一种显微计数新方法ADAM-rWBC在成分血残留白细胞检测中的应用

Detection of the Residual Leukocytes in Blood Components: a Method of ADAM-r WBC for Microscopic Counting

目的评估一种基于显微计数新方法（ADAM．rWBC）在残余白细胞定量检测中的性能和应用可行性。方法以SysmexKX21全自动血球计数法及NageotteI（11细胞计数板法作为参比，分析ADAM-rWBC检测白细胞的定量准确性和可重复性，并评估其在成分血白细胞残留检测中的实际性能。结果对WBC浓度分别为40、10和1cell／gl的3份滤白红细胞悬液样品进行平行检测，ADAM．rWBC的批间变异系数分别为8．8、11．3和31．1，准确度分别为100．O％、87．5％和37．5％；而Nageotte计数板法的批间变异系数则分别为20．4、31．8和15．3，准确度分别为50．O％、12．5％和37．5％。对36份全血标本（白细胞浓度范围为4辱与共4500～10700cell／g1），采用ADAM．rWBC进行稀释定量与采用Sysmexkx21进行直接计数的结果间差异无统计学意义（P=0．655），且线性相关性较好（Slope=1．00±0．01，R。=0．832，P〈0．001）。对34份滤白红细胞悬液进行残留白细胞测定，平行采用ADAM-rWBC和Nageotte计数法所获结果间的差异无统计学意义（P=0.18），两种方法定量值均低于3．0cell／μl，符合白细胞残余量〈12．5cell／μl的质控要求。结论采用ADAM-rWBC进行白细胞定量测定准确可靠，相比于Nageotte计数法重复性和精度更佳，能满足成分血白细胞残余量检测的国标需求。

Objective Transfusion of blood components containing high amounts of leucocytes possibly causes side-effects in recipients. Therefore, the measurement of the residual leucocytes is certainly required for quality control of blood components. The study aimed to evaluate the performance of a new microscopic system （ADAM-rWBC） for residual leucocytes determination in blood components. Methods The quantitative accuracy, reproducibility and practical performance of ADAM-rWBC in detection of leucocytes was evaluated when compared with sysmex KX21 hematology analyzer and manual counting in the nageotte chamber. Results In a parallel detection of 3 specimens which contained 40, 10 and 1 cell/μ 1, the inter-assay coefficient of variation （CV %） was 8.8, 11.3, and 31.1 for ADAM-rWBC and 20.4, 31.8, and 15.3 for Nageotte. The accuracy was 100%, 87.5%, and 37.5% for ADAM-rWBC and 50%, 12.5%, and 37.5% for Nageotte, respectively. In the detection of 36 complete blood samples （white leucocytes counting ranged from 4500 to 10 700 cell/μ 1）, the WBC quantification results from ADAM-rWBC diluting- measurement were comparable （P =0.655） and well-correlated （Slope=1.00±0.01, R 2=0.832, P 〈0.001） with that from Sysmex kx21 hematology analyzer. In detection of 34 blood components after leucocytes depletion, no significant difference （P =0.18） was observed between ADAM-rWBC and Nageotte chamber, all sample presenting a WBC amount 〈3.0 ceil/ μ1, which coincided with the standard requirement of 〈12.5 cell/μ1. Conclusion The ADAM-rWBC was a accurate and reliable method for white leucocyte measurement. In comparison with manual counting, the ADAM-rWBC was more reproducible and was satisfied of convenience and be able to meet the national requrement.