소아에 있어서 C-반응성 단백의 모세혈 및 정맥혈 검사의 비교평가
Comparison of C-reactive Protein between Capillary and Venous Blood in Children
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목 적:감염이 있는 환자들을 진단하는데 있어 CRP 검사 결과는 치료의 방향을 결정하는데 많은 도움을 준다. 하지만 영ㆍ유아에게 있어서 채혈의 어려움 때문에, 정맥혈 검사를 대채할수 있는 모세혈 채혈이 시도되고 있다. 이번 연구에서는 모세혈 채혈을 통한 CRP 검사 결과가정맥혈 검사 결과와 차이가 있는지 비교평가 하였다. 방 법:인하대병원 응급의료센터, 소아청소년과에 내원하거나 입원한 100명(0-14세, 남녀 47:53)을 대상으로 정맥혈은 Hitachi 7180TM (Hitachi, Tokyo, Japan),모세혈은 LC-178CRPTM (Horiba Ltd., Kyoto, Japan,LC-178CRP)장비를 사용해 검사하였다. 통계적 분석방법은 교차분석을 통하여 정맥혈과 모세혈의 CRP 판독차이를 검정하였으며, 회귀분석 및 Bland Altman plot 방법을 통하여 일치도를 평가하였다. 결 과:교차분석으로 모세혈과 정맥혈 검사의 CRP 판독차이를 검정한 결과 일치도는 90.63%로 유관한 관계성이 있었다(P <0.0001). Bland Altman Plot으로 분석한 결과 95% 신뢰구간의 일치 한계선내에서 측정되었다. 단순회귀모형으로 분석한 결과 기울기(β)는 1.3434였으며, 결정계수(R2 )는 0.9888로 매우 높은 선형관계를 확인할 수 있었다. 또한 정맥혈에서의 값은 모세혈에서 시행한 값보다 평균적으로 높음을 확인할 수 있었다. 결 론:모세혈의 CRP는 정맥혈과 매우 높은 상관관계를 보였다. 일반적으로 정맥혈 검사를 하는것이 더 좋겠지만, 채혈이 어려운 경우 LC-178CRPTM를 이용한 모세혈에서의 채혈은 정맥혈 검사를 대신할 수 있는 간편한 방법으로 생각된다.
Abstract
Purpose : In evaluation of patients, laboratory results are crucial in determination of a treatment plan. Obtaining venous blood from infants and children is a difficult procedure. Substitution of a capillary blood sample for a venous blood sample has been suggested. However, there are few studies showing mutual correlation between C-reactive protein (CRP) results in capillary and venous blood. This study was designed to determine whether the result of the capillary sample is the same as the result of the venous blood sample. Methods : After informed consent, a pair of venous and fingertip capillary blood samples were simultaneously collected from 100 children. The LC-178CRPTM was used for analysis of capillary blood and the Hitachi 7180 automatic hematology analyzer was used for analysis of venous blood. We compared CRP of both venous and capillary blood samples. Results were analyzed by crosstabulation analysis, simple regression analysis and the Bland Altman Plot method. Results : A close correlation (90.63%) was observed between capillary and venous blood analyzed by crosstabulation analysis. CRP results were similar between the two groups and showed a high coefficient correlation (β=1.3434, R2=0.9888,P <0.0001) when analyzed by a simple regression model. The average value in venous blood was also higher compared to capillary blood. According to Bland Altman Plot analysis, lab results were measured at a 95% confidence interval. Conclusion : CRP results from capillary blood showed close correlation with venous blood sampling. At present, venous blood sampling is the preferred method. However, due to difficulty in venous blood sampling, capillary sampling could be considered as an alternative technique for use with children.
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