三分群血细胞分析仪血小板计数结果影响因素分析

Analysis of influence factors of platelet count results of three-cluster blood cell analyzer

目的对影响三分群血细胞分析仪血小板检测结果的相关因素进行分析,寻求解决假性异常结果的途径和方法,避免临床误诊。方法随机选取门诊和住院患者100例,其中,末梢血50例,静脉血50例,均采用乙二胺四乙酸二钾(EDTA-K2)进行抗凝后30min内上机检测,异常结果行手工计数和血涂片染色观察。结果 100例原始标本中共有异常结果11例,包括减低8例,增高3例;通过更换抗凝剂、手工计数、涂片染色观察,6例减低结果被纠正,2例为EDTA抗凝剂依赖引起的假性血小板减少症(EDTA-PTCP),3例属反应性增高。结论当仪器出现与临床诊断严重不符的血小板异常结果时,应及时分析原因,通过更换抗凝剂种类、适当控制标本放置时间,同时辅以手工计数和血涂片染色观察可有效区分真性与假性计数结果异常,提高检测结果的准确性。

Objective To analyze the related influence factors of platelet count results of three-cluster blood cell analyzer, and seek ways and means of solving pseudo exception results, so as to avoid clinical misdiagnosis. Methods One hundred cases of out-patients and in-patients were chosen randomly, with 50 cases of peripheral blood and 50 cases of venous blood. All patients were made the test by the machine within 30 minutes after anticoagulant by ethylene diamine tetraacetic acid dipotassium （EDTA-K2）. The abnormal results were counted by hand and observed by blood smear staining. Results In the original samples of 100 cases, there were 11 cases of abnormal results, including 8 cases of decreased and 3 eases of increased. Through the exchange of anticoagulant, manual count and observation of smear staining, 6 cases of decreased were corrected, 2 cases were pseudo-thrombocytopenia （EDTA-PTCP） caused by EDTA anticoagulant resistance, 3 cases were increased reactivity. Conclusion When the equipments show that abnormal platelet results don＇t comply with clinical diagnosis seriously, it is necessary to analyze the reasons in time. Through exchanging the types of anticoagulant, control- ling storage time of samples appropriately and suppplemented by manual count and observation of blood smear staining, the true and false count abnormal results can be distinguished effectively, and the accuracy of test results can be improved.