AbstractThis study was performed to analyze fingertip capillary blood sampling in pediatric patients using microcapillary blood collection tubes and microhematocrit tubes and to compare the blood cell analysis results obtained via these two blood collection methods. Finger capillary blood was collected from 110 outpatients using microcapillary blood collection tubes and microhematocrit tubes and complete blood count analysis was performed with a Sysmex XS-900i hematology analyzer and manual microscopy for blood cell morphology.

摘要本研究旨在分析使用微毛细管采血管和微血细胞比容管对儿科患者指尖毛细血管采血的情况，并比较通过这两种采血方法获得的血细胞分析结果。使用微毛细血管采血管和微血细胞比容管从110名门诊患者收集手指毛细血管血，并使用Sysmex XS-900i血液分析仪进行全血细胞计数分析，并手动显微镜检查血细胞形态。

Paired data was evaluated for agreement and bias using the microhematocrit samples as the reference group and the samples from the microcapillary blood collection tubes as the observation group. The two blood collection methods demonstrated good agreement for measuring red blood cell (RBC) parameters (i.e., RBC, Hb, Hct, MCV, MCH and MCHC), wherein the relative bias was > allowable total error (TEa) in 0.91%, 1.82%, 11.82%, 1.82%, 0.91% and 8.18% of the parameter measures, respectively.

使用微血细胞比容样品作为参考组，使用来自微毛细血管采血管的样品作为观察组，评估配对数据的一致性和偏倚。两种采血方法在测量红细胞（RBC）参数（即RBC，Hb，Hct，MCV，MCH和MCHC）方面表现出良好的一致性，其中相对偏差分别为0.91%，1.82%，11.82%，1.82%，0.91%和8.18%的参数测量。

According to industry requirements, the proportion of samples meeting the acceptable bias level should be > 80%. Additionally, the estimated biases at each medical decision level were within clinically acceptable levels for RBC, Hb, Hct, and MCV. However, the proportion of WBC and PLT counts with relative bias > TEa was 25.45% and 35.45%, respectively.

根据行业要求，符合可接受偏差水平的样本比例应>80%。此外，每个医疗决策水平的估计偏差均在RBC，Hb，Hct和MCV的临床可接受水平内。然而，相对偏差>TEa的WBC和PLT计数比例分别为25.45%和35.45%。

Furthermore, the relative bias of the WBC count at the medical decision level of 0.5 × 109/L and that of the PLT counts at the medical decision levels of 10 × 109/L and 50 × 109/L were clinically significant. Bland–Altman analysis further showed a mean bias of 0.66 × 109/L (95% LoA, − 0.79 to 2.11) for the WBC count and 39 × 109/L (95% LoA, − 46 to 124) for the PLT count from the blood samples collected in the micro.

此外，WBC计数在0.5×109/L的医疗决策水平上的相对偏差和PLT计数在10×109/L和50×109/L的医疗决策水平上的相对偏差具有临床意义。Bland-Altman分析进一步显示，WBC计数的平均偏差为0.66×109/L（95%LoA，0.79至2.11），微量采集的血液样本中PLT计数的平均偏差为39×109/L（95%LoA，46至124）。

IntroductionComplete blood count (CBC) is a frequently used laboratory test. CBC can provide information on blood cell production, as well as offer data on the immune system via white blood cell (WBC) counts and determine the oxygen-carrying capacity of patients by assessing red blood cell (RBC), hemoglobin (Hb), and hematocrit (Hct) counts.

简介全血细胞计数（CBC）是一种常用的实验室检查。CBC可以提供有关血细胞生成的信息，以及通过白细胞（WBC）计数提供免疫系统的数据，并通过评估红细胞（RBC），血红蛋白（Hb）和血细胞比容（Hct）来确定患者的携氧能力计数。

Furthermore, these tests can aid in the diagnosis of anemia, certain cancers, infections, acute bleeding, allergies, and immune deficiencies, serving as practical tools for pediatricians1. Accurate and effective blood test results are highly dependent on high-quality samples. However, obtaining high-quality blood samples for CBC analysis in pediatric patients remains a challenge.

此外，这些测试可以帮助诊断贫血，某些癌症，感染，急性出血，过敏和免疫缺陷，为儿科医生提供实用工具1。准确有效的血液检测结果高度依赖于高质量的样本。然而，在儿科患者中获得用于CBC分析的高质量血液样本仍然是一个挑战。

Pediatric patients typically have poor compliance with spontaneous cooperation and possess slender blood vessels. Consequently, venous blood sampling is often accompanied by pain and mental stress. Moreover, venipuncture blood sampling in this patient population is not only extremely difficult but also carries potential risks.

