血常规MCHC对标本性状异常的提示价值及抗干扰方案的探讨  

Probing value of blood routine MCHC for abnormal specimen characteristics and discussion on anti-interference solution

作　　者：王莹[1] 单洪丽[1] 曲林琳[1] WANG Ying;SHAN Hongli;QU Linlin(Department of Clinical Laboratory,the First Hospital of Jilin University,Changchun,Jilin 130021,China)

机构地区：[1]吉林大学第一医院检验科,吉林长春130021

出　　处：《国际检验医学杂志》2022年第3期285-289,共5页International Journal of Laboratory Medicine

基　　金：吉林省卫生厅重点实验室科研课题(2017J071)。

摘　　要：目的探讨血常规平均红细胞血红蛋白浓度(MCHC)水平异常升高的常见干扰原因及抗干扰处理方法。方法选取2019年8月至2020年6月于该院检验科行血常规检测且首次MCHC水平异常升高(MCHC>380 g/L)的102例患者为研究对象,分析其MCHC水平异常升高的原因。针对不同干扰因素采用水浴、稀释和(或)血浆置换等方式处理后,经全自动血液分析仪重新检测血常规,记录和比较处理前后白细胞计数(WBC)、红细胞计数(RBC)、血红蛋白(Hb)、血细胞比容(HCT)、平均红细胞体积(MCV)、平均红细胞血红蛋白量(MCH)、MCHC、血小板(PLT)水平,比较采用不同抗干扰方案测得的各指标水平。结果在102例患者的血常规标本中,脂血标本12份、红细胞冷凝集标本68份、溶血标本20份、高白细胞(WBC>350×10^(9)/L)标本2份。与处理前比较,血浆置换处理脂血标本后,WBC、Hb水平差异无统计学意义(P>0.05),RBC、HCT水平升高,MCV、MCH、MCHC和PLT水平降低,差异均有统计学意义(P<0.05)。与处理前比较,红细胞凝集标本采用37℃水浴20 min处理后,各指标水平差异无统计学意义(P>0.05)。采用37℃水浴30 min处理后,其中9份标本MCHC无法纠正,进一步行稀释+温育(稀释液与标本一同温育)或血浆置换法重新检测,MCHC可准确纠正(P<0.05)。与处理前比较,采用41°C水浴10 min处理后,除WBC、Hb外其余各指标水平差异有统计学意义(P<0.05)。与处理前比较,溶血标本采用血浆置换法处理后,RBC、HCT、MCV水平升高,MCH、MCHC、PLT水平降低,差异均有统计学意义(P<0.05)。结论对于MCHC水平异常升高的标本,检验人员应先分析可能的干扰因素,针对不同干扰选择快速有效的方法进行纠正,为患者提供准确的检验报告。Objective To investigate the common interference and anti-interference solution of abnormally elevated mean corpuscular hemoglobin concentration(MCHC)in routine blood test.Methods A total of 102 patients with abnormally elevated MCHC levels(MCHC>380 g/L)who underwent blood routine test in the laboratory department of our hospital from August 2019 to June 2020 were selected as the research objects,and the causes of abnormally elevated MCHC levels were analyzed.According to different interference factors,after treatment by water bath,dilution and/or plasma exchange,the blood routine indicators were retested by automatic blood analyzer.The levels of white blood cell count(WBC),red blood cell count(RBC),hemoglobin(Hb),hematocrit(HCT),mean corpuscular volume(MCV),mean corpuscular hemoglobin(MCH),MCHC and platelet(PLT)before and after treatment were recorded and compared.The indicator levels corrected by different anti-jamming solutions were also compared.Results Among the blood routine specimens of 102 patients,12 cases were lipemia,68 cases were erythrocyte agglutination,20 cases were hemolyzed,and 2 cases were hyperleukocyte(WBC>350×10^(9)/L).Compared with before treatment,after plasma exchange treatment of lipid blood samples,there were no significant differences in the levels of WBC and Hb(P>0.05),the levels of RBC and HCT increased,and the levels of MCV,MCH,MCHC and PLT decreased,and the differences were statistically significant(P<0.05).Compared with before treatment,there was no significant difference in the level of each indicator after the hemagglutination specimens were treated with 37℃water bath for 20 min(P>0.05).After being treated in a 37℃water bath for 30 min,the MCHC of 9 specimens could not be corrected,and the MCHC could be corrected accurately after further dilution+incubation(incubating the dilution solution with the specimen)or plasma exchange method.Compared with before treatment,after treatment with 41℃water bath for 10 min,there were significant differences in the levels of other indicat

关 键 词：平均红细胞血红蛋白浓度 脂血 红细胞冷凝集 溶血 

分 类 号：R446.11[医药卫生—诊断学]