200例标本平均红细胞血红蛋白浓度升高原因分析

Analysis of the Causes of the Increase of Mean Corpuscular Hemoglobin Concentration in 200 Cases

目的了解平均红细胞血红蛋白浓度(MCHC)升高对判断血细胞分析标本干扰因素存在的意义。方法选取平均红细胞血红蛋白浓度(MCHC)大于365g/L的标本200份,观察是否有红细胞冷凝集现象、乳糜血、溶血或球形红细胞增多等情况,并做相应的处理,重新检测标本,分析标本处理前后红细胞及相关指标的变化情况。分析平均红细胞血红蛋白浓度(MCHC)升高对判断标本存在干扰的意义。结果 200例标本中65例标本有红细胞冷凝集现象,125例为乳糜血,4例标本黄疸,2例标本溶血,4例镜下可见不同程度的球形红细胞增多。红细胞冷凝集标本水浴前后测定RBC、HCT、MCV、MCH、MCHC五个指标差异具有统计学意义,乳糜血标本在血浆等量置换前后HGB、MCH、MCHC三个项目的结果差异有统计学意义。结论 MCHC升高提示标本存在干扰因素,应该采取相应的方法处理标本,重新检测。

Objective To investigate the significance of the increasing of mean corpuscular hemoglobin concentration （MCHC） for determining the interference factors of blood cell analysis specimens. Methods 200 specimens with more than 365g/L MCHC were analyzed with cold agglutination of the red blood cells, chylemia, hemolysis or spherocytosis. Then thay were given corresponding treatment, re-tested, and analyzed the changes of red blood cell samples before and after treatment and related indicators, to analyze the significance of MCHC in the determination of the interference of the specimens. Results In 200 cases, 65 cases had red blood cell cold agglutination phenomenon, 125 cases had chylous blood, 4 cases were jaundice, 2 cases had hemolysis, and 4 cases were showed different degrees of spherocytosis under microscope. Hct, MCV, MCH and MCHC had significant differencein RBC determination of red blood cell samples before and after cold agglutination water bath. Hb, MCH, MCHC of chyle blood specimens in plasma were statistically significant differences among the results of three projects before and after equivalent replacement. Conclusion The increase of MCHC indicates that there are interference factors in the specimens, and the corresponding method should be adopted to deal with the samples.