Comparison of liquid and dried blood for neonatal hemoglobinopathy screening: laboratory and programmatic issues.
Comparison of liquid and dried blood for neonatal hemoglobinopathy screening: laboratory and programmatic issues.
复制标题
用于新生儿血红蛋白病筛查的液体和干燥血液的比较：实验室和程序问题。
作者：
C. Papadea;J. Eckman;R. Kuehnert;A. Platt
目标
比较两种系统中新生儿血红蛋白筛查的实验室和程序问题，使用液体脐带血或在滤纸（DB）上干燥的足跟穿刺血，以确定血红蛋白表型的准确性;脐带血与DB的采集率;以及错误的类型和原因。
方法
在一家大型医院实验室对6904例新生儿的脐带血样本进行电泳分析。在国家公共卫生实验室通过等电聚焦分析同一队列的DB样本。
结果
实验室间一致性为99.4%的6904匹配的标本对，其中包括27个疾病和596载体表型。在42对中，潜在疾病表型与脐带血样本发生不一致。15份脐带血样本和14份DB样本出现了涉及携带者表型的错误。需要重复检测的不确定结果在脐带血检测系统（92）中比在DB系统（23）中更常见。文书的抄写和技术的局限性占大多数的实验室错误。脐带血（181例）样本采集不依从性的发生率高于DB（86例）。
结论
这两种系统都可能出现错误，但对于新生儿血红蛋白病筛查同样可靠。
OBJECTIVES
To compare laboratory and programmatic issues in neonatal hemoglobin screening in two systems using either liquid cord blood or heel puncture blood dried on filter paper (DB) to determine the accuracy of hemoglobin phenotype; the collection rate of cord blood versus DB; and the types of and reasons for errors.
METHODS
Cord blood samples for 6904 newborns were analyzed by electrophoresis in a large hospital laboratory. DB samples on the same cohort were analyzed by isoelectric focusing in a state public health laboratory.
RESULTS
Interlaboratory concordance was 99.4% for 6904 matched specimen pairs, which included 27 disease and 596 carrier phenotypes. In 42 pairs, discordances for potential disease phenotypes occurred with cord blood samples. Errors involving carrier phenotypes occurred in 15 cord blood samples and 14 DB samples. Inconclusive results requiring repeat testing occurred more often in the cord blood testing system (92) than in the DB system (23). Clerical transcriptions and limitations of the techniques accounted for most laboratory errors. Noncompliance in sample collection occurred more frequently with cord blood (181) than DB (86).
CONCLUSIONS
Both systems are subject to errors, but are equally reliable for neonatal hemoglobinopathy screening.