测不成熟粒细胞(IG)指数的临床应用;建立本实验室应用Sysmex XE-2100全自动血液分析仪进行IG检测的正常参考值范围。方法应用临床标本连续测定20次,观察其批内精密度;用2个水平质控物连续测定20 d,观察其批间精密度;分别应用血液分析仪和流式细胞仪对101例标本进行IG指数测定,对其结果进行相关性回归分析和一致性比较;对883例全血标本分别用血液分析仪进行自动幼稚粒细胞计数和手工推片染色后显微镜检分类,比较血液分析仪检测与显微镜镜检的一致性;以Sysmex XE-2100全自动血液分析仪和配套试剂盒测定766名健康者的IG值,以确立本室检测的参考范围。结果高、中、低值检测的批内精密度结果IG绝对计数的CV值分别为4.78%、5.35%、13.06%,IG百分率的CV值分别为3.82%、6.03%、14.54%;批间精密度2个水平的CV值分别为IG绝对值4.38%、5.13%;IG百分率4.3%、5.1%,均<15%,在允许范围内。与流式细胞法比较具有良好相关性,相关系数(r)为0.916;与人工镜检比较的r为0.8903;年龄间比较各年龄组IG值间P均>0.05,即年龄间差...     

Sysmex XS～800i血细胞分析仪应用评价

目的对Sysmex XS-800i血细胞分析仪技术性能进行测试评价。方法应用Sysmex XS-800i血细胞分析仪对全血标本的白细胞计数（WBC）、红细胞计数（RBC）、血红蛋白（Hb）、红细胞比积（HCT）、血小板计数（PLT）及白细胞分类计数等参数进行检测，并与显微镜目测结果进行比较。结果Sysmex XS-800i血细胞分析仪各项参数的本底计数均达到厂商设计规定的要求；各参数的携带污染率低（0．41％～0．75％）；其检测WBC、RBC、Hb、HCT、PLT的线性及重复性良好，变异系数均小于4％；其白细胞分类计数与显微镜目测中性粒细胞、淋巴细胞、单核细胞、嗜酸性粒细胞、嗜碱性粒细胞结果的相关系数（r）分别为0．989、0．986、0．837、0．908及0．765；其对形态异常血细胞的检出敏感性为100％，特异性为84％，有效率为88％。结论Sysmex XS-800i血细胞分析仪分析性能良好；检测结果与显微镜目测有良好的一致性；检测快速、准确、重复性好，可用于各型医院实验室对批量全血标本血细胞分析进行有效的筛选。     

P-QCM家用便携式凝血分析仪在PT、INR检测中的应用评价

目的评价派瑞林修饰石英晶体微天平(P-QCM)芯片家用便携式凝血分析仪检测凝血酶原时间(PT)、国际标准化比值(INR)的准确性及在临床检测中的应用。方法采用家用P-QCM凝血分析仪和Sysmex CS5100全自动凝血检测仪分别检测50例门诊住院患者的PT、INR。比较两种凝血仪在PT、INR的相关性和一致性。结果 P-QCM凝血仪的PT、INR批间CV值小于5%。P-QCM凝血仪与Sysmex CS5100凝血仪的PT-INR测定结果的相关性均良好,相关系数分别为R~2=0.940和R2=0.922(P0.05)。Bland-Altman分析结果具有较好一致性。结论 P-QCM家用凝血仪检测PT、INR符合临床实验室的质量要求,可以用于家庭口服华法林剂量的监测。     

急诊床旁血气分析仪所测钾、钠和血红蛋白与检验科设备所测结果对比研究

目的：对比分析Radiometer公司急诊床旁ABL 90FLEX型血气分析仪检测血气分析报告中钾、钠和血红蛋白结果与医院检验科血细胞分析仪、自动生化仪所测相应结果。方法：对2013-09-2014-03解放军总医院第一附属医院急救部接诊的600例患者的上述指标进行统计学分析,计算其平均偏倚并进行相关性和一致性检验。结果：600例患者的自动生化仪及血气分析仪检测血钾结果差异有统计学意义,所测结果有相关性和一致性（一致性差）;血钠结果比较差异有统计学意义,所测结果有相关性和一致性（一致性较好）;血细胞分析仪及血气分析仪检测血红蛋白结果比较差异无统计学意义,所测结果有相关性和一致性（一致性好）。结论：ABL 90FLEX型血气分析仪所测钾、钠指标可靠性较好,可结合其偏倚情况指导某些急症的紧急处置,血红蛋白指标可靠性好,可直接采用指导治疗。     

