新鲜血比对方法在血液分析仪室内质量控制中的应用

Application of comparison method in internal quality control of hematology analyzer by using fresh blood

目的：利用新鲜血样本以比对方法对血液分析仪全血细胞计数进行室内质量控制。方法：选择性良好、规范化操作的血液分析仪为参比仪，用该仪器定值的健康人新鲜血校准比对血液分析仪（比对仪），进行为期3个月比对实验，建立比对仪比对参数WBC、RBC、Hb、HCT、PLT低、中、高值相对偏差范围。每工作日选取门诊患者比对参数低、中、高值至少2个水平新鲜血常规标本，将比对仪和参比仪检测结果进行比对，计算WBC、RBC、Hb、HCT、PLT相对偏差；以日期为横坐标，相对偏差为纵坐标，将相对偏差范围设置为±2s，在实验室信息系统中建立新鲜血比对质控图，以制定的新鲜血比对质量控制规则对相对偏差进行判断、分析，对失控情况作出相应处理，保证仪器正常运作。结果：以建立的方法进行室内质量控制，2006年比对仪WBC、RBC、Hb、HCT、PLT低、中、高水平比对样本测定结果相对偏差分别为（0．75±2．964）％、（1．19±2．488）9／5、（1．43±2．439）％；（-0．39±1．327）％、（-0．26±1．297）％、（-0．35±1．095）％；（-0．43±1．393）％、（-0．17±1．139）％、（0．24±1．166）％；（-0．43±1．362）％、（-0．36±1．381）％、（-0．57士1．299）％；（-0．93±4．330）％、（0．04±4．118）％、（-0．41±4．149）％。2006年该比对仪作为第二台仪器参加美国病理学家学会血细胞分析能力验证，WBC、RBC、HGB、HCT、PLT测定值与靶值的偏倚范围分别为（-0．5～5．1）％、（-1．0～1．6）％、（-1．7～1．4）％、（-1．5～1．3）％、（-4．5～7．4）％。结论：该方法能方便、经济地对血液分析仪进行有效的质量控制。

Objective： To investigate the comparison method on internal control of hematology analyzer by using fresh blood. Methods： The hematology analyzer with well function was selected as the reference analyzer, fresh blood samples from healthy subjects were measured by reference analyzer and the values were used to calibrate compared hematology analyzers. The acceptable limits of relative deviation of WBC, RBC, HGB, HCT, PLT were established by comparative experiments during three months. The results of fresh blood samples from patients with low/medium/high levels measured by compared analyzer were compared with those from reference analyzer, the relative deviation of WBC, RBC, HGB, HCT, PLT was calculated respectively. The internal quality control charts in laboratory information system were established, with date as x-axis, relative deviation as y-axis. The acceptable relative deviation limits were set to be ± 2 s,and to be used for laboratory quality control. Results. The relative deviation of WBC,RBC,HGB,HCT,PLT with high,medium,low levels were（0.75±2. 964）%, （1.19±2.488）%,（1.43±2.439）% ; （-0.39±1.327）%,（-0.26±1.297）%,（-0.35± 1.095）% ;（-0.43±1.393）%,（-0.17±1. 139）%,（0.24±1.166）%; （-0.43±1.362）%, （-0.36±1.381）%,（-0.57±1.299）%;（-0.93±4.330）%,（0.04±4.118）%,（-0.41± 4. 149）% ,respectively in 2006. As the second instrument,the compared analyzer was involved in College of American Pathologists Proficiency Testing with satisfactory results,the bias of WBC, RBC,HGB,HCT,PLT were within （-0.5～5.1）%,（-1.0～1.6）%,（-1.7～1.4）%, （-1.5～1.3） %, （-4.5～7.4）%, respectively. Collelusion： The quality control on compared hematology analyzer can be effectively ,conveniently and economically performed using this method.