血液细胞分析仪与流式参考方法测定低值血小板样本的比较研究

Low platelet counts detected with automatic hematology analyzer and flow reference method:A comparative study

目的评价血液细胞分析仪和流式参考方法对低值血小板样本测定的相关性和一致性。方法 133例血小板<100×109/L抗凝血标本,采用Sysmex XE-2100、Mindray BC-5800、ABX Pentra 60以及流式参考方法测定,对结果进行比较。结果 XE-2100和BC-5800与参考方法相关性良好(r=0.971 7、0.960 5,P<0.001)。Bland-Altman分析中,各仪器结果与参考方法偏差的均值为(-2.69-+3.32)×109/L。在输血判定的一致性分析中,以10×109/L或20×109/L作为血小板输血决定水平时,XE-2100(PLT-I)和BC-5800具有相似的Kappa值(0.88 vs 0.84和0.89 vs 0.89)。结论 XE-2100和BC-5800与流式参考方法具较好的相关性和一致性。但对于严重血小板减少的输血判定,血液分析仪计数欠准确,应采用流式参考方法进行血小板计数复检。

Objective To assess the correlation and consistence of low platelet counts detected with automatic hematology analyzer and flow reference method.Methods Platelet counts in 133 anti-coagulated blood samples with a platelet count of 100×109/L were detected with automatic hematology analyzers,Sysmex XE-2100,Mindray BC-5800,ABX Pentra 60,and flow reference method,respectively and compared.Results The platelet counts detected with XE-2100 and BC-5800 correlated well with those detected with flow reference method（r=0.971 7 and 0.960 5,P0.001）.Bland-Altman analysis showed that the average value of platelet counts detected with 3 hematology analyzers was-2.26-3.32×109/L.The Kappa coefficient for XE-2100（PLT-I） and BC-5800 was similar when 10×109/L or 20×109/L was used as the platelet transfusion threshold（0.88 vs 0.84 and 0.89 vs 0.89）.Conclusion XE-2100 and BC-5800 show a good correlation and consistence with the flow reference method in counting low platelets.However,hematology analyzers are not accurate enough in detecting low platelet counts for the decision of platelet transfusion in severe thrombocytopenic patients,and the number of platelets should be recalculated with flow reference method.