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目的探讨孕妇人群中无创式检测血红蛋白(Hb)结果与静脉血结果的差异和临床意义,为孕妇的贫血筛查提供参考依据。方法采用无创式脉搏血氧血红蛋白仪Or Sense NBM-200检测2014年1月同济大学附属第一妇婴保健院180例孕妇血红蛋白(脉搏血氧血红蛋白,Sp Hb),并同时检测其静脉血红蛋白(venous Hb,v Hb),将结果进行比较,评估其准确性、相关性及一致性。结果在180例孕妇中Sp Hb与v Hb的差异无统计学意义(P=0.463)。Peason相关分析显示,Sp Hb与v Hb相关系数为0.789(P<0.001),表明两种方式检测结果有明显相关关系。用Bland-Altman分析Sp Hb与v Hb的差值,结果显示在不贫血孕妇中,平均偏倚为6.6 g/L,95%的一致性界限中的最大差值15.2 g/L为两方式的均值120.0 g/L的12.7%;轻度贫血孕妇中,平均偏倚为7.0 g/L,95%的一致性界限中的最大差值16.6 g/L为两方式的均值108.1 g/L的15.4%;中度贫血孕妇中,平均偏倚为6.2 g/L,95%的一致性界限中的最大差值20.2 g/L为两方式的均值95.6 g/L的21.1%,表明两种检测方法在不同贫血程度的孕妇中均具有良好的一致性,但其准确性随着贫血程度的加重而降低。结论使用NBM-200检测仪得到的Sp Hb与v Hb具有较好的一致性和相关性,虽然准确性有待进一步提升改进,但其具有无创伤和快速的优点,可以更好地为孕妇进行贫血筛查。
Objective To explore the differences and clinical significance of noninvasive detection of hemoglobin (Hb) and venous blood in pregnant women and to provide a reference for anemia screening in pregnant women. Methods The noninvasive pulse oximetry instrument Or Sense NBM-200 was used to detect 180 pregnant women’s hemoglobin (Sp Hb) in the First Affiliated Maternal and Child Health Hospital of Tongji University in January 2014. Venous hemoglobin (venous hemoglobin) Hb, v Hb), the results were compared to assess its accuracy, relevance and consistency. Results The difference of Sp Hb and v Hb in 180 pregnant women was not statistically significant (P = 0.463). Peason correlation analysis showed that the correlation coefficient between Sp Hb and v Hb was 0.789 (P <0.001), indicating that there was a significant correlation between the two methods. The difference between Sp Hb and v Hb was analyzed by Bland-Altman and the mean bias was 6.6 g / L among non-anemic pregnant women. The maximum of the 95% agreement limits was 15.2 g / L as the mean of the two modalities 120.0 g / L in 12.7%. The average bias of 7.0% in mild anemia pregnant women was 16.6 g / L, which was 15.4% of 108.1 g / L in the two methods. The mean bias was 6.2 g / L for moderately anemic pregnant women, with a maximum difference of 20.2 g / L for the 95% agreement limit being 21.1% for the two methods with an average of 95.6 g / L, indicating that the two tests were performed at different anemia Degree of pregnant women have good consistency, but its accuracy decreases with the degree of anemia. Conclusions Sp Hb and v Hb obtained by using NBM-200 detector have good consistency and correlation. Although the accuracy needs further improvement and improvement, it has the advantages of noninvasiveness and rapidness, and can better anemia for pregnant women Screening.