儿科患者通常对自发合作的依从性较差，血管细长。。此外，在该患者人群中进行静脉穿刺采血不仅极其困难，而且还存在潜在风险。

For example, deep venipuncture in children can lead to numerous adverse consequences, such as infection, cardiac arrest, bleeding tendency, and venous thrombosis2,3. Therefore, CBC tests in pediatric patients are frequently conducted using capillary blood collection.Based on the available standards and recommendations such as the WHO Best Practices in Phlebotomy and the Clinical Laboratory Standards Institute (CLSI) GP42-A6, several national and international professional bodies, including those in China and Croatia, have issued corresponding guidance documents4,5,6,7.

例如，儿童深静脉穿刺可导致许多不良后果，如感染，心脏骤停，出血倾向和静脉血栓形成2,3。因此，儿科患者的CBC测试经常使用毛细血管采血进行。根据世卫组织静脉切开术最佳实践和临床实验室标准研究所（CLSI）GP42-A6等现有标准和建议，包括中国和克罗地亚在内的多个国家和国际专业机构发布了相应的指导文件4,5,6,7。

Capillary blood collection already occupies an indispensable position in pediatric clinical work. Compared with venous blood sampling, capillary blood collection has se.

毛细血管采血在儿科临床工作中已占据不可或缺的地位，与静脉采血相比，毛细血管采血具有更高的安全性。

Data availability

数据可用性

The corresponding author has all the data associated with this study. The data supporting the findings of this study are available from the corresponding author upon reasonable request.

通讯作者拥有与本研究相关的所有数据。根据合理的要求，通讯作者可以提供支持本研究结果的数据。

ReferencesPabon-Rivera, S., Flores, R. R. & Frei-Jones, M. The complete blood count: A practical tool for the pediatrician. Pediatr. Rev. 44, 363–382. https://doi.org/10.1542/pir.2021-005273 (2023).Article

参考文献Pabon Rivera，S.，Flores，R。R。和Frei Jones，M。全血细胞计数：儿科医生的实用工具。儿科。修订版44363-382。https://doi.org/10.1542/pir.2021-005273。文章

PubMed

PubMed

Google Scholar

谷歌学者

Jeong, G., Shin, S. M., Kim, N. S. & Ahn, Y. M. Sudden unexpected cardio-respiratory arrest after venipuncture in children. Korean J. Pediatr. 61, 108–113. https://doi.org/10.3345/kjp.2018.61.4.108 (2018).Article

Jeong，G.，Shin，S.M.，Kim，N.S。＆Ahn，Y.M。儿童静脉穿刺后突然意外的心肺骤停。韩国J.Pediatr。61108-113。https://doi.org/10.3345/kjp.2018.61.4.108（2018年）。文章

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Shah, S. H. et al. Clinical risk factors for central line-associated venous thrombosis in children. Front. Pediatr. 3, 35. https://doi.org/10.3389/fped.2015.00035 (2015).Article

Shah，S.H.等人。儿童中心线相关静脉血栓形成的临床危险因素。正面。儿科。3，35。https://doi.org/10.3389/fped.2015.00035（2015年）。文章

PubMed

PubMed

PubMed Central

公共医学中心

Google Scholar

谷歌学者

Institute, C. A. L. S. Procedures and Devices for the Collection of Diagnostic Capillary Blood Specimens: Approved Standard. 6th edn. CLSI document GP42-A6. Wayne, PA: CLSI. (2008).Organization, W. H. WHO Guidelines on Drawing Blood: Best Practices in Phlebotomy (WHO, 2010).

