全血细胞分析仪与外周血涂片对检测恶性血液病患者白细胞分类结果的比较  

Comparison of blood cell analyzer and peripheral blood smear on the white cell classification results in patients with malignant hematological diseases

作　　者：陈小君 孟淑娟 

机构地区：[1]曹妃甸区工人医院,河北唐山063000 [2]唐山钢铁集团公司医院,河北唐山063000

出　　处：《热带医学杂志》2015年第10期1377-1379,共3页Journal of Tropical Medicine

摘　　要：目的降低血细胞分析仪对血液病患者白细胞分类计数的出错率,弥补血细胞分析仪对细胞形态识别能力的不足,提高外周白细胞分类的准确性。方法收集唐钢医院75例血液病患者标本,经EDTA-K2抗凝采用Sysmex XT-1800i全血五分类血细胞仪进行CBC+diff检测,同时对异常白细胞分类标本制备血涂片2张,经瑞氏-吉姆萨染色后在显微镜下进行白细胞分类计数,观察嗜酸性粒细胞、中性粒细胞、淋巴细胞、单核细胞等指标。结果将血涂片计数与血细胞仪测定共同观察指标进行比较,差异性主要表现在淋巴细胞和单核细胞,分别为(47.35±18.14)vs(38.40±17.60)和(6.80±2.12)vs(12.68±1.40),差异均有统计学意义(t=12.650,P<0.05;t=15.200,P<0.05)。结论血液病患者由于细胞颗粒和染色质的异常,往往错误的识别淋巴细胞或单核细胞,导致单核细胞计数偏高或淋巴细胞降低,正确重视血涂片非常重要。Objective To reduce the error of white blood cell classification,compensate the cell morphology identification ability,and improve the accuracy of peripheral white blood cell classification of the blood cell analyzer. Methods Samples of75 patients with hematological diseases were collected from the Tangshan Iron and Steel Hospital. After anticoagulated by EDTA-K2,samples were used for the detection of CBC＋diff using the Sysmex XT-1800i whole blood five classification system,at the same time abnormal white blood cell classification specimen prepared two pieces of two blood smears were prepared from the same sample and stained with Wright-Giemsa staining and counted for different types of white blood cells such as neutrophils,lymphocytes and monocytes. Results By the comparison of determination of blood smear and blood cell counting instrument,differences mainly display in the counting of lymphocytes and monocytes by blood smear method and the blood counting instrument were significantly different（47.35±18.14）vs（38.40±17.60）;（6.80±2.12）vs（12.68±1.40）（t=12.650,P〈0.05;t =15.200,P〈0.05）. Conclusion The discrepancy generated in the blood counting instrument might be due to the chromosome abnormalities in the patients white blood cells,resulting in the over estimate of monocytes and under estimate of lymphocytes,therefore compensate by blood smear examination is important.

关 键 词：血细胞分析仪 白细胞分类计数 血涂片 

分 类 号：R552[医药卫生—血液循环系统疾病]