血浆渗透压升高对不同类型血细胞分析仪MCV测定结果的影响

Influence of Plasma Osmotic Pressure Rise in MCV Detection with Different Type Cytoanalyzer

目的:探讨由不同溶质导致的渗透压升高对不同型号血细胞分析仪红细胞平均体积(MCV)测定的影响,并提出处理方法。方法:配制含有不同溶质的高渗血样,分别在XE-2100、XS-1000i、LH750和BC-3000PLUS血细胞分析仪(全血模式)上测定其MCV,并将葡萄糖导致的高渗血样用BC-3000PLUS(预稀释模式)测定,最后对不同仪器测定的MCV结果进行分析比较。结果:由葡萄糖导致的血浆渗透压升高使MCV测定值的假性增高(最大偏差可达63.04%),由NaCl及尿素导致的血浆高渗压对MCV测定的影响不明显(偏差<1.5%)。四种血细胞分析仪对MCV假性增高的敏感程度依次为:XS-1000i XE-2100 LH750 BC-3000PLUS。将标本预稀释后放置10 min,MCV测定值恢复正常。结论:高血糖所致的血浆高渗压可导致血细胞分析仪测定时MCV结果假性升高,需要用预稀释方法处理后报告结果。

Objective：To investigate the interference of plasma osmotic pressure increased caused by different kinds of solute in MCV detection in four different type cytoanalyzer,and then put forward the solve measures. Methods：Preparing hypertonic blood samples of certain osmotic pressure caused by difference kinds of solution, determining the MCV of samples by Sysmex XE 2100,XS-1000i,Beckman Coulter LH750 and Mindray BC-3000PLUS （whole blood mode） ,and by BC-3000PLUS （ predilute mode）, comparing the results in different detecting mode. Results： The high plasma osmotic pressure caused by glucose would lead to the artefactual erythrocyte swelling（maximum CV is 63.04% ）. And the rise caused by sodium Chloride or urea would not show an obvious effect in MCV detection（CV〈 1.5%）. The sensitivity of the artefactual increase in MCV measurements was as fallows： XS-1000i〉XE-2100〉 LH750〉BC-3000PLus. After prediluting and placing the samples for 10 minutes, the measurements returned to nor- mal. Conclusion：The hypertonic pressure caused by hyperglycemia will lead to the artefactual increase of the MCV measurements by the cytoanalyzer. Therefore the samples should be prediluted and are measured again before repor ting.