三种不同采血方式的样本进行血细胞分析的对比研究  

Comparison of hematology analysis of blood samples obtained with three different sampling methods

作　　者：肖秀林[1] 王昌富[1] 汪永红[1] 高清萍[1] 陈芳[1] 

机构地区：[1]湖北省荆州市中心医院检验医学部,434020

出　　处：《国际检验医学杂志》2007年第7期585-587,590,共4页International Journal of Laboratory Medicine

摘　　要：目的探讨三种不同采血方式对血细胞分析5项测定参数的影响。方法随机选择在该院门诊检验科进行血细胞分析的患者40例,对同一患者按采血方式与采血容器的不同组合同时采取三种EDTA抗凝血样：（1）采集2ml静脉血置于真空负压管（简称真空管）;（2）取静脉血160μl置于微量抗凝管（简称微量管）;（3）采集末梢血160μl置于微量抗凝管（简称末梢血管）。所有样本均用XT-1800i血细胞分析仪进行检测。结果（1）静脉血微量管5项主要参数均略高于真空管;末梢血WBC、RBC、Hb、MCV检测结果高于静脉血真空管和微量管,血小板则偏低,尤以〈100×10^9/L组最为明显。但微量管与真空管、末梢血与静脉血检测数据呈显著相关,且微量管与真空管、末梢血与静脉血之间的偏差均低于CLIA′88规定的允许范围。（2）三种血样在血细胞分析仪上的Plt检测结果不同程度地低于显微镜计数结果,以末梢血PltB组（Plt〈100×10^9/L）最为明显。同时血膜片镜检发现,三种血样均约有半数可见大血小板和/或血小板聚集现象。结论不同样本类型及采血容器对血细胞分析检测结果的影响在可接受的范围之内,利用EDTA真空负压管采集静脉血具有结果稳定、样本量多、便于复查等诸多优点,在优先推行静脉采血的同时可根据临床实际情况选择样本类型及采血容器。当出现血小板减少的数据,应重采静脉血或应用相差显微镜-草酸铵法计数,有条件的最好采用免疫血小板计数法进行复检。Objective To investigate effects of three different sampling methods on 5 parameters of hematology analysis. Methods 40 samples were selected at random from outpatients in our hospital. From each patient we obtained three types of samples.. （1） 2 ml venous blood in the vacuum container with negative pressure （vacuum container sample for abbreviation）; （2） 160 μl venous blood in the anti-coagulation microtube （microtube sample for abbreviation） ; （3） 160 μl peripheral blood in the anti-coagulation microtube （peripheral blood for abbreviation）. All the samples were tested with the XT-1800i analyzer. Results （1） The venous blood in different containers produced statistically different results. For the blood from the same patient, the five main parameters of microtube sample were higher than that of vacuum container sample; the main parameters of peripheral blood and venous blood displayed statistical difference, WBC, RBC, Hb, and MCV of peripheral blood were higher than those of venous blood in the vacuum container and the microtube, while PLT was lower, which was especially obvious in the samples with PLT〈100 × 10^9/L. Significant correlation existed between the results of microtube samples and vacuum samples, peripheral blood and venous blood. The deviations between the results of microtube samples and vacuum samples, peripheral blood and venous blood were both lower than the limits defined by CLIA＇88. （2） For all the three types of samples, significant difference existed between platelet count with the hematology analyzer and microscopes. The results from the hematology analyzer were lower than those from microscopes, which were most obvious for peripheral blood. Microscopic observation of blood smears displayed that large platelets or aggregation of platelets existing in all the three types of samples. Conclusion The effects of different sample types and sampling containers are within the acceptable limitation. Venous blood in EDTA vacuum containers shows many advantages, s

关 键 词：血细胞分析 静脉血 末梢血 真空负压管 微量抗凝管 

分 类 号：R446.1[医药卫生—诊断学]