冷凝集素干扰血细胞分析结果水浴前后结果均失真研究

Research on cold agglutinin for interfering blood cells analysis results and results distortion before and after water bath

目的探讨冷凝集素对血细胞分析多项参数结果的干扰,对于标本直接检测和温水浴一段时间后再进行检测结果均出现失真现象进行原因分析,并比较不同纠正方案的技术要点,确保实施后达到纠正效果。方法利用希森美康(Sysmex)XE-5000血细胞分析仪进行检测,分析异常结果的细胞分布图和报警信息;配合手工镜检计数、血涂片分类以及冷凝集素特异性抗体鉴定和效价分析,寻找失真的原因;同时比较纠正冷凝集素干扰的多种方案的技术要点。结果发现高效价冷凝集素干扰的血细胞分析标本,采用温水浴(若水浴过程中温度失控超过了37℃)储存15min后,立刻上机检测,则多种血细胞破裂受损、特别是血小板出现数值剧烈升高的失真结果。结论日常血细胞分析检测过程中,实验室人员应该具备及时发现冷凝集素干扰的能力,同时掌握常规各种纠正方案的技术要点,进行快速、准确的纠正。

Objective To investigate the interference of cold agglutinin on the multiple parameters results of blood cells,to analyze the causes of results distortion phenomena by directly detecting the sample and detecting the sample after warm water bath for a time,to compare the technical key points among different correction schemes for ensuring reach the correction effect after implementation.Methods The Sysmex XE-5000 blood cell analyzer was used to conduct the testing,the cellular distribution picture and alarm message of abnormal results were analyzed;the distortion reasons were searched by coordinating with manual microscopic counting,blood smear classification and cold agglutinin specific antibody identification and titer analysis.Meanwhile the technical key points of multiple schemes for correcting cold agglutinin interference were compared.Results It was found that high titer cold agglutinin interfered the blood cells analysis sample.Adopting warm water bath(if the temperature being out of control exceeding 37℃during the bath process)to store for 15 min,the detection was immediately conducted by the instrument,then the multiple blood cells were ruptured and injured,especially appeared the distortion results of platelet value sharply increase.Conclusion In the routine blood cell analysis process,the laboratory personnel should have the ability to find the cold agglutinin interference in time,meanwhile master the technical key points of various correction schemes to correct quickly and accurately.