严重血小板减少症患者血小板计数结果准确性评价  

Accuracy of haematology analysers platelet counting in severe thrombocytopenia

作　　者：陈玲娟[1] 李珊珊[1] 潘瑞琪[1] 廖明星[1] 胡琼英[1] 艾承锦[1] CHEN Lingjuan;LI Shanshan;PAN Ruiqi;L IAO Mingxing;HU Qiong ying;AI Chengjin(Department of Laboratory Medicine,Teaching Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan 610072,China)

机构地区：[1]成都中医药大学附属医院检验科,成都610072

出　　处：《国际检验医学杂志》2018年第20期2484-2487,共4页International Journal of Laboratory Medicine

基　　金：国家自然科学基金资助项目(81601835)

摘　　要：目的评价血液分析仪XE2100、LH780、BC6600对严重血小板减少症患者EDTA-K2抗凝全血血小板计数准确性。方法按患者就诊顺序选取XE2100血液分析仪血小板计数≤30×109/L的患者标本60例,分别用XE2100、LH780、BC6600血液分析仪和显微镜计数血小板,并做涂片镜检观察有无血小板聚集和形态异常,以显微镜计数结果为对照,参照CLSI EP9的方法评估3台血液分析仪对严重血小板减少症患者标本血小板计数的准确性。结果 XE2100、LH780、BC6600血液分析仪与显微镜计数血小板差值的均值分别为4.9×109、4.8×109、5.4×109/L,差值范围分别为(-8.0~20.2)×109、(-12.1~17.2)×109、(-4.2~35.5)×109/L;3台血液分析仪血小板计数结果分别与显微镜计数结果作配对t检验,结果显示差异有统计学意义(P<0.01);与显微镜计数结果作线性回归分析,相关系数(r)分别为0.831、0.788、0.783(P<0.01)。结论对于可能需要预防性输注血小板的患者应采用显微镜计数法复核血小板计数结果。血小板计数≤30×109/L的标本不能直接根据患者delta值审核报告,应采用显微镜计数法复核血小板计数结果。建议增加血小板数(5.0~30.0)×109/L的低值血小板室间质评物和室内质控品。Objective To determine the accuracy of haematology analysers in current routine practice for platelet counts equal to 30x 109/L or less. Methods Sixty patients with XE2100 hematology analyser platelet counts^30x 109/L were selected according to the patient visit order. Platelet counts estimated by XE2100, LH780 and BC6600 hematology analysers were compared with the microscopic direct platelet counting meth od. The accuracy of haematology analysers platelet counting in severe thrombocytopenia was evaluated with the CLSI EP9 method. Results Compared with microscopic direct platelet counting method, the average difference of XE2100,LH780 and BC6600 hematology analysers were 4.9x 109/L （ranged from 8.0x 109/L to 20.2x 109/L）,4.8x 109/L （ranged from 12.1x 109/L to 17.2x 109/L） and 5.4x 109/L （ranged from 4.2x109/L to 35. 5x109/L） respectively. It was found that there were statistically significant difference between the platelet counts of hematology analysers and the microscopic direct platelet counting method （P〈 0.01）. There were significant correlation coefficients between the microscope counting results and the platelet counts obtained with XE2100,LH780 and BC6600 （r=0. 831,0. 788 and 0. 783,P^0.01）. Conclusion It＇s recommend that patients with probable prophylactic transfusions should be re examined for their platelet count by microscopy. It re emphasizes the need for external quality control to improve analyser calibration for samples with low platelet counts. We can not directly report the platelet counts based on the patientls delta value if the platelet counts are 30x 109/L or below and it should be validated by microscopic direct platelet counting method. We suggest increasing the low value platelet interstitial assessment （5.0 30. 0）x109/Land laboratory quality control materials.

关 键 词：血小板计数 准确性 血小板减少症 显微镜计数 

分 类 号：R446.111[医药卫生—诊断学]