血小板直方图异常时PLT-I结果可靠性的预测研究  

Predictive study on the reliability of PLT-I results when platelet histograms are abnormal

作　　者：肖婷 周丽 马嘉忆 冯钰泽 陈鸣 徐含青 XIAO Ting;ZHOU Li;MA Jiayi;FENG Yuze;CHEN Ming;XU Hanqing(Department of Clinical Laboratory,the First Affiliated Hospital of Army Medical University,Chongqing 400038,China;Department of Laboratory Pathology,the 83rd Group Army Hospital of the Chinese People′s Liberation Army,Xinxiang,Henan 453000,China)

机构地区：[1]陆军军医大学第一附属医院检验科,重庆400038 [2]中国人民解放军陆军第八十三集团军医院检验病理科,河南新乡453000

出　　处：《国际检验医学杂志》2025年第9期1097-1103,共7页International Journal of Laboratory Medicine

摘　　要：目的通过对血小板直方图异常的非聚集样本的回顾性分析,探讨预测血小板电阻抗法(PLT-I)结果可靠性的因素。方法收集322例希森美康XN9000血液分析仪流水线上血小板直方图异常且DI-60全自动数字图像分析系统未见血小板聚集的样本。以低值血小板通道(PLT-F)结果为标准,计算PLT-I结果的绝对偏差和相对偏差,并分析偏差在允许范围内和超出允许范围两组样本的各项参数。采用Logistic回归分析PLT-I与PLT-F偏差超出允许范围的潜在因素,受试者工作特征(ROC)曲线评价潜在因素对PLT-I与PLT-F偏差超出允许范围的预测价值。结果PLT-I与PLT-F偏差在允许范围内有279例(86.65%),偏差超出允许范围43例(13.35%);两组样本间比较,平均红细胞体积(MCV)、红细胞分布宽度标准差(RDW-SD)、DI-60红细胞碎片、血小板分布宽度(PDW)、DI-60大血小板比率差异有统计学意义(P<0.05);Logistic回归分析结果显示DI-60红细胞碎片、DI-60大血小板比率是PLT-I与PLT-F偏差超出允许范围独立潜在因素(P<0.05);DI-60红细胞碎片、DI-60大血小板比率预测PLT-I与PLT-F偏差超出允许范围的截断值分别为1.75个和66%;两项联合的曲线下面积(AUC)为0.813,灵敏度为88.4%,特异度为66.3%,其预测价值优于单项(P<0.05)。结论血小板直方图异常时,DI-60大血小板比率和DI-60红细胞碎片是预测PLT-I结果是否可靠的潜在因素且两项联合具有较高的预测价值。Objective To explore the factors predicting the reliability of platelet-impedance(PLT-I)results through a retrospective analysis of non-aggregated samples with abnormal platelet histograms.Methods A total of 322 samples with abnormal platelet histograms were collected from the Sysmex XN9000 automatic hematology analyzer,all of which showed no platelet aggregation as determined by the DI-60 automatic digital image analysis system.Using the platelet count fluorescent(PLT-F)results as a standard,the absolute and relative deviations of PLT-I results were calculated,and the parameters of samples with deviations within and outside the allowable range were analyzed.Logistic regression analysis was used to identify potential factors associated with deviations of PLT-I from PLT-F beyond the allowable range.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of these potential factors for deviations beyond the allowable range.Results The deviations of PLT-I from PLT-F were within the allowable range in 279 cases(86.65%)and outside the allowable range in 43 cases(13.35%).Comparisons between the two groups revealed statistically significant differences in mean red blood cell valume(MCV),red blood cell distribution width-cuefficient of variation(RDW-SD),DI-60 red cell fragments,platelet distribution width(PDW),and DI-60 large platelet ratio(P<0.05).Logistic regression indicated that DI-60 red cell fragments and DI-60 large platelet ratio were independent potential factors for deviations of PLT-I from PLT-F beyond the allowable range(P<0.05).The cut off values for predicting deviations beyond the allowable range were 1.75 for DI-60 red cell fragments and 66%for DI-60 large platelet ratio.The area under the curve(AUC)for the combined diagnosis of the two factors was 0.813,with a sensitivity of 88.4%and a specificity of 66.3%,indicating a higher predictive value than individual factors(P<0.05).Conclusion When platelet histograms are abnormal,DI-60 large platelet ratio and DI-60 red cell frag

关 键 词：血小板计数 直方图异常 血小板电阻抗法 偏差 

分 类 号：R446.1[医药卫生—诊断学]