凝血检验、血常规的影响因素及控制变异方法分析

The analysis of coagulation tests,blood routine test influence factors and the variation control method

目的探讨凝血检验及血常规分析的影响因素及控制变异方法。方法选取2015年1~5月本院招募的健康成年志愿者60名,行凝血常规和血常规检测,对检测结果进行统计分析。结果压脉带使用3分钟时的活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶时间(thrombin time,TT)和凝血酶原时间(prothrombin time,PT)分别为(24.60±1.85)秒、(16.54±4.18)秒和(9.80±2.96)秒,均明显低于压脉带即刻时水平,差异有显著性(P<0.05)。压脉带使用3分钟时的红细胞(red blood cell,RBC)和血红蛋白(hemoglobin,HGB)分别为(5.28±0.64)×10^(12)/L和(155.97±6.75)g/L,均明显高于压脉带即刻时水平,白细胞(white blood cell,WBC)和血小板(blood platelet,PLT)分别为(4.26±0.28)×10~9/L和(172.16±8.95)×10~9/L。离心前后放置2小时APTT分别为(37.18±2.68)秒和(30.05±3.19)秒,差异有显著性(P<0.05),而血浆纤维蛋白原(plasma fibrinogen,FIB)、TT和PT差异无显著性(P>0.05);离心前后放置4小时APTT、TT和PT差异有显著性(P<0.05)。标本放置24小时后RBC和PLT分别为(4.17±0.30)×10^(12)/L和(165.29±5.58)×10~9/L,明显低于其他放置时间点,而WBC为(5.32±0.26)×10~9/L,高于其他放置时间点,差异有显著性(P<0.05)。结论标本采集和标本放置时间及方式对凝血检验及血常规分析有影响,重视控制变异方法,能极大提高检测数据可靠性。

Objective To investigate coagulation tests, blood routine test influence factors and the variation control method. Method 60 healthy adult volunteers had been recruited in our hospital from January 2015 to May 2015, for blood coagulation and blood routine examination, the results were statistically analyzed. Result Pressure pulse belt used 3 minutes of activated partial thromboplastin time（APTT）, prothrombin time（PT） and thrombin time（TT） were（24.60±1.85）s,（16.54±4.18）s and（9.80±2.96）s, which were significantly lower than the pressure pulse with immediate level（P〈0.05）, and the red blood cell（RBC） and hemoglobin（HGB） respectively was（5.28±0.64）×10^（12）/L and（165.29±5.58）×10~9/L, that was significantly higher than that of pulse pressure with immediate level. The white blood cell（WBC） and blood platelet（PLT） were（4.26±0.28）×10~9/L and（165.29±5.58）×10~9/L, that were significantly lower than the pressure pulse with immediate（P〈0.05）. Before and after centrifugation placed 2 hours APTT were（37.18±2.68）s and（30.05±3.19）s, the difference was statistically significant（P〈0.05）. Before and after centrifugation placed 4 hours APTT, PT and TT difference was statistically significant（P〈0.05）. The specimens after placed 24 hours RBC, and PLT were（4.17±0.30）×10^（12）/L and（165.29±5.58）×10~9/L, obviously lower than other time points, while WBC was（5.32±0.26）×10~9/L, higher than the other time points（P〈0.05）. Conclusion Sample collection and sample standing time and manner has effects on blood coagulation and blood test analysis, attention to the control method of variation, can greatly improve the reliability of detection data.