夏天冷凝集致血常规检测结果异常分析

Analysis of abnormal blood test results caused by cold agglutination in summer

目的探讨夏天发生冷凝集对血常规各参数的影响、原因及处理方法。方法对2019年7月31日一例来自东部战区总医院秦淮医疗区肿瘤科的冷凝集标本在实验室25℃条件下及37℃水浴30 min后同时用三种品牌血球仪检测血常规。结果检测结果显示水浴前红细胞与血红蛋白比例严重失调,红细胞比容(HCT)明显减低、平均红细胞体积(MCH)及平均红细胞血红蛋白浓度(MCHC)明显升高,而经水浴后发现红细胞与血红蛋白比例、HCT、MCV、MCHC结果基本恢复正常。结论本例患者出现冷凝集的原因考虑跟继发感染的支原体肺炎有关,但冷凝集发生在夏季较为罕见,可能是该患者冷凝集抗体滴度较高或者冷凝集素温度阈值较宽所致,经水浴处理后结果恢复正常。

Objective To investigate the influence of cold agglutination on blood routine parameters in summer,and to analyze the reasons and treatment methods.Methods On July 31,2019,a cold agglutination specimen from the Department of Oncology,Qinhuai Medical Area,General Hospital of Eastern Theater Command,Chinese PLA was tested for blood routine by three blood cell meters of different brand at 25℃and 37℃water bath for 30 minutes.Results The results showed that the ratio of red blood cell to hemoglobin was seriously unbalanced before water bath,hematocrit(HCT)was significantly decreased,and mean corpuscular volume(MCH)and mean corpuscular hemoglobin concentration(MCHC)were significantly increased.After water bath,the ratio of erythrocyte to hemoglobin and the results of HCT,MCV and MCHC all returned to normal.Conclusion The cause of cold agglutination in this patient is considered to be related to Mycoplasma pneumonia secondary infection.Considering that cold agglutination is rare in summer,the cold agglutination might be caused by the high titer of cold agglutination antibody or the wide temperature threshold of cold agglutinin.The results returned to normal after water bath treatment.