影响新生儿干血片G6PD筛查试验结果的相关因素分析  

Analysis of factors infecting result of neonatal dried blood G6PD screening test

作　　者：陈丕绩 蒋明 谢意文 蔡巧青[2] 

机构地区：[1]广东省深圳市盐田区人民医院检验科,518081 [2]北京大学深圳医院妇产科,深圳518000

出　　处：《检验医学与临床》2015年第4期505-506,509,共3页Laboratory Medicine and Clinic

摘　　要：目的 分析新生儿干血片红细胞葡萄糖-6-磷酸脱氢酶（G6PD）筛查试验过程中可能产生影响的各类因素,为提高临床质控水平、有效减少检测过程中的外在影响因素提供参考。方法 以该院2013年6月至2014年5月862例新生儿为研究对象,分别进行受试新生儿基本资料、标本留置时间、温度、打孔部位、血片去除、加酮试剂后仪器测定时间的分组研究,探讨G6PD测定结果的影响因素。结果 季节性上,春夏季新生儿G6PD水平明显低于秋冬季;分娩方式上,阴道产G6PD水平明显低于剖宫产;标本留置时间上,留置时间越长,G6PD水平越低;温度方面,2~8℃冷藏G6PD水平明显高于室温;血片去除方面,去除血片的G6PD水平明显高于不去除血片;加酮试剂后仪器测定时间方面,随着测定时间的延长,G6PD水平逐渐下降。干血片G6PD检测结果在季节、分娩方式、标本留置时间、温度、血片去除和加酮试剂后仪器测定时间方面检测数据比较,差异均有统计学意义（P〈0.05）。性别和打孔部位对G6PD水平变化无明显影响（P〉0.05）。结论 应在新生儿G6PD筛查过程中建立起完善有效的管理与质控机制,加强管理,并根据影响因素适当调整临床诊断的临界点,以减少假阴性或假阳性的产生,提高临床新生儿筛查的工作质量。Objective To analyze factors which might affect the result of neonatal dried blood spots glucose tablets of red blood cell-6-dehydrogenase（G6PD）screening test,to improve the clinical quality control level,effectively reduce the external factors in the process of detection.Methods A total of 862 neonatus in June 2013 to May2014were selected in this research.According to the basic data,sample retention time,temperature,punching parts,blood removal,addition of ketone reagent determination time,all the subjects were grouped and investigated the factors affecting the determination results of G6PD.Results In terms of season,G6PD level of neonatus in spring and summer was significant lower than that of autumn and winter.In the terms of delivery mode,G6PD level of neonatus by vaginal birth was significant lower than that by cesarean section.In terms of samples indwelling time,the longer the indwelling time,the lower the G6PD level.In terms of temperature,the G6PD level of samples stored up in 2~8℃ was significant higher than that in room temperature.In terms of blood removal,G6PD level removed blood spots was significant higher than that of neonatus didn′t remove blood spots.In terms of addition of ketone reagent instrument for measuring time,G6PD level decreased along with the extension of time of determination.The G6PD levels of different groups divided by season,mode of delivery,sample retention time,temperature,blood removal and addition of ketone reagent instrument for measuring time were significant different（P〈0.05）,but those levels of different groups divided by gender and drilling sites had no significant different（P〉0.05）.Conclusion Management and quality control system should be established in the screening test of G6PD,the management should be strengthened to reduce the false negative or positive results.

关 键 词：新生儿 干血片 红细胞葡萄糖-6-磷酸脱氢酶 影响因素 

分 类 号：R722.19[医药卫生—儿科]