迈瑞BC-5390与Sysmex XN-10两台血细胞分析仪新鲜血检测结果的比对分析

目的通过对实验室两台不同品牌的血细胞分析仪新鲜血检测结果进行比对分析,了解两台仪器检测结果的相关性和一致性,提高实验室检测结果的准确性。方法以Sysmex XN-10血细胞分析仪为参比仪器,随机选取高、中、低值EDTA-K2抗凝新鲜血标本共10例分别在迈瑞BC-5390与Sysmex XN-10全自动血细胞分析仪进行检测,对两台仪器的全血细胞计数包括白细胞(WBC)、红细胞(RBC)、血红蛋白(Hb)、红细胞压积(HCT)、血小板(PLT)、平均红细胞体积(MCV)、平均红细胞血红蛋白量(MCH)、平均红细胞血红蛋白浓度(MCHC)共8项检测结果进行比对和相关性分析。结果 8个检测项目仪器间检测结果的相关系数r值均0.975,各项目相对偏差符合率≥80%,结果差异无统计学意义(P0.05),比对结果显示两台血细胞分析仪具有良好的相关性。结论两台不同品牌的血细胞分析仪8项检测结果存在可比性,可应用于临床检测工作。     

Accuracy of noninvasive and invasive point-of-care total blood hemoglobin measurement in an outpatient setting

Objective: The purpose of this study was to determine the accuracy of noninvasive hemoglobin measurement using pulse CO-oximetry (Pronto? SpHb?, Masimo Corp.) and a commonly used, invasive, point-of-care, automated spectrophotometer (HemoCue 201+?, HemoCue, Inc.), in comparison with hemoglobin measurements obtained from a laboratory hematology analyzer (measuring total blood hemoglobin) in the outpatient setting. Methods: Adult patients presenting to an outpatient research clinic were tested for total blood hemoglobin measurement by 3 methods: noninvasive pulse CO-oximetry (SpHb?), finger-stick blood sample on a point-of-care device, and venous sample on a laboratory hematology analyzer (reference device). Bias and standard deviation (SD) of SpHb? and HemoCue 201+? compared with the values obtained with the laboratory hematology analyzer were calculated and Bland-Altman graphs were generated. Results: Samples from 152 subjects were assessed (average age, 46 years; 69% female). The bias ± SD compared with the reference method was -0.5 ± 1.0 g/dL for SpHb? and 0.3 ±1.0 g/dL for HemoCue 201+?. The Bland-Altman plots assessing agreement of the test methods to the reference method had limits of agreement of -2.5 to 1.5 g/dL for SpHb? and -1.7 to 2.3 g/dL for HemoCue 201+?. A noninvasive measurement could not be obtained in 4 subjects after 2 attempts (2.5% failure rate), whereas the HemoCue 201+? measurements were obtained for all subjects. Conclusion: Noninvasive SpHb? testing had bias and SD similar to those of HemoCue 201+?. Because SpHb? measurement is noninvasive, it may offer additional patient and provider benefits.     

血常规标本存放条件对血细胞计数的影响

目的 探讨血常规标本存放条件对检测结果的影响.方法 所有全血标本室温或4 ℃条件下存放,连续5 d应用Sysmex KX-21全自动血细胞分析仪进行检测,并进行统计学分析.结果 室温下存放标本,白细胞(WBC)于48 h、红细胞(RBC)于96 h、血小板(PLT)于24 h、血红蛋白(Hb)于120 h、血细胞比容(...     

Determination of capillary hemoglobin levels using the HemoCue system in intensive care patients

Purpose

The study aimed to compare hemoglobin (Hb) values determined using the portable HemoCue system (HemoCue Hb 201+; HemoCue AB, Ängelholm, Sweden) with laboratory Hb level determination.

Materials and Methods

Adult patients hospitalized in our surgical intensive care unit who required an Hb level determination were included. To determine Hb level, one drop of arterial (A) or venous (V) blood was analyzed using HemoCue (HemoCue_[A/V]), and also with an automated analyzer in the laboratory (Hb reference method, or Hb Lab_[A/V]). Capillary blood (Cap) sample obtained simultaneously by fingerstick was analyzed using HemoCue (HemoCue_[Cap]). Factors that could interfere with the accuracy of fingerstick measurements were also studied. Paired Hb level measurements were compared by Bland and Altman analysis (Hb Lab_[A/V] vs HemoCue_[A/V] and HemoCue_[Cap]).

