高白细胞值对血红蛋白测定的影响及纠正

The Influence of Abnormally Higher WBC on Hemoglobin Determination and Its Redress

目的 探讨高白细胞 (WBC)值对血红蛋白 (Hb)测定的影响及其纠正。方法 制备 4 8个不同浓度梯度的 WBC悬液 ;在全自动血细胞分析仪的预稀释模式下进行测定 ,观察去 WBC前后 Hb测定值的变化 ,建立校正Hb测定值的直线回归方程并应用回归方程对 1 4例高 WBC值全血标本进行可行性验证。结果 高 WBC值 (≥4 0 .0× 1 0 9/L )将使 Hb测定值明显升高 (P<0 .0 0 1 ) ;去 WBC前后 Hb测定值的差值与 WBC值的对数呈直线相关(r=0 .95 2 6 ) ,其回归方程为 Y(Hb差值 ) =- 2 5 .0 9+2 1 .89× lg[WBC(× 1 0 9/L ) ];应用回归方程计算高 WBC值全血标本去 WBC前后 Hb测定值理论差值 ,与实测差值比较二者无显著差异 (P>0 .0 5 )。结论 高 WBC的存在将使 Hb测定值假性增高 ,通过线性回归方程校正可得到

Objective To discuss the influence of abnormally higher white blood cell(WBC) on hemoglobin (Hb) determination and work for its redress. Methods High WBC concentration suspensions of 48 concentration gradients were prepared to be determined in the pre dilution pattern of automated hematology analyzer while the changes of Hb concentration before and after removal of WBC being observed. At the same time, a regression equation was set up to correct errors and redress the Hb concentration. Then, the data from 14 whole blood samples with abnormally higher WBC were used in this regression equation to verify its utility. Results The Hb concentration of samples with abnormally higher WBC was higher than that of samples where WBC was removed ( P <0.001). While WBC count≥40.0×10 9/L, there was logarithmic linear correlation between Hb concentration difference and WBC count ( r =0.9526). Using the regression equation (Hb difference)=-25.09+21.89×lg[WBC (×10 9/L)], we found that there was no significant difference ( P >0.05) between the “practically detected Hb difference” and the “theoretically adjusted Hb difference” in the whole blood samples with abnormally higher WBC. Conclusion Abnormally higher WBC may lead to increase of error in the detection of Hb concentration; the ultimate result in close proximity to true Hb concentration of whole blood samples with abnormally higher WBC can be acquired through the linear regression equation.