新鲜全血在不同血细胞分析仪比对试验中的评价

Anti-coagulant fresh whole blood on different hematology analyzers:a contrast test

目的验证不同血细胞分析仪检测结果之间的可靠性和可比性,规范操作血细胞分析仪的比对试验。方法参照国际血液学标准化委员会(ICSH)及美国临床实验室标准化委员会(NCCLS)文件,在仪器正常运行的情况下,评价各比对仪器的携带污染率、精密度和总精密度、差异百分率;分析比较20份抗凝新鲜全血中各项指标在不同血细胞分析仪之间的差异;每日取高、中、低3份新鲜血,在各仪器上平行检测,连续比对7日,观察各项指标与参考样机之间的相关性;分析比较仪器分类与手工分类的相关性;通过直线回归方程计算相对偏差,估计每台仪器各检测指标的试验误差。结果除白细胞分类外,各比对仪器携带污染率正常;各检测指标的变异系数以及在不同血细胞分析仪上的总体变异系数均<5%;各检测项目的差异百分率符合ICSH制定的标准;20份样品在不同血细胞分析仪上检测的各项指标经两两比较的q检验(Newman-Keuls法),各配伍组总体均数无统计学差异(P>0.05);连续7日测得的各项指标与参考样机之间的相关系数均大于0.97,其相对偏差在实验允许误差范围内。白细胞分类中,中性粒细胞和淋巴细胞在各比对仪器之间以及仪器与手工分类之间的相关性较好,而嗜酸粒细胞、嗜碱粒细胞和单核细胞,不论在各仪器还是仪器与手工分类之间,都存在较大的试验误差(P<0.05,P<0.01)。结论不同血细胞分析仪检测结果之间的比对试验急需规范化,同一科室的多台血细胞分析仪应定期进行比对,以保证检验结果的准确性。

Objective To analyze the reliability and comparability of different hematology analyzers and to standardize the operation of a contrast test.Methods The carry-over rate,precision,total precision and percentage of differences of hematological analyzers were evaluated and differences of items in whole blood were compared by detecting 20 anti-coagulant fresh blood samples based on the documents of ICSH and NCCLS.Every 3 blood samples of high-value,middle-value and low-value were detected by hematological analyzers everyday for 7 days.The relative deviation was calculated by linear regression equation to assess the test inaccuracy of items on every machine.Results The carry-over rate of all contrast hematological analyzers were normal except for the white blood cell classification.Coefficient of the variation of the detective items and the total coefficient of variation of different hematological analyzers were all less than 5%.The test results of 20 blood samples detected on different hematological analyzers were analyzed by a q test which indicated that there were no statistical differences between blocks（P〉0.05）.The correlative coefficient was over 0.97 and the relative deviation was within the range of allowable error.In white blood cell classification,items of neutrophilic granulocytes and lymphocytes had a better correlatability among contrast analyzers and between by machines and byhand.While eosinophilic leukocytes,basophilic leukocytes and lymphocytes had large test errors（P〈0.05,P〈0.01）.Conclusions Standardization of results by different hematological analyzers should be paid more attentionto,and contrast tests of different analyzers should be regularly carried out.