两种血小板抗体试剂在儿童患者应用的一致性评价  

The consistency of two kind of reagents in detection of platelet antibody for pediatric patients

作　　者：郭凯 王笑欢 张慧敏[1] 王孟键 邱立娟[1] 宋珊珊 汪德清[2] 李小飞 马曙轩[1] Guo Kai;Wang Xiaohuan;Zhang Huimin;Wang Mengjian;Qiu Lijuan;Song Shanshan;Wang Deqing;Li Xiaofei;Ma Shuxuan(Department of Transfusion Medicine,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045,China)

机构地区：[1]国家儿童医学中心,首都医科大学附属北京儿童医院输血科,100045 [2]解放军总医院第一医学中心输血科 [3]解放军医学院首都医科大学附属北京友谊医院

出　　处：《北京医学》2019年第10期929-931,共3页Beijing Medical Journal

基　　金：国家自然科学基金(81770194)

摘　　要：目的评价两种血小板抗体检测试剂在儿童患者应用的一致性。方法选择2016年12月至2017年5月首都医科大学附属北京儿童医院的患儿血液标本1 409例,分别使用血小板抗体检测试剂A和试剂B,通过固相凝集法对血小板抗体进行平行检测,分析其差异性与一致性,并计算试剂B的灵敏度、特异度、阳性预测值与阴性预测值。结果1 409例样本中,试剂A和试剂B检出患儿血小板抗体强阳性、弱阳性和阴性例数分别为114、62、1 233例和113、60、1236例,差异无统计学意义(Zu=4.000,P=0.900)。两种试剂检测血小板抗体的配对Bowker分析亦显示,差异无统计学意义(t=1.911,P=0.385),且具有高度一致性(Kappa=0.956;U=45.032,P<0.001)。同时,试剂B可能具有较高检测效能:灵敏度为97.72%、特异度为99.92%、阳性预测值为99.42%、阴性预测值为99.68%。结论试剂B可替代试剂A进行患儿血小板抗体检测。Objective To assess the consistency of two kind of reagents in the detection of platelet antibodies from pediatric patients.Methods A total of 1 409 cases from December 20 th,2016 to March 5 th,2017 were selected randomly in Beijing Children’s Hospital.The platelet antibody was parallel checked by solid phase agglutination using platelet antibody detection reagents A and B.The difference and consistency of the results were analyzed.Simultaneously,the sensitivity,specificity,positive predictive value and negative predictive value of reagent B values were calculated.Results Among 1 409 samples,114,62,1 233 and 113,60 and 1 236 cases were strongly positive,weakly positive and negative for platelet antibodies detected by reagent A and B,respectively,with no significant difference(Zu=4.000,P=0.900).Paired Bowker analysis of platelet antibody results for both two kind of reagents showed no statistically significant difference(t=1.911,P=0.385),and that a high degree of agreement(Kappa=0.956;U=45.032,P<0.001).Furthermore,compared to A reagent,B reagent was extremely efficient,the sensitivity,specificity,positive predictive value and negative predictive value were 97.72%,99.92%,99.42%and 99.68%,respectively.Conclusions The A reagent could replace by B reagent in the platelet antibody detection.

关 键 词：血小板抗体 固相凝集法 一致性 儿童 

分 类 号：R44[医药卫生—诊断学]