无创血红蛋白仪NBM200在肾脏病患者中的应用研究

目的探索无创血红蛋白仪对肾性贫血的诊断价值。 方法选择解放军总医院肾脏病科301例肾病患者进行检测。分别使用无创血红蛋白检测仪NBM200(OrSense Ltd，以色列)及血液分析仪(Sysmex，日本)检测血红蛋白浓度，将两组数据进行相关分析，构建回归模型，检验一致性，评价无创血红蛋白检测在肾性贫血诊断中的价值。 结果301例肾病患者的SpHb(noninvasive hemoglobin monitoring by spectrophotometry，SpHb)与THb(true hemoglobin，THb)的数据差异有统计学意义(P<0.001)；Pearson相关分析显示SpHb数据与THb数据呈正相关(r＝0.804，P<0.001)；随机选取200例做回归模型：THb＝22.784＋0.885×SpHb-2.720×分期-3.588×性别，剩余101例验证模型，计算误差率为7.9%；按THb四分位法分组，采用Bland-Altman分析法显示在THb低于102 g/L时，两种检测方法一致性较差，THb高于102 g/L时，两种检测方法具有良好的一致性；NBM200对肾性贫血诊断的特异度为87.9%，灵敏度为75.3%。 结论在肾科大部分患者中使用NBM200检测仪得到血红蛋白值与实际值有较好的一致性和相关性，可以用于临床监测血红蛋白动态变化趋势，但其准确性有待进一步提升改进；NBM200检测仪在肾病患者中尚不能完全替代静脉血红蛋白检测。

Research on the application of non-invasive hemoglobin instrument NBM200 in the patients with kidney diseases

ObjectiveTo investigate the diagnostic value of the non-invasive hemoglobin instrument NBM200 in the patients with renal anemia. MethodsA total of 301 patients with kidney diseases were selected in the Department of Nephrology, Chinese PLA General Hospital. The hemoglobin concentration was measured with the non-invasive hemoglobin detector (NBM200) and the blood analyzer (Sysmex), and the two groups of data were used to conduct correlation analysis, construct a regression model, test the consistency, and evaluate the value of the non-invasive hemoglobin detection method in the diagnosis of renal anemia. ResultsThere were significant differences between the data of SpHb (non-vasive hemoglobin monitored by spectrophotometry) and THb (true hemoglobin) in the 301 patients with renal diseases (P<0.001). Pearson correlation analysis showed that the data of SpHb was positively correlated with those of THb (r=0.804, P<0.001). 200 cases were randomly selected for establishing a regression model: THb=22.784+ 0.885×SpHb-2.720×stage-3.588×gender, and the remaining 101 cases were used for validating the model, showing an error rate of 7.9%. According to the THb quartile method, the Bland-Altman analysis showed that when the THb was lower than 102 g/L, the consistency of the two detection methods was poor. When the THb was higher than 102 g/L, the two detection methods had good consistency. The specificity of NBM-200 for the diagnosis of renal anemia was 87.9%, and the sensitivity was 75.3%. ConclusionIn most patients of the department of nephrology, the NBM200 detector was used to obtain a good consistency and correlation between the hemoglobin value and the actual value, showing that it could be used for clinical monitoring of hemoglobin dynamics, but its accuracy needs further improvement. NBM200 detector cannot completely replace the venous hemoglobin test in patients with renal diseases.