在血液溶解的儿科血液样本中不准确地确定的临床影响
Dennis J Dietzen1, Ronald Jackups2, Mark A Zaydman2
1Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO, United States; Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, United States.
概括
由于未检测到的血液溶解,全血测量可能不准确,特别是在新生儿中. 需要进一步的诊断工具来确保在儿科患者中可靠的测试.
科学领域:
- 临床化学 临床化学
- 儿科诊断 儿科诊断 儿科诊断
- 实验室医学 实验室医学
背景情况:
- 全血分析提供速度和减少样本体积,但有风险未被检测到的血液溶解.
- 血液溶解可以显著损害测量的准确性.
- 这项研究探讨了全血测试中错误的频率和规模.
研究的目的:
- 为了确定全血测量的错误的发生率和程度.
- 为了评估血液溶解对测定精度的影响.
- 确定患有这些错误风险较高的患者群体.
主要方法:
- 对2岁以下患者的全血和血数据的回顾性分析.
- 使用血"H指数"检测血液溶解.
- 在2小时窗口内使用配对的全血和血样本估计偏差.
主要成果:
- 在血样本中观察到显著的血液溶解 (20%).
- 在新生儿重症监护室发生的血解率最高 (接近50%).
- 8%的配对样本显示正常血的全血含量升高,4%显示正常的全血含量降低的血;偏差范围从-1.0到4.0毫摩尔/升.
结论:
- 全血分析具有相当大的测量误差风险.
- 需要改进检测全血样本中血液溶解的方法.
- 基于全血的临床决定需要仔细考虑潜在的血液溶解诱导的不准确性.
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