ALIFAX TEST1血沉仪临床适用性评估

目的评估魏氏替代法ALIFAX TEST1血沉仪(以下简称TEST1血沉仪)的临床适用性。方法收集2019年1-2月南京医科大学第一附属医院风湿免疫科、血液科和骨科患者红细胞沉降率(ESR)检测标本各30例,分别使用TEST1血沉仪和魏氏法进行测定分析。对血细胞比容(HCT)<35%的标本魏氏法检测结果经Fabry公式校正后再与TEST1血沉仪检测结果进行相关性比较。统计分析2017年6-12月(用魏氏改良法Monitor100血沉仪检测)与2018年同期(用魏氏替代法TEST1血沉仪)上述3个科室住院患者ESR检测的异常率。结果上述3个科室TEST1血沉仪与魏氏法两种方法测定结果具有相关性,要Fabry公式校正后,风湿免疫科(r=0.9574,P<0.01)和骨科(r=0.9451,P<0.01)优于血液科(r=0.8765,P<0.01)。对于HCT<35%的标本,TEST1血沉仪检测结果与魏氏法相关性降低(r=0.8781,P<0.01);当HCT明显低于正常范围(<25%)时TEST1血沉仪检测结果与魏氏法则无相关性(r=0.5838,P>0.05)。TEST1血沉仪与Monitor100血沉仪同期检测ESR相比,风湿免疫科患者差异无统计学意义(P>0.05),血液科和骨科患者TEST1血沉仪检测的ESR低于Monitor100血沉仪(血液科:χ^2=76.35,P<0.001;骨科:χ^2=17.93,P<0.001)。结论TEST1血沉仪基本适用于风湿免疫科、血液科和骨科标本的检测。对于贫血患者而言,TEST1血沉仪受HCT影响比魏氏法小,但重度贫血(HCT<25%)患者宜选用魏氏法,且结果需按照Fabry公式进行校正。

Evaluation on clinical suitability of ALIFAX TEST1 erythrocyte sedimentation rate instrument

Objective To evaluate the clinical suitability of ALIFAX TEST 1 erythrocyte sedimentation rate(ESR)instrument.Methods Each 30 ESR detection samples were respectively collected from the departments of rheumatic immunology,hematology and orthopedics in the First Affiliated Hospital of Nanjing Medical University from January to February 2019.ESR was measured by TEST1 and Westergren method respectively.The results of Westergren method with hematocrit(HCT)<35% were corrected by Fabry formula and then conducted the correlation comparison with the results detected by TEST1.The abnormal rates of ESR results in three departments were statistically analyzed by modified Westergren method(detected by Monitor100 ESR instrument)from June to December 2017 and Westergren substitution method(TEST1 ESR instrument)during the same period in 2018.Results The results detected by the TEST1 ESR instrument and Westergren method in 3 departments had the correlation,corrected by Fabry formula,in which the departments of rheumatic immunology(r=0.957 4,P<0.01)and orthopedics(r=0.945 1,P<0.01)were superior to the hematology department(r=0.876 5,P<0.01).The correlation between the TEST1 ESR instrument and Westergren method was decreased in the sample of HCT < 35%(r=0.878 1,P<0.01).Furthermore when HCT obviously was lower than the normal range(<25%),the TEST1 ESR instrument and Westergren method had no correlation(r=0.583 8,P>0.05).In comparing the ESR results simultaneously measured by TEST1 ESR instrument and Monitor100 ESR instrument,the difference in the patients of the rheumatic immunology department had no statistical significance(P>0.05).ESR detected by the TEST1 ESR instrument in the patients of hematology and orthopedics departments was lower than that detected by Monitor100 ESR instrument(hematology department:χ^2=76.35,(P<0.001),orthopaedics department:χ^2=17.93,(P<0.001).Conclusion The TEST1 ESR instrument is basically suitable for the sample detection of the departments of rheumatic immunology,hematology and orthopedics.For the patients with anemia,TEST1 is less affected by HCT than Westergren method.However,for the patients with severe anemia(HCT<25%),it is suitable for selecting the Westergren method,moreover the detection results need to be corrected by the Fabry formula.