BC-6800全自动血液细胞分析仪复检规则的建立与评估

Establishment and evaluation on the blood re-examination rules for BC6800 fully automatic hematology analyzer

目的参考国际血液学复检专家组推荐的血细胞复检规则,结合迈瑞BC-6800全自动血液细胞分析仪的性能特点,探讨适用于本实验室的血细胞复检规则。方法随机检测患者标本1 690例(其中首检标本1 352例,复检标本338例),同时涂片做显微镜检查。按照国际血细胞复检规则和涂片镜检阳性规则进行评估,计算出真阳性、真阴性、假阳性和假阴性的概率。通过对结果的分析,并结合迈瑞BC-6800全自动血液细胞分析仪的性能特点与本实验室的实际情况,制定出改良的血细胞复检规则。其后,随机检测200例患者标本对改良的复检规则进行验证。结果根据国际血液学复检专家组推荐的41条复检规则涂片镜检阳性规则对检测结果进行统计学处理,真阳性率为15.7%(266/1 690),假阳性率为25.4%(429/1 690),真阴性率为56.6%(957/1 690),假阴性率为2.2%(38/1 690)。采用改良的复检规则和镜检阳性规则评估结果,真阳性率为13.5%(228/1 690),假阳性率为7.6%(128/1 690),真阴性率为75.1%(1 269/1 690),假阴性率为3.8%(65/1 690)。验证实验真阳性率为16.5%(33/200),假阳性率为8.0%(16/200),真阴性率为72.5%(145/200),假阴性率为3.0%(6/200)。结论本实验室采用改良复检规则后,在保证关键病理细胞没有漏检,并且假阴性率低于国际血液学复审专家组认可的5.0%的基础上,复检率下降到21.1%,保证检测质量同时提高了工作效率。

Objective Based on the international hematology panel＇s recommendation for the blood cells re-examination,to inves tigate the ways of the blood cells re-examination in our lab by the MaiRui BC-6800 auto hematology analyzer. Methods 1690 cases of patient specimens （1352 cases of the first inspection and 338 cases of retest） were randomly selected, and the smears were ob- served by the microscopy. The true positive,true negative,false positive and false negative rates were calculated according to the in- ternational standards and the smear positive rules. From the results, the improved blood cells re-examination rules were established and they were used to test another 200 blood samples. Results According to international blood smear criteria,we analyzed the tes- ting and found that the true positive rate was 15.7% （266/1690） ,false positive rate was 25.4%（429/1690） ,true negative rate was 56.6%（957/1690） and false negative rate was 2.2% （38/1690）. While under our new improved re-examination rules, the true positive rate was 13.5% （228/1690）,false positive rate was 7.6%（128/1690）,true negative rate was 75. 1% （1269/1690） and false negative rate was 3.8% （65/1690）. Conclusion Under our new improved reexamination ways,there is no missed key patho- logical cells. ：Besides the false negative rate is 5.0 % lower than the international hematology review panel＇s standard, the re-exami- nation rate drops to 21.1%. So it not only assures the quality but also improves the efficiency.