SYSMEX XE-5000血液分析仪血小板准确计数的相关分析

Correlation analysis of SYSMEX XE-5000 hematology analyzer in counting platelet

目的探讨红细胞碎片（FRC）、红细胞体积（MCV）、血小板参数[血小板分布宽度（PDW）、大血小板比率（P-LCR）、血小板压积（PCT）]、幼稚血小板（IPF）对SYSMEX XE-5000血液分析仪（简称XE-5000）计数血小板（PLT）准确性的影响。方法选取采用XE-5000电阻抗法检测无FRC的标本200例,按MCV（〈60、60~〈70、70~〈80、≥80 fL）分为4组（A1组、B1组、C1组、D1组,每组各50例）;选取MCV≥70 fL且FRC分别为0.1%~0.99%（A2组）、≥1.0%（B2组）的标本各40例;选取MCV≥70 fL且无FRC、PLT参数（PDW、PCT、PLCR）显示＂—＂（表示检测不出结果）的标本50例（C2组）,分别采用电阻抗法、光学法和手工法计数以上330例标本的PLT并推片镜检;分别采用电阻抗法、光学法和手工法连续5 d测定1例幼稚PLT增高患者的PLT并进行镜检。结果 A1组、A2组、B1组、B2组、C2组电阻抗法和手工法计数PLT差异有统计学意义（P〈0.05）,C1组和D1组两种方法之间差异无统计学意义（P〉0.05）。A1组、B1组、C1组、D1组、A2组、B2组、C2组光学法与手工法计数PLT差异均无统计学意义（P均〉0.05）。电阻抗法测定幼稚PLT增高患者的PLT连续5 d均低于手工法和光学法;手工法计数PLT结果相对稳定,而电阻抗法、光学法结果随着幼稚PLT的不断成熟而增高,镜检有大量巨大PLT。结论采用XE-5000测定MCV〈70 fL、含有FRC或PLT参数结果显示＂—＂的标本时应选择光学法通道进行PLT复查,并进行涂片镜检。IPF增高且镜检有较多巨大PLT的标本应进行手工计数。

Objective To investigate the accuracy of platelet（ PLT） counting which was influenced by erythrocyte fragments（ FRC）,red blood cell volume（ MCV）,PLT parameters [platelet distribution width（ PDW）,platelet-larger cell ratio（ P-LCR） and platelet hematocrit（ PCT） ] and immature platelets（ IPF） by SYSMEX XE-5000 hematology analyzer（ XE-5000）. Methods The 200 samples with no FRC were analyzed by XE-5000,and were classified into 4groups and each group of 50 cases： A1 group（ MCV 60 fL）,B1 group（ 60 fL≤MCV 70 fL）,C1 group（ 70 fL≤MCV 80 fL） and D1 group（ MCV ≥ 80 fL）,respectively. The samples with FRC of different concentrations and MCV ≥70 fL were classified into 2 groups and each group of 40 cases： A2 group（ 0. 1% ≤FRC≤0. 99%） and B2group（ FRC≥1. 0%）,respectively. The samples of 50 cases with no FRC,MCV≥70 fL and PLT parameters（ PDW,PCT and P-LCR） showed ＂-＂（ C2 group） were chosen. PLT counting was performed in the 330 cases and determined for microscopy by electrical impedance analysis, optics and manual method. One case of naive patients with thrombocythemia was continuously observed for 5 d by electrical impedance analysis,optics and manual method. Results There were significant differences between electrical impedance analysis and manual method from A1,A2,B1,B2 and C2 groups（ P 0. 05）. It showed no statistical significance between electrical impedance analysis and manual method from C1 and D1 groups（ P 0. 05）. It showed no statistical significance between optics and manual method from A1,B1,C1,D1,A2,B2 and C2 groups（ P 0. 05）. One case of naive patients with thrombocythemia was continuously observed for 5 d by the 3 methods,respectively. The results of electrical impedance analysis were less than those of optics and manual method. The results of manual method were relatively stable,and the results of electrical impedance analysis and optics increased with the mature of PLT. There existed giant PLT by microscopy. Conclusions When the samples of MCV 70 fL,FRC and PLT parameters shows ＂-＂ by XE-5000,and it should be measured by optics and smear microscopy. While the specimens with high IPF and many giant PLT under microscopy,they should be detected by manual method.