Sysmex XN-9000血细胞分析仪在血小板复检中的应用价值  

Application Value of Sysmex XN-9000 Blood Cell Analyzer in Platelet Reexamination

作　　者：董秋秋 鞠丽 Dong Qiuqiu;Ju Li(Department of Clinical Testing Center,The First Affiliated Hospital of Soochow University,Suzhou 215006,Jiangsu Province,China)

机构地区：[1]苏州大学附属第一医院临床检测中心,江苏苏州215006

出　　处：《中外医药研究》2023年第7期126-128,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:评估Sysmex XN-9000血细胞分析仪在血小板复检中的应用价值。方法:收集2018年7月—2019年11月苏州大学附属第一医院静脉血样本606份,采用Sysmex XN-9000全自动血细胞分析仪(日本sysmex公司)及配套试剂,其中低血小板、大血小板、小红细胞和红细胞碎片样本均采用电阻抗法(PLT-I)、光学法(PLT-O)和荧光法(PLT-F)通道检测,同时与涂片人工镜检(PLT-M)结果进行比较。对血小板聚集样本进行分析,采用受试者工作(ROC)曲线,计算血小板Clumps警示值最佳阈值。收集低于血小板Clumps警示阈值样本,以验证血小板Cumps警示阈值设立后漏检率。结果:低血小板、小红细胞和红细胞碎片干扰、大血小板样本的PLT-F、PLT-O通道与PLT-M的相关性优于PLT-I通道;低血小板、小红细胞和红细胞碎片干扰样本的PLT-F通道与PLT-M相关性优于大血小板样本;在存在小红细胞和红细胞碎片干扰的样本复检中PLT-O和PLT-F通道具有明显优势。血小板Clumps警示值≥115时,其敏感性和特异性分别为83.6%和91.7%,AUC为0.914,所以设立血小板Clumps警示值最佳阈值为115,对血小板Clumps警示值<115的样本(300份)进行验证,以PLT-M为标准,验证其阈值设立后漏检率为2.33%。结论:Sysmex XN-9000血细胞分析仪在处理日常工作中遇到的低血小板、小红细胞和红细胞碎片、大血小板干扰情况时,可采用PLT-O和PLT-F通道进行快速复检;当血小板Clumps警示值≥115时,建议现场重新采血或更换抗凝剂进行复检,必要时需进行手工充池计数,避免由于血小板聚集造成假性减低情况发生。但是,其他实验室应根据自己的实验室检测系统,建立符合实际的血小板Clumps判断值,并在实际工作中周期性地进行验证,适当调整,避免由于仪器原因造成异常标本的漏检。Objective:To evaluate the application value of Sysmex XN-9000 blood cell analyzer in platelet reexamination.Methods:A total of six hundred and six venous blood samples were collected from the First Affiliated Hospital of Soochow University from July 2018 to November 2019,using Sysmex XN-9000 automatic blood cell analyzer(sysmex,Japan)and supporting reagents.The samples of low platelet,large platelet,small red blood cell and red blood cell fragments were detected by electrical resistance method(PLT-I),optical method(PLT-O)and fluorescence method(PLT-F),and the results were compared with those of smear microscopy(PLT-M).The platelet aggregation samples were analyzed,and the optimal threshold of platelet Clumps warning value was calculated using receiver operating(ROC)curve.Samples lower than the platelet Clumps warning threshold were collected to verify the missed detection rate after the platelet Cumps warning threshold was established.Results:The correlation between PLTM channel and PLT-F channel and PLT-O channel in low platelet,small red blood cell and red blood cell fragment interference and large platelet sample is better than PLT-I channel.The correlation between PLT-F channel and PLT-M in low platelet,small red blood cell and red blood cell fragment interfered samples was better than that in large platelet samples.PLT-O and PLT-F channels have obvious advantages in the reexamination of samples with small red blood cells and red blood cell fragments.When the Clumps warning value was≥115,the sensitivity and specificity were 83.6% and 91.7%,respectively,and the AUC was 0.914.Therefore,the optimal threshold of Clumps warning value was set as 115.The 300 samples with Clumps warning value<115 were verified.Using PLT-M as the standard,the missed detection rate was 2.33% after the threshold was set.Conclusion:The Sysmex XN-9000 blood cell analyzer can use PLT-O and PLT-F channels for rapid retesting when dealing with low platelets,small red blood cells and red blood cell fragments,and large platelet interference

关 键 词：血小板复检 血小板报警信息 荧光血小板通道 光学血小板通道 血细胞分析仪 

分 类 号：R44[医药卫生—诊断学]