CELL-DYN Sapphire血液分析仪的CD61免疫学法、光学法、电阻抗法在低值血小板计数中的比较与应用  

Comparison and application of low platelet counts by CD61 immunological,optical,electrical impedance methods of CELL-DYN Sapphire hematology analyzer

作　　者：张驰[1] 张洪波[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院检验科,湖北武汉430030

出　　处：《检验医学》2015年第3期274-279,共6页Laboratory Medicine

摘　　要：目的评价和比较CELL-DYN Sapphire血液分析仪的3种检测方法在低值血小板（PLT）检测方面的优劣性。方法选择基础血液病或肿瘤化疗后引起的PLT低于50×10^9/L 100例,分别使用电阻抗法、光学法和CD61免疫学法3种方法进行PLT计数,并与显微镜手工法（MPLT）作比较。运用SPSS 19.0和Med Calc V12.7.2.0分析软件对数据进行方差分析、Passing-Bablok回归分析和Bland-Altman偏倚分析。结果 ANOVA分析显示,电阻抗法、光学法PLT计数与MPLT比较,差异有统计学意义（分别为P=0.00,P=0.002）,CD61免疫学法与MPLT差异无统计学意义（P=0.915）;OPLT和CD61免疫学法与MPLT的相关性较好（分别为slope1.0,95%CI为0.95-1.06,r=0.946和slope 1.0,95%CI为0.99-1.01,r=0.998）,电阻抗法与MPLT的相关性较差（slope 1.27,95%CI为1.10-1.44,r=0.845）。通过偏差分析,电阻抗法、光学法PLT计数比MPLT检测的数值更高（差异均值分别为6.3、1.3）,CD61免疫学法与MPLT检测的数值差异无统计学意义（差异均值=-0.02）。结论在低值PLT的检测中,电阻抗法与MPLT存在明显的统计学差异,相关性差,且结果有明显偏差（偏高）;光学法与MPLT存在统计学差异,结果仍存在少量偏差（偏高）,但相关性较好;而CD61免疫学法与MPLT均值无明显差异,相关性好,结果无明显偏差。所以,当临床出现低值病例时,推荐使用CD61免疫学法PLT进行计数。Objective To evaluate and compare the advantages and disadvantages of 3 detection methods of CELL-DYN Sapphire hematology analyzer in the aspect of low platelet（PLT） detection.Methods A total of 100 patients whose platelet 〈50 × 10^9/ L caused by basis hematonosis or after chemotherapy were enrolled.PLT counts were determined by electrical impedance method（IPLT）,optical method（OPLP） and CD61 immunological method（CD61-PLT）.The results were analyzed comparatively with those of manual microscopy.Variance analysis,PassingBablok regression analysis and Bland-Altman bias analysis were performed by SPSS 19.0 and Med Calc V12.7.2.0softwares statistically.Results ANOVA analysis showed that there was statistical significance for IPLT and OPLT with manual method（MPLT）.（P = 0.00,P = 0.002）.CD61-PLT and MPLT had no statistical significance（P = 0.915）.OPLT and CD61-PLT had good correlation with MPLT without statistical significance[slope 1.0,95% confidence interval（CI） ： 0.95-1.06,r = 0.946 and slope 1.0,95% CI： 0.99-1.01,r = 0.998].IPLT had poor correlation with MPLT with statistical significantce（slope 1.27,95% CI： 1.10-1.44,r = 0.845）.According to variance analysis,the values of IPLT and OPLT were higher than those of MPLT（mean deviations were 6.3 and 1.3）.CD61-PLT and MPLT had no significant difference（mean deviation was- 0.02）.Conclusions IPLT has significantly statistical difference with MPLT for low PLT determination,with poor correlation,and the result has a significant upward deviation.The means of OPLT and MPLT have statistical significance with good correlation,but the result has a still small upward deviation.The CD61-PLT and MPLT have no obvious difference with a good correlation,and the results are not significantly different.Therefore,it is recommended that we can use CD61-PLT as a new reference method and OPLT and IPLT as alternative methods.

关 键 词：低值PLT CD61免疫学法 光学法 电阻抗法 CD-SAPPHIRE 预防性血小板输注 

分 类 号：R446.11[医药卫生—诊断学]