研究所，C.A.L.S。诊断性毛细血管血液标本采集程序和装置：批准的标准。第6版。CLSI文件GP42-A6。宾夕法尼亚州韦恩：克莱西。（2008年）。组织，W.H。WHO抽血指南：静脉切开术的最佳实践（WHO，2010）。

Google Scholar

谷歌学者

Krleza, J. L. et al. Capillary blood sampling: National recommendations on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine. Biochem. Med. 25, 335–358. https://doi.org/10.11613/BM.2015.034 (2015).Article

Krleza，J.L.等人，《毛细血管采血：代表克罗地亚医学生物化学和检验医学学会的国家建议》。生物化学。医学25335-358。https://doi.org/10.11613/BM.2015.034（2015年）。文章

Google Scholar

谷歌学者

Pediatric Disease Laboratory Medicine Expert Committee of Chinese Medical Doctor Association Laboratory Physician Branch, World Association of Chinese Laboratory and Pathologists. Consensus on Peripheral Blood Sampling in China. Chin. Med. J. 98, 1752–1760, https://doi.org/10.3760/cma.j.issn.0376-2491.2018.22.006 (2018).Hjelmgren, H.

中国医师协会检验医师分会儿科疾病检验医学专家委员会、世界中国检验病理学家协会。中国外周血采样共识。下巴。医学杂志981752-1760，https://doi.org/10.3760/cma.j.issn.0376-2491.2018.22.006（2018年）。Hjelmgren，H。

et al. Capillary blood sampling increases the risk of preanalytical errors in pediatric hospital care: Observational clinical study. J. Spec. Pediatr. Nurs. 26, e12337. https://doi.org/10.1111/jspn.12337 (2021).Article .

毛细血管采血增加了儿科医院护理中分析前错误的风险：观察性临床研究。J、 儿科规范。护士。26，e12337。https://doi.org/10.1111/jspn.12337（2021年）。文章。

PubMed

PubMed

Google Scholar

谷歌学者

Becker, M. et al. Differences between capillary and venous blood counts in children-A data mining approach. Int. J. Lab. Hematol. 44, 729–737. https://doi.org/10.1111/ijlh.13846 (2022).Article

Becker，M.等人，《儿童毛细血管和静脉血细胞计数的差异——一种数据挖掘方法》。国际J.实验室血液学。44729-737。https://doi.org/10.1111/ijlh.13846（2022年）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Doeleman, M. J. H., Esseveld, A., Huisman, A., de Roock, S. & TielGroenestege, W. M. Stability and comparison of complete blood count parameters between capillary and venous blood samples. Int. J. Lab. Hematol. https://doi.org/10.1111/ijlh.14080 (2023).Article

Doeleman，M.J.H.，Esseveld，A.，Huisman，A.，de Roock，S。＆TielGroenestege，W.M。毛细血管和静脉血样之间全血细胞计数参数的稳定性和比较。国际J.实验室血液学。https://doi.org/10.1111/ijlh.14080。文章

PubMed

PubMed

Google Scholar

谷歌学者

China National Accreditation Service for Conformity assessment. CNAS⁃CL02: 2023 Guidance on the Application of Accreditation Criteria for the Medical Laboratory Quality and Competence (China Metrology Publishing House, 2023).

中国合格评定国家认可委员会。。

Google Scholar

谷歌学者

China National Accreditation Service for Conformity assessment. Guidance on the Application of Accreditation Criteria for the Medical Laboratory Quality and Competence in the Field of Clinical Hematology (China Metrology Publishing House, 2018).

中国合格评定国家认可委员会。《临床血液学领域医学实验室质量和能力认证标准应用指南》（中国计量出版社，2018）。

Google Scholar

谷歌学者

Services, D. O. H. A. H. Clinical laboratory improvement amendments of 1988: Final rule. Fed. Regist. 57, 7188–7288. (1992).Clinical and Laboratory Standards Institute (CLSI). Measurement procedure comparison and bias estimation using patient samples. 3rd ed.CLSI guideline EP09c [S].

服务部，D.O.H.A.H.1988年临床实验室改进修正案：最终规则。联邦登记处。577188–7288。（1992年）。临床和实验室标准研究所（CLSI）。使用患者样本进行测量程序比较和偏差估计。第三版CLSI指南EP09c【S】。

Wayne, Pennsylvania: Clinical andLaboratory Standards Institute (2018).BE, S. Clinical Decision Levels for Lab Tests[M]. Medical Economic Book (1987).Lippi, G. et al. Preanalytical quality improvement: From dream to reality. Clin. Chem. Lab. Med. 49, 1113–1126. https://doi.org/10.1515/CCLM.2011.600 (2011).Article .

