血浆置换法和公式校正法纠正乳糜血对仪器法测定血红蛋白影响的探讨  

Correction of the Impact of Chylemia on Hematology Analysis by Plasma Exchange and Formula Calibration Method

作　　者：王克迪[1] 徐东江[2] 苏建荣[1] 

机构地区：[1]首都医科大学附属北京友谊医院临床检验中心,北京100050 [2]北京积水潭医院检验科,北京100035

出　　处：《现代检验医学杂志》2017年第3期137-139,143,共4页Journal of Modern Laboratory Medicine

摘　　要：目的探讨乳糜血血浆置换法和公式校正法两种方法对乳糜血血细胞检验结果的校正效果,为实验室能够准确提供血细胞检测结果提供依据。方法收集10例无溶血、黄疸、乳糜的标本进行血细胞测定设为对照组,每个标本分为4份,分别加入5,10,20和40μl脂肪乳,制备不同程度的乳糜血,采用血浆置换法处理标本,每份标本置换2次,然后用血细胞分析仪重新测定,将结果与对照组结果进行比较。此外,将测定的乳糜血标本结果和离心后乳糜血浆的血细胞结果带入校正公式HGB_(修正值)=HGB_(修正值)-(HGB_(乳糜血血浆)-HGB_(乳糜血血浆)×HCT_(修正前)),得出的HGB_(修正值)与对照组和血浆置换法结果进行比较和统计学分析。结果乳糜血可造成HGB,MCH和MCHC三项指标明显升高,与其真实值差异有统计学显著性意义(P<0.05),经过2次血浆置换后该3项参数恢复到正常和稳定的状态。公式校正法结果与真实值差异无统计学意义(P>0.05)。结论乳糜血标本经血浆置换法和公式校正法处理后均可消除乳糜微粒对仪器法测定HGB的影响,为临床提供准确的结果。Objective Comparison the corrective effect of plasma exchange method and formula method for chylemia on hematology analysis. Methods A total of l0 samples without hemolysis,jaundice and lipemia were set as control group,each sample was divided into 4 parts,then 5,10,20 and 40 μL lipid emulsion was added. Each chylous samples was treated by plasma exchange method for two times, and routine blood test was reanalyzed with hematology analyzer. The comparisons before and after the exchange was made, while the test results on each exchange were analyzed. For another part, the HGB of chylous plasma was tested, the value was substituted into HGB ted value = HGBbefore correction -（HGBchylouspl -HGBchhylous plassma× HCTbefore correction）. Results The chylemia could lead significant increase of HGB,MCH and MCHC （P^0.05）. After plasma exchanging for two times, the three parameters returned to normal and the count of WBC, RBC and PLT decline slightly with no significance. There were no differences between plasma exchange method and formula calibration method. Conclusion Plasma exchange method and formula calibration method could significantly reduce the impact of chylemia on routine blood analysis, which facilitate the clinical work with correct analysis of routine blood test. Keywords： chylemia ; blood cell detection; plasma exchange ; formula

关 键 词：乳糜血 血细胞检测 血浆置换 公式 

分 类 号：R446[医药卫生—诊断学]