CAJ | 학술논문

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。
목적：분석신생인간혈편홍세포포도당‐6‐린산탈경매（G6PD）사사시험과정중가능산생영향적각류인소，위제고림상질공수평、유효감소검측과정중적외재영향인소제공삼고。방법이해원2013년6월지2014년5월862례신생인위연구대상，분별진행수시신생인기본자료、표본류치시간、온도、타공부위、혈편거제、가동시제후의기측정시간적분조연구，탐토G6PD측정결과적영향인소。결과계절성상，춘하계신생인G6PD수평명현저우추동계；분면방식상，음도산G6PD수평명현저우부궁산；표본류치시간상，류치시간월장，G6PD수평월저；온도방면，2～8℃랭장G6PD수평명현고우실온；혈편거제방면，거제혈편적G6PD수평명현고우불거제혈편；가동시제후의기측정시간방면，수착측정시간적연장，G6PD수평축점하강。간혈편G6PD검측결과재계절、분면방식、표본류치시간、온도、혈편거제화가동시제후의기측정시간방면검측수거비교，차이균유통계학의의（P＜0．05）。성별화타공부위대G6PD수평변화무명현영향（P＞0．05）。결론응재신생인G6PD사사과정중건립기완선유효적관리여질공궤제，가강관리，병근거영향인소괄당조정림상진단적림계점，이감소가음성혹가양성적산생，제고림상신생인사사적공작질량。
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 ,effec‐tively reduce the external factors in the process of detection .Methods A total of 862 neonatus in June 2013 to May 2014 were 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 fac‐tors affecting the determination results of G 6PD .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 instru‐ment 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 G 6PD ,the management should be strengthened to reduce the false negative or positive results .