宾夕法尼亚州韦恩：临床和实验室标准研究所（2018）。BE，S。实验室测试的临床决策水平[M]。医学经济书（1987）。Lippi，G。等。分析前质量改进：从梦想到现实。。化学。实验室医学491113-1126。https://doi.org/10.1515/CCLM.2011.600（2011年）。文章。

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Lippi, G., von Meyer, A., Cadamuro, J. & Simundic, A. M. Blood sample quality. Diagnosis (Berl) 6, 25–31. https://doi.org/10.1515/dx-2018-0018 (2019).Article

。诊断（Berl）6，25-31。https://doi.org/10.1515/dx-2018-0018（2019年）。文章

PubMed

PubMed

Google Scholar

谷歌学者

Zhongzhi, Z. Histology and Embryology [M]. 5th Edn. Beijing: people's Health Publishing House.Nikolić, L. I., Gojnić-Dugalić, M. G., Dunjić, B. S., Lazović, V. D. & Čolović, R. B. Pseudotrombocytopenia caused by EDTA in obstetrics and perinatology—Case report. Hosp. Pharmacol. 4, 528–532.

钟志，Z。组织学与胚胎学〔M〕。第5版。北京：人民卫生出版社。Nikolić，L.I.，Gojnić-Dugalić，M.G.，Dunjić，B.S.，Lazović，V.D.＆Čolović，R.B。EDTA在产科和围产期病例报告中引起的假性血小板减少症。医院药理学。4528-532。

https://doi.org/10.5937/hpimj1702528N (2017).Article .

https://doi.org/10.5937/hpimj1702528N (2017).Article .

Google Scholar

谷歌学者

Nikolić, L. I., Suvajdžić-Vuković, N. D. & Plećaš, D. V. Pseudothrombocytopenia. Hosp. Pharmacol. 3, 348–353. https://doi.org/10.5937/hpimj1601348N (2016).Article

Nikolić，L.I.，SuvajžIć-Vuković，N.D.和Dancing，D.V.假性血小板减少症。Hosp.Pharmacol。3.348-353.https://doi.org/10.5937/hpimj1601348N(2016).文章

Google Scholar

谷歌学者

Peng, Z. et al. Comparison of performances of five capillary blood collection tubes. Int. J. Lab. Hematol. 37, 56–62. https://doi.org/10.1111/ijlh.12231 (2015).Article

Peng，Z.等人。五种毛细血管采血管性能的比较。国际J.实验室血液学。37，56-62。https://doi.org/10.1111/ijlh.12231（2015年）。文章

CAS

中科院

PubMed

PubMed

Google Scholar

谷歌学者

Download referencesAcknowledgementsWe thank every patient who participated in this research.FundingThis work was supported by grants from the Natural Science Foundation of Shandong Province (ZR2020MH116), National Natural Science Foundation of China (81600110), Medical and Health Science and Technology Program of Zhejiang Province (2021KY017, 2022KY027), Zhejiang Provincial Department of Education Program (Y202146133), Traditional Chinese Medicine Science and Technology Program of Zhejiang Province (2023ZL009), and Basic Scientific Research Funds of Department of Education of Zhejiang Province (KYYB202216) to Hongxiang Xie.Author informationAuthor notesThese authors contributed equally: Xie Hongxiang, and Lv Shiyu.Authors and AffiliationsLaboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, No.

下载参考文献致谢我们感谢每一位参与这项研究的患者。资助这项工作得到了山东省自然科学基金（ZR2020MH116），国家自然科学基金（81600110），浙江省医疗卫生科学技术计划（2021KY0172022KY027），浙江省教育厅计划（Y202146133），浙江省中医药科学技术计划（2023ZL009）和浙江省教育厅基础科学研究基金（KYB202216）的资助。作者信息作者注意到这些作者做出了同样的贡献：谢鸿祥和吕世玉。作者和附属机构杭州医学院浙江省人民医院（附属人民医院）临床检验科实验室医学中心。

158 Shangtang Road, Hangzhou, 310014, Zhejiang, People’s Republic of ChinaXie Hongxiang & Wang SumeiDepartment of Clinical Laboratory Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, 16766 Jingshi Road, Jinan, 250014, Shandong, People’s Republic of ChinaXie Hongxiang, Lv Shiyu & Xu WanjuDepartment of Clinical Laboratory, Zaozhuang Chest Hospital, Zaozhuang Tumor Hospital, Zaozhuang, Shandong, People’s Republic of ChinaZhang YanyingAuthorsXie HongxiangView author publicationsYou can also search for this author in.

