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指尖血检测结果差异明显

By LabMedica International staff writers
Posted on 15 Feb 2016
穿刺手指获得的血液常用于床旁检测,但几项研究评估了对连续获得的数滴指尖血进行检测所得的检测参数变化,这些参数结果变化可能为制定临床决策和评估床旁护理检测的准确性带来不利影响。
医学实验室检测的最准确方法是抽取静脉血,并交给实验室进行检测,但某些情况下(例如在缺乏资源的医疗环境中、需要更快速得到结果时、或医疗专业人员未接受过采血培训、或没有实验室时)很难实现这一点。这些情况下,需要具有更高可靠性的指尖血检测装置。
Rice University(Houston,TX,USA)的生物工程师使用一种血液分析仪对11名捐赠者各一根手指连续6次采集的一系列20微升指尖血进行了分析,分析其血红蛋白浓度、白细胞总数(WBC)计数、白细胞三项分类和血小板计数。研究团队使用一种血红蛋白计检测7名捐献者各自提供的10滴指尖血的血红蛋白浓度,以确定对最小液滴体积进行检测的结果是否有差别,并与捐献者静脉血的检测结果进行比较。研究人员遵守最佳操作规程,确保检测结果准确。例如,他们擦掉第一滴血,以清除消毒剂的干扰,并且在采血过程中不会挤压或“按揉”手指。
结果显示,每滴血液的血红蛋白含量、血小板计数和白细胞计数差异都很大。连续采集指尖血,使用血液分析仪检测,得到的血红蛋白变异系数(CV)百分比平均值比对照静脉血高3.4倍,白细胞计数比对照静脉血高5.7倍,淋巴细胞计数比对照静脉血高3倍,中性粒细胞计数比对照静脉血高7.7倍,血小板计数比对照静脉血高4倍。使用床旁血红蛋白计进行检测,指尖血的血红蛋白平均百分比CV比静脉血高5倍。研究人员发现,6-9次连续点滴试验结果的平均值与静脉血检测结果相等。
本研究的第一作者,一名博士生,Meaghan M. More...
Bond说明,“部分捐献者连续两次采集的血滴的血红蛋白浓度变化超过2 g/dL。我们的检测结果显示我们需要慎重对待指尖血检测结果的准确性,因为对类似贫血、感染和镰状细胞性贫血、疟疾、艾滋病和其他疾病进行诊断时,这些检测结果的准确性的重要性与日俱增。本研究已发表于2015年11月18日刊的American Journal of Clinical Pathology(美国临床病理学杂志)。

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