XN-2000血液分析仪低值PLT计数复检规则的制定  

Establishment of review criteria for low PLT count in XN-2000 hematology analyzer

作　　者：黄媛[1] 黄春梅[1] 李建英[1] 王庚[1] 王欣[1] 吴卫[1] 崔巍[1] 

机构地区：[1]北京协和医院检验科,北京100730

出　　处：《临床检验杂志》2014年第1期48-51,共4页Chinese Journal of Clinical Laboratory Science

摘　　要：目的：通过评估XN-2000血液分析仪对PLT计数的检测性能，初步探讨联合人工镜检法和血液分析仪自动复检功能来制定低值PLT的复检规则。 方法：用XN-2000血液分析仪的3种通道计数650例新鲜全血标本的PLT，得出荧光PLT计数（PLT-F），电阻抗PLT计数（PLT-I）和光学PLT计数（PLT-O）。比较分析PLT-F、PLT-I和PLT-O的精密度及其与流式细胞分析法（FCM）和镜检法计数PLT的一致性。进而对本实验室原有的低值PLT复检规则重新进行制定。 结果：PLT-F变异系数（CV）为2.7%～4.7%，低于PLT-I和PLT-O的4.2%～16.2%。PLT在（2～50）×109/L区间时，PLT-F与FCM法PLT计数的一致性高于PLT-I和PLT-O，r分别为0.969、0.826和0.950,PLT-F与镜检法PLT的一致性也高于PLT-I和PLT-O，r分别为 0.914、0.874和0.898,提示PLT-F检测低值PLT的准确性优于PLT-I和PLT-O。通过对本实验室原有的低值PLT复检规则的重新制定，使复检的假阴性率降为零，人工复检率下降了51.47%（158/307）。新的复检规则为：当PLT-I＜80×109/L时，自动追加PLT-F检测，如果没有PLT相关报警出现，可直接报告PLT-F结果；当出现报警时，进行人工镜检，报告镜检PLT结果。 结论：与PLT-I及PLT-O相比，低值PLT-F检测具有更好的精密度和准确性。通过重新制定复检规则，可明显降低低值PLT的人工复检率。Objective：To evaluate the performance of platelet （PLT） count of XN-2000 hematology analyzer, and establish the review criteria for low PLT count by combining manual microscopy with automated review function of the hematology analyzer. Methods：A total of 650 fresh whole blood specimens were measured with the three channels of XN-2000 hematology analyzer, and the fluorescent PLT count （PLT-F）, electric impedance PLT count （PLT-I） and optical PLT count （PLT-O） results were obtained. Then, the precision of PLT-F, PLT-I and PLT-O and the consistency of PLT count between the hematology analyzer and flow cytometry or manual microscopy were analyzed. In addition, the automated review function of the hematology analyzer was integrated with the microscopic review criteria for low PLT count, and updated. Results：The precision of PLT-F （CV： 2.7%~4.9%） was significantly lower than that of PLT-I and PLT-O （CV： 4.3%~16.3%）. When PLT count was in the range of （2~50）×109/L, the consistency between PLT-F and flow cytometric PLT count （r=0.969） was higher than that between PLT-I and flow cytometric PLT count （r=0.874） and between PLT-O and flow cytometric PLT count （r=0.950）. There was similar consistency between PLT-F, PLT-I and PLT-O and manual PLT count （r=0.914, 0.874, and 0.898, respectively）, indicating that the accuracy of PLT-F was better than that of PLT-I and PLT-O for low PLT count. Based on our evaluation, we updated our microscopic review criteria as follows. When PLT-I is lower than 80×109/L, PLT-F will be automatically retested. If there is no PLT IP message, PLT-F will be reported. However, if there is PLT abnormal message, manual microscopy should be performed and manual PLT count will be reported. Following the new review criteria, the false negative rate for low automated PLT count reduced to zero and manual review rate decreased 51.47%（158/307）. Conclusion： For low PLT count, PLT-F has better precision and accuracy than PLT-I and PLT-O. The manual re

关 键 词：PLT 低值 复检规则 流式细胞分析法 

分 类 号：R446[医药卫生—诊断学]