血细胞分析仪未检出血小板分布宽度的原因分析及该类标本血小板计数准确性评价

Analysis of the Causes on PDW Results Disappeared in Automatic Hematology Analyzer and the Evaluation of Platelet Result

目的对全自动血细胞分析仪未检出血小板分布宽度（PDW）的标本进行原因分析，并评价该情况下全自动血细胞分析仪计数血小板的准确性。方法对全自动血细胞分析仪未检出PDW的标本，采用涂片观察血小板形态大小、聚集、小红细胞及细胞碎片等；对该类标本行手工血小板计数，并比较其与血细胞分析仪计数结果的一致性；复查PDW。结果在200例PDW未检出的标本中104例（52％）可见大血小板，36例（18％）可见血小板聚集，28例（14％）可见小红细胞或红细胞碎片，32例（16％）无明显形态异常；大血小板、血小板聚集或细胞碎片标本血小板手工计数结果与全血细胞分析仪计数结果有统计学差异（P〈0．05）；全血细胞分析仪复检PDW，有64例（32％）标本有结果，其中以大血小板标本为主（50例）。结论全自动血细胞分析仪未检出PDW的原因主要有大血小板、血小板聚集、小红细胞或细胞碎片等，该类标本血细胞分析仪血小板计数异常，应行血小板手工计数校正。

Objective To investigate the causes on platelet distribution width （PDW） results not shown in the automatic hematology analyzer and evaluate the accuracy of the platelet results of these samples with the automatic hematology analyzer. Methods The platelet morphology was observed in microscope for the specimen which PDW were not shown in the automatic hematology analyzer. And the platelet results counted in microscope were statistically compared with that in the automatic hematology analyzer. Results In the 200 specimens which PDW were not shown in automatic hematology analyzer, there were 104 specimens（52 %） in which large platelet was found, 36 cases（18 %） in which platelet aggregation was visible, 28 cases（14 %） in which the microcytes or erythrocyte debris could be seen, 32 cases（16 %） in which the obvious abnormal was not found. The platelet results counted in microscope for the specimens,in which large platelets,platelet aggregation or microcytes were found, were very different with the results counted with the automatic hematology analyzer（P〈0. 05）. The PDW of the 200 specimens were rechecked in the automatic hematology analyzer. And 64 cases （32%） PDW results were got,of which 55 cases（85.9%） PDW results were beyond the normal range. Conclusion The main causes for the PDW not shown in automatic hematology analyzer includes large platelets, platelets aggregation and microcytes etc. The platelet results in these specimens by automatic hematology analyzer were different with that counted in microscope. Therefore, the platelet of these specimens should be counted in microscope.