Results

One hundred fifty blood samples were obtained from 79 patients. The mean absolute differences between Hb Lab [A] and HemoCue [A], Hb Lab [V] and HemoCue [V] and Hb Lab [A/V] and HemoCue [Cap] were 0.1 g/dl (95% confidence interval, −1.9 to + 2.2 g/dl), 0.1 g/dl (95%CI, −2.5 to +2.6 g/dl) and 1.1 g/dl (95%CI, −3.6 to + 5.8 g/dl, respectively. Edema was the sole independent risk factor for discordance between HemoCue_[Cap] and Hb Lab_[A/V] (odds ratio, 6.65; 95% CI, 1.99-22.21; P < .001].

Conclusions

Hemoglobin level determination using HemoCue should not be used in critically patients, especially when capillary blood samples are used and/or in presence of edema.     

高脂血对两种方法测定血红蛋白的影响及其校正

目的 观察高脂血对两种不同方法测定血红蛋白(Hb)的影响,并寻求校正高脂血干扰Hb测定的方法.方法 用Sysmex XE-5000全血细胞分析仪(十二烷基磺酸钠比色法,SLS-Hb法)及SIEMENS ADVIA2120全血细胞分析仪(氰化高铁Hb测定法,HiCN法)对30份高脂血标本进行全血细胞分析,低速离心后分别用等量生理盐水和仪器配套稀释液替代上层浑浊血浆,混匀后进行Hb测定,同时根据文献报道的Hb估算公式估算Hb值.结果 两种方法测定的直接测定组Hb、平均红细胞血红蛋白(MCH)、平均红细胞血红蛋白浓度(MCHC)均明显高于生理盐水组、稀释液组和估算组.结论 高脂血均造成两种方法测定Hb假性升高,生理盐水或稀释液等量置换血浆能消除高脂血对Hb测定的影响,可避免高脂血因素的影响,并能对Hb比色测定结果进行校正.     

Anemia screening in potential female blood donors: comparison of two different quantitative methods

BACKGROUND: Anemia screening before blood donation requires an accurate, quick, practical, and easy method with minimal discomfort for the donors. The aim of this study was to compare the accuracy of two quantitative methods of anemia screening: the HemoCue 201⁺ (Aktiebolaget Leo Diagnostics) hemoglobin (Hb) and microhematocrit (micro‐Hct) tests. STUDY DESIGN AND METHODS: Two blood samples of a single fingerstick were obtained from 969 unselected potential female donors to determine the Hb by HemoCue 201⁺ and micro‐Hct using HemataSTAT II (Separation Technology, Inc.), in alternating order. From each participant, a venous blood sample was drawn and run in an automatic hematology analyzer (ABX Pentra 60, ABX Diagnostics). Considering results of ABX Pentra 60 as true values, the sensitivity and specificity of HemoCue 201⁺ and micro‐Hct as screening methods were compared, using a venous Hb level of 12.0 g per dL as cutoff for anemia. RESULTS: The sensitivities of the HemoCue 201⁺ and HemataSTAT II in detecting anemia were 56 percent (95% confidence interval [CI], 46.1%‐65.5%) and 39.5 percent (95% CI, 30.2%‐49.3%), respectively (p < 0.001). Analyzing only candidates with a venous Hb level lower than 11.0 g per dL, the deferral rate was 100 percent by HemoCue 201⁺ and 77 percent by HemataSTAT II. The specificities of the methods were 93.5 and 93.2 percent, respectively. CONCLUSION: The HemoCue 201⁺ showed greater discriminating power for detecting anemia in prospective blood donors than the micro‐Hct method. Both presented equivalent deferral error rates of nonanemic potential donors. Compared to the micro‐Hct, HemoCue 201⁺ reduces the risk of anemic female donors giving blood, specially for those with lower Hb levels, without increasing the deferral of nonanemic potential donors.     

