光学法血小板计数在小红细胞性贫血患者中的应用

Application of platelet count of optical method in patients with microcytic anemia

目的探究光学法血小板计数在小红细胞性贫血患者中的应用。方法选取广东省第二中医院2019年12月至2020年3月门诊及住院小红细胞性贫血患者含EDTA-K2抗凝全血标本10^(9)份,根据平均红细胞体积(MCV)大小分为3组(MCV<70 fl、70 fl≤MCV