中华人民共和国浙江省杭州市上汤路158号谢鸿祥和王素梅山东第一医科大学第一附属医院和山东省前佛山医院临床检验科，济南市经石路16766号，250014，中华人民共和国山东省谢鸿祥，吕世玉和徐万举中华人民共和国山东省枣庄市枣庄市肿瘤医院枣庄胸科临床检验科张燕英作者谢鸿祥观点作者出版物您也可以在中搜索该作者。

PubMed Google ScholarLv ShiyuView author publicationsYou can also search for this author in

PubMed Google ScholarLv ShiyuView作者出版物您也可以在

PubMed Google ScholarZhang YanyingView author publicationsYou can also search for this author in

PubMed谷歌学者张燕英查看作者出版物您也可以在

PubMed Google ScholarXu WanjuView author publicationsYou can also search for this author in

PubMed Google ScholarXu WanjuView作者出版物您也可以在

PubMed Google ScholarWang SumeiView author publicationsYou can also search for this author in

PubMed Google ScholarWang SumeiView作者出版物您也可以在

PubMed Google ScholarContributionsXie Hongxiang: conceptualization, funding acquisition, investigation, methodology, formal analysis, and writing – original draft. Lv Shiyu and Zhang Yanying: conceptualization, investigation, methodology, formal analysis, and writing – original draft.

PubMed Google ScholarContributionsXie Hongxiang：概念化，资金获取，调查，方法论，形式分析和写作-原稿。吕世玉和张燕英：概念化，调查，方法论，形式分析和写作-原稿。

Xu Wanju and Wang Sumei: investigation, methodology, administration of project, and writing – review & editing. Each author has agreed to be responsible for the manuscript's content and approved its submission.Corresponding authorsCorrespondence to.

徐万举和王素梅：调查，方法论，项目管理，写作-评论和编辑。每位作者都同意对稿件的内容负责并批准其提交。通讯作者通讯。

Xu Wanju or Wang Sumei.Ethics declarations

徐万举或王素梅。道德宣言

Competing interests

相互竞争的利益

The authors declare no competing interests.

作者声明没有利益冲突。

Additional informationPublisher's noteSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.Rights and permissions

Additional informationPublisher的noteSpringer Nature在已发布地图和机构隶属关系中的管辖权主张方面保持中立。权限和权限

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.

开放获取本文是根据知识共享署名4.0国际许可证授权的，该许可证允许以任何媒体或格式使用，共享，改编，分发和复制，只要您对原始作者和来源给予适当的信任，提供知识共享许可证的链接，并指出是否进行了更改。

The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

本文中的图像或其他第三方材料包含在文章的知识共享许可中，除非在材料的信用额度中另有说明。如果材料未包含在文章的知识共享许可中，并且您的预期用途不受法律法规的许可或超出许可用途，则您需要直接获得版权所有者的许可。

To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/..

要查看此许可证的副本，请访问http://creativecommons.org/licenses/by/4.0/..

Reprints and permissionsAbout this articleCite this articleHongxiang, X., Shiyu, L., Yanying, Z. et al. Consistency analysis of two fingertip capillary blood sampling methods for complete blood count.

转载和许可本文引用本文Hongxiang，X.，Shiyu，L.，Yanying，Z。等人。两种指尖毛细血管全血计数采血方法的一致性分析。

Sci Rep 14, 15011 (2024). https://doi.org/10.1038/s41598-024-64448-zDownload citationReceived: 14 March 2024Accepted: 10 June 2024Published: 01 July 2024DOI: https://doi.org/10.1038/s41598-024-64448-zShare this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

Sci Rep 1415011（2024）。https://doi.org/10.1038/s41598-024-64448-zDownload引文收到日期：2024年3月14日接受日期：2024年6月10日发布日期：2024年7月1日OI：https://doi.org/10.1038/s41598-024-64448-zShare本文与您共享以下链接的任何人都可以阅读此内容：获取可共享链接对不起，本文目前没有可共享的链接。复制到剪贴板。

Provided by the Springer Nature SharedIt content-sharing initiative

由Springer Nature SharedIt内容共享计划提供

KeywordsCapillary bloodBlood collection tubesMicrohematocrit tubesComplete blood count

关键词毛细血管采血管微血细胞比容管全血细胞计数

CommentsBy submitting a comment you agree to abide by our Terms and Community Guidelines. If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate.

评论通过提交评论，您同意遵守我们的条款和社区指南。如果您发现有虐待行为或不符合我们的条款或准则，请将其标记为不合适。