Sysmex XE-2100血细胞分析仪定量分析外周血幼稚粒细胞性能评价

目的评价Sysmex XE-2100血细胞分析仪定量分析外周血幼稚粒细胞（1G）的性能。方法选取202份XE-2100IG报警值〉200的样本．分别采用XE-2100和镜检分析IG％,评价两者之间相关性,选取5份不同IG％水平的样本进行XE-2100批内精密度（重复性）评价,分别选取8份标本在4℃和室温进行样本稳定性评价。结果XE-2100分析IG％结果与镜检结果具有良好的相关性（γ=0．8382,P〈0．001）;5份不同IG％水平样本重复性的变异系数（CV）从4．93％N15．5％;XE-2100分析4℃和室温保存24小时内的样本结果稳定。结论XE-2100定量分析外周血幼稚粒细胞性能良好,基本满足临床实验室要求。     

不同医院全血细胞计数比对实验结果分析

目的分析3家医院不同分析仪全血细胞计数比对实验结果。方法以西安交通大学第二附属医院(简称交大二院)采用的日本希森美康公司XE-2100型全自动血细胞分析仪(简称XE-2100分析仪)作为参比仪器,以西京医院采用的日本希森美康公司XN-3000分析仪(检测XN-3000分析仪)及唐都医院采用的XE-2100作为实验仪器,按照美国临床和实验室标准化协会(CLSI)发布的EP9-A2文件的要求,对白细胞(WBC)、红细胞(RBC)、血红蛋白(Hb)、血小板(PLT)、红细胞比容(HCT)检测结果进行比对分析,计算检测结果相关系数(r),以美国临床实验室修正法规(CLIA′88)规定的室间质量评价总允许误差范围为标准,判断检测结果偏差是否可接受。结果交大二院XE-2100分析仪和西京医院XN-3000分析仪WBC、RBC、Hb、HCT检测结果的r值分别为0.998、0.998、0.984、0.981,相关性良好,PLT检测结果的r值为0.953,相关性不佳;WBC、RBC、Hb、HCT检测结果比较差异无统计学意义(P0.05),但PLT检测结果比较差异有统计学意义(P0.05)。交大二院XE-2100分析仪和唐都医院XE-2100分析仪WBC、RBC、PLT、Hb、HCT检测结果的r值分别为0.999、0.999、0.998、0.999、0.998,相关性良好;各参数检测结果比较差异无统计学意义(P0.05)。结论不同医院全血细胞计数部分参数检测结果相关性良好,检测结果可以互认。     

Accuracy of Noninvasive and Invasive Point-of-Care Total Blood Hemoglobin Measurement in an Outpatient Setting

Abstract

Objective: The purpose of this study was to determine the accuracy of noninvasive hemoglobin measurement using pulse CO–oximetry (Pronto® SpHb®, Masimo Corp.) and a commonly used, invasive, point–of–care, automated spectrophotometer (HemoCue 201+®, HemoCue, Inc.), in comparison with hemoglobin measurements obtained from a laboratory hematology analyzer (measuring total blood hemoglobin) in the outpatient setting. Methods: Adult patients presenting to an outpatient research clinic were tested for total blood hemoglobin measurement by 3 methods: noninvasive pulse CO–oximetry (SpHb®), finger–stick blood sample on a point–of–care device, and venous sample on a laboratory hematology analyzer (reference device). Bias and standard deviation (SD) of SpHb® and HemoCue 201+® compared with the values obtained with the laboratory hematology analyzer were calculated and Bland–Altman graphs were generated. Results: Samples from 152 subjects were assessed (average age, 46 years; 69% female). The bias ± SD compared with the reference method was ?0.5 ± 1.0 g/dL for SpHb® and 0.3 ± 1.0 g/dL for HemoCue 201+®. The Bland–Altman plots assessing agreement of the test methods to the reference method had limits of agreement of +2.5 to 1.5 g/dL for SpHb® and +1.7 to 2.3 g/dL for HemoCue 201+®. A noninvasive measurement could not be obtained in 4 subjects after 2 attempts (2.5% failure rate), whereas the HemoCue 201+® measurements were obtained for all subjects. Conclusion: Noninvasive SpHb® testing had bias and SD similar to those of HemoCue 201+®. Because SpHb® measurement is noninvasive, it may offer additional patient and provider benefits.     

高白细胞对血细胞分析仪检测红细胞和血红蛋白的影响

目的探讨高白细胞(WBC)(>70×109/L)对XE2100和LH750血细胞分析仪测定红细胞和血红蛋白的影响。方法采集65例WBC>70×109/L(19例WBC≥250×109/L、19例150×109/L70×109/L)组两种方法测定WBC差异无统计学意义(P>0.05),而RBC和Hb差异有统计学意义(P<0.05);对照组WBC、RBC和Hb检测结果均一致。线性回归提示WBC对两种方法测定RBC和Hb的差异具有正相关性的影响。结论 XE2100与LH750检测高WBC(>70×109/L)患者血样的RBC和Hb差异有统计学意义,临床应用应引起重视。