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目的:用日本Sysmex公司XN-9000全自动血细胞分析仪分析临床标本,探讨电阻抗法,光学法,荧光法计数血小板的准确性以及影响血小板计数准确性的相关因素。方法:采用电阻抗法、光学法,荧光法和手工法计数血小板分别为PLT-I,PLT-O,PLT-F和PLT-M,分别用PLT-I,PLT-O,PLT-F对PLT-M作Bland-Altman图。结合CLIA188室间评估指标(血小板的允许误差限值为T±25%),分析2种方法的一致性;并统计分析对照组及血小板直方图异常标本的红细胞碎片计数(FRC%)、小红细胞百分率(MicroR%)、网织血小板比率(IPF%)的95%可信区间,观察其对仪器法检测结果的影响。结果:正常对照组60例PLT计数电阻抗法、光学法,荧光法和手工法比较都具有较好的一致性。小红细胞组60例PLT计数电阻抗法计数血小板最高,偏差随着FRC%和或MicroR%的增多而变大,血小板直方图异常越明显,而光学法、荧光法和手工法之间具有较好的一致性,此时FRC%和MicroR%明显高于正常对照组,IPF%无明显差别。幼稚(大)血小板组60例PLT计数电阻抗法和光学法结果可信度低,且光学法最低,而荧光法与手工法一致性较好,此时IPF%明显升高。结论:XN-9000分析仪计数血小板在正常血液标本中,3种方法与手工法一致性好,结果均可靠。在小红细胞和或红细胞碎片干扰标本及血小板形态异常标本中,电阻抗法结果不可靠,可用荧光法或手工法进行复查。而光学法抗小红细胞和红细胞碎片能力较强,对幼稚血小板会漏检。
OBJECTIVE: To analyze the accuracy of platelet counting and the related factors that influence the accuracy of platelet counting by means of electrical impedance spectroscopy, optical method, fluorescence method and XN-9000 automatic hematology analyzer from Japan Sysmex Corporation. Methods: PLT-I, PLT-O, PLT-F and PLT-M were counted by electrical impedance spectroscopy, optical method, fluorescence method and manual method respectively. PLT-I, PLT- -M for Bland-Altman diagram. Combined with CLIA188 inter-laboratory evaluation index (platelet allowed error limit of T ± 25%), the consistency of the two methods were analyzed; and statistical analysis of the control group and platelet abnormalities specimens erythrocyte fragment count (FRC%), Percentage (MicroR%), reticulated platelet ratio (IPF%) of 95% confidence interval, to observe its impact on the instrumental test results. Results: 60 cases of normal control group PLT count impedance method, optical method, fluorescence and manual methods have better consistency. In the group of small red blood cells (PLT) counts, the platelet count was the highest in 60 PLT counting resistance methods. The deviation became larger with the increase of FRC% and or MicroR%, and the abnormality of platelet histogram became more obvious. However, there was a good correlation between optical method, fluorescence method and manual method The consistency of FRC% and MicroR% was significantly higher than that of the normal control group, IPF% no significant difference. The PLT counting electrical impedance and optics results of 60 cases of naive (large) platelet group were less reliable and the optical method was the lowest, while the fluorescence method and manual method were better, and the IPF% was significantly increased. Conclusion: The XN-9000 analyzer counts platelets in normal blood samples, and the three methods are in good agreement with the manual method, the results are reliable. In the small red blood cells and or red blood cell debris interference specimens and platelet abnormalities in specimens, the results of electrical impedance method is not reliable, available fluorescence or manual method for review. The optical anti-small red blood cells and erythrocyte debris ability to detect naive platelets.