血细胞分析仪红细胞参数干扰因素分析及处理  

Analysis and treatment of interference factors of red blood cell parameters in hematology analyzer

作　　者：李艳[1] 孙家祥[1] 叶敏[1] LI Yah SUN Jia-xiang YE Min(Department of Clinical Laboratory, Deyang City People＇ s Hospital, Deyang 618000, China)

机构地区：[1]四川省德阳市人民医院检验科,618000

出　　处：《中国实用医药》2017年第27期37-38,共2页China Practical Medicine

摘　　要：目的探讨血细胞分析中红细胞参数干扰因素及纠正方法。方法 32例标本,其中冷凝集标本6例(冷凝集组)、高脂血标本22例(高脂血组)、高白细胞(WBC)标本4例(高WBC组)。所有样本均使用EDTA-K2真空管采集静脉血2~3 ml,初检30 min内完成。冷凝集组标本用37℃水浴10~20 min后立即上机再次检测;高脂血组标本采用低速离心(速度为1000 r/min)15 min后,用等量血球稀释液置换血浆混匀后再次上机检测;高WBC组标本采用压积管低速离心去除白细胞层及血浆层加入等量稀释液混匀后再次检测。分析各组处理前后血红蛋白(Hb)、平均红细胞血红蛋白含量(MCH)、平均红细胞血红蛋白浓度(MCHC)、红细胞计数(RBC)、红细胞压积(HCT)、平均红细胞体积(MCV)等红细胞参数变化。结果高脂血组和高WBC组标本处理前后Hb、MCH、MCHC水平比较差异均具有统计学意义(P<0.05),而RBC、HCT、MCV水平比较差异无统计学意义(P>0.05)。冷凝集组标本处理后的RBC(4.05±0.45)×1012/L、HCT(36.9±3.5)%、MCV(91.1±4.1)fl,均高于处理前的(2.52±0.32)×1012/L、(18.6±2.2)%、(73.8±3.2)fl,MCH(30.6±3.8)pg、MCHC(335.8±15.8)g/L均低于处理前的(49.4±3.5)pg、(668.8±26.4)g/L,差异均具有统计学意义(P<0.05);而冷凝集组处理前后Hb水平比较差异无统计学意义(P>0.05)。结论冷凝集、高脂血和高WBC会对红细胞参数产生明显影响,标本必须适当处理后方可获得正确结果。Objective To investigate the interference factors and corrective methods of red blood cell parameters in hematology analyzer. Methods Among 32 specimen, there were 6 cold agglutination specimen （cold agglutination group）, 22 hyperlipidemia specimens （hyperlipidemia group） and 4 high white blood cells （WBC） specimens （high WBC group）. All samples were collected with EDTA-K2 vacuum tube for 2-3 ml and the initial examination was completed within 30 rain. The cold agglutination group was tested again immediately after 10±20 rain of water bath at 37±C. The hyperlipidemia group received low-speed centrifugation （speed as 1000 r/rain） for 15 rain, and the same amount of blood cell dilution was used to replace t±e plasma and then tested again after mixing. The high WBC group was treated with a pressure tube at low speed to remove the white blood cell layer and plasma layer. The same amount of dilution was mixed and tested again. Analysis was made on changes of red blood cell parameters of hemoglobin （Hb）, mean corpuscular hemoglobin （MCH）, mean corpuscular hemoglobin concentration （MCHC）, red blood cell （RBC） count, hematocrit （HCT） and mean corpuscular volume （MCV） before and after treatment. Results The hyperlipidemia group and high WBC group had statistically significant difference in Hb, MCH; MCHC level before and after treatment （P〈0.05）, and hadno statistically significant difference in RBC, HCT, MCV level （P〉0.05）. The cold agglutination group had higher RBC as （4.05 ± 0.45） × 10^12/L, HCT as （36.9± 3.5）% and MCV as （91.1 ± 4.1） fl after treatment than （2.52 ± 0.32） × 10^12/L, （18.6 ± 2.2）% and （73.8 ± 3.2） fl before treatment, and lower MCH as （30.6 ± 3.8） pg and MCHC as （335.8 ± 15.8） g/L than （49.4 ± 3.5） pg and （668.8 ± 26.4） g/L before treatment. Their difference was statistically significant （P〈0.05）. Cold agglutination group had no statistically significant difference in Hb level before and

关 键 词：红细胞参数 冷凝集 高脂血 高白细胞 

分 类 号：R446.11[医药卫生—诊断学]