应用Sysmex XT-4000i体液模式进行脑脊液细胞计数的性能评价  

Performance Estimation of Sysmex XT-4000i in Body Fluid Mode for Counting Blood Cells in Cerebrospinal Fluid

作　　者：耿丽丽 刘义庆[1] 王泽筠[1] 沈亚娟[1] 亓琳[1] 赵万辉[1] 张炳昌[1] 

机构地区：[1]山东大学附属省立医院临床医学检验部,济南250021

出　　处：《临床输血与检验》2017年第6期630-635,共6页Journal of Clinical Transfusion and Laboratory Medicine

基　　金：山东省自然科学基金(No.ZR2016HM52);山东省科学技术发展计划资助项目(No.2014GGH218041);山东省临床重点专科项目(No.鲁卫医字[2013]26号)资助

摘　　要：目的评估血细胞分析仪Sysmex XT-4000i体液(body fluid,BF)模式进行脑脊液细胞计数的性能。方法收集2015年6~12月山东省立医院住院患者脑脊液标本142份,用XT-4000i进行细胞计数和分类,并与人工显微镜(人工灌板和细胞离心染色)计数进行方法学比较。结果 XT-4000i和人工显微镜计数之间白细胞计数(y=1.17x+3.21,n=118,r2=0.98)、单个核细胞计数(y=0.81x+13.61,n=101,r2=0.88)、多个核细胞计数(y=0.82x+5.15,n=101,r2=0.88)、红细胞计数(y=1.01x+146.40,n=62,r2=0.99)均呈高度相关。XT-4000i检测的研究参数高荧光强度细胞(HF-BF)水平与显微镜下查到大细胞(吞噬细胞或恶性细胞等)具有相关性(y=0.54x+3.31,n=101,r2=0.27,P<0.001),真阳性率是13.9%,真阴性率是96.9%。XT-4000i检测的另一研究参数嗜酸性粒细胞(EO-BF)水平与人工显微镜方法的相关性无统计学意义(P>0.05),真阳性率是9.8%,真阴性率是80.0%。XT-4000i的白细胞、单个核细胞、多个核细胞和红细胞计数均表现出良好的精密度(CV≤30%)。白细胞计数和红细胞计数具有良好的携带污染率(carry-over≤0.3%)和线性分析(r2=0.99)。结论 XT-4000i体液模式的准确度和精密度良好,可用于日常脑脊液细胞计数。高荧光强度细胞水平对脑脊液中的大细胞具有一定的提示预测作用。Objective To evaluate the performance of the body fluid （BF） mode on Sysmex XT-4000i for counting blood cells in cerebrospinal fluid （CSF） . Methods One hundred and forty -two CSF specimens were collected from the inpatients in Shandong Provincial Hospital from June to December, 2015. Blood ceils of all the specimens were counted for method comparison between Sysmex XT-4000i and manual microscope （counting chamber and stainedcytospin slides） . Results Excellent correlations were found for counting white blood cells （y=1.17x＋3.21, n=118, r2=0.98） , mononuclear cells （y=0.81x＋13.61, n=101, r2=0.88） , polynuclear cells （y=0.82x＋5.15, n=101, r2=0.88） and red blood cells （y = 1.01x＋146.40, n = 62, r2= 0.99） . Good agreement was found between levels of high fluorescent （HF） cells detected by XT-4000i and large cells （macrophages or malignant cells） found under the microscope （y = 0.54x＋3.31, n= 101, r2= 0.27, P 〈0.000 1） . The true positive rate of HF ceils was 13.9% and their true negative rate was 96.9%. However, no correlation was found between eosnophils detected by XT-4000i and under the microscope （P 〉0.05） . The true positive rate of eosnophils was 9.8% and their true negative rate was 80.0%. Good precision （CV≤30%） was got in white blood cells, mononuclear cells, polynuclear cells and red blood ceils counted by XT-4000i. Both carry- over （≤0.3%） andlinearity （r2=0.99） were also excellent for white blood cells and red blood cells. Conclusion The BF mode on XT-4000i may be routinely used for CSF cells count because of its excellent accuracy and precision. HF cells may have some predictive value in large cells in CSF.

关 键 词：脑脊髓液 血细胞计数 血细胞分析仪 SYSMEX XT-4000i 

分 类 号：R446.1[医药卫生—诊断学]