乳糜血对肿瘤患者血细胞分析参数的干扰和纠正  

Interference and correction of chylemia on blood cell analysis parameters in tumor patients

作　　者：张佳玲 齐军 ZHANG Jialing;QI Jun(Department of Clinical Laboratory,National Cancer Center,National Clinical Research Center for Cancer,Cancer Hospital and Shenzhen Hospital,Chinese Academy of Medical Sciences Peking Union Medical College,Shenzhen 518116,Guangdong,China)

机构地区：[1]国家癌症中心、国家肿瘤临床医学研究中心、中国医学科学院北京协和医学院肿瘤医院深圳医院检验科,广东深圳518116

出　　处：《检验医学》2024年第8期770-773,共4页Laboratory Medicine

基　　金：深圳市“医疗卫生三名工程”基金项目(SZSM202311002);深圳市恶性肿瘤临床医学研究中心基金项目(深科技创新〔2021〕287号)。

摘　　要：目的分析乳糜血对肿瘤患者血细胞分析相关参数的影响,并探讨血浆置换法对乳糜血的纠正作用,为实验室准确报告血细胞分析结果提供参考。方法选取2022年1月—2023年8月北京协和医学院肿瘤医院深圳医院检验科接收的确认为乳糜血的肿瘤患者全血标本54例。采用血细胞分析仪检测血浆置换前后白细胞(WBC)、血小板(PLT)、红细胞(RBC)、血红蛋白(HGB)、血细胞比容(HCT)、平均红细胞体积(MCV)、平均红细胞血红蛋白含量(MCH)、平均红细胞血红蛋白浓度(MCHC)水平。以仪器“乳糜/HGB异常?”报警消除、MCHC恢复到正常水平或稳定状态,或与历史结果相符为乳糜血被纠正。比较纠正前后各项参数检测结果的差异。收集患者临床资料,了解乳糜血标本来源。结果乳糜血标本主要采集自中老年乳腺癌、肺癌、肝癌、胰腺癌患者(37.04%,20/54)。纠正前WBC、PLT、HGB、MCH、MCHC显著高于纠正后(P<0.05);RBC、HCT、MCV纠正前后差异无统计学意义(P>0.05)。结论乳糜血主要影响WBC、PLT、HGB、MCH、MCHC结果,血浆置换法可以消除干扰。Objective To analyze the influence of chylemia on blood cell analysis parameters in tumor patients,and to investigate the correction effect of plasma exchange on chylemia,so as to provide a reference for laboratory to accurately report the results of blood cell analysis.Methods From January 2022 to August 2023,54 whole blood samples of tumor patients who were confirmed to have chylemia were enrolled from the Department of Clinical Laboratory of Cancer Hospital and Shenzhen Hospital of Chinese Academy of Medical Sciences Peking Union Medical College.cencer of By blood cell analyzer,white blood cell(WBC)count,platelet(PLT)count,red blood cell(RBC)count,hemoglobin(HGB),hematocrit(HCT),mean corpuscular volume(MCV),mean corpuscular hemoglobin(MCH)and mean corpuscular hemoglobin concentration(MCHC)were determined before and after plasma exchange.With the instrument alarm“Turbidity/HGB Interf?”was eliminated,the MCHC returned to normal or stable levels,or it was consistent with historical results,the state of chylemia was corrected.The results were compared before and after correction.The clinical data of patients were collected to understand the source of chylemia samples.Results Chylemia samples were mainly collected from middle-aged and elderly patients with breast cancer,lung cancer,liver cancer and pancreatic cancer(37.04%,20/54).WBC count,PLT count,HGB,MCH and MCHC before correction were higher than those after correction(P<0.05).There was no statistical significance in RBC count,HCT and MCV before and after correction(P>0.05).Conclusions Chylemia mainly affects the results of WBC count,PLT count,HGB,MCH and MCHC,and plasma exchange can eliminate the interference.

关 键 词：乳糜血 血细胞分析 血浆置换 干扰 肿瘤 

分 类 号：R446.11[医药卫生—诊断学]