Sysmex XN-9000血液分析流水线复检规则的建立与评价

Establishment and evaluation of review rules for Sysmex XN-9000 blood analyzer assembly line

目的 建立适合实验室的Sysmex XN-9000血液分析流水线复检规则,保证实验结果的准确性。方法 收集2019年5月6-31日该院住院、门诊及体检全血标本18 863份,其中6-10日4 400份,11-31日14 463份。对触犯复检规则的标本进行复检。结果 4 400份标本复检的灵敏度为100.00%,特异度为96.78%,阳性预期值为57.10%,阴性预期值为100.00%,总有效率为96.91%。根据复检规则要求,对4 400份标本中617例标本进行了人工复检,其中真阳性295例,假阳性22例,真阴性297例,假阴性3例,阳性预期值为93.10%,阴性预期值为99.00%,假阴性率为1.00%。每天抽查60例未触犯复检规则的阴性标本涂片镜检,5d共抽查300例,出现3例假阴性。14 463份标本复检的灵敏度为100.00%,特异度为95.81%,阳性预期值为56.24%,阴性预期值为100.00%,总有效率为96.02%。结论 在保证假阴性率小于5%时,特别是白血病不漏检的前提条件下,该实验室设置的Sysmex XN-9000血液分析流水线复检规则有效降低了复检率,减轻了工作量,具有明显优势。

Objective To establish the review rules of Sysmex XN-9000 blood analyzer assembly line for the laboratory to ensure the accuracy of the experimental results.Methods 18863 blood samples were collected from the hospital from 6 to 31 May 2019,including 4400 from 6 to 10 and 14463 from 11 to 31.The samples that violate the review rules were rechecked.Results The sensitivity,specificity,positive predictive value,negative predictive value and total effective rate of 4400 samples were 100.00%,96.78%,57.10%,100.00%and 96.91%respectively.According to the review rules,617 samples of 4400 samples were rechecked artificially,including 295 true positive,22 false positive,297 true negative and 3 false negative.The sitive predictive value was 93.10%,the negative predictive value was 99.00%,and the false negative rate was 1.00%.Every day,60 cases of negative samples that did not violate the review rules were randomly selected for smear microscopy,300 samples were randomly examined in 5 days,and 3 false negative samples were found.The sensitivity,specificity,positive predictive value,negative predictive value and total effective rate were 100.00%,95.81%,56.24%,100.00%and 96.02%respectively.Conclusion Under the premise that the false negative rate is less than 5%,especially the leukemia is not missed,the review rules of Sysmex XN-9000 blood analyzer assembly line in the laboratory effectively reduce the retest rate,reduce the workload,and have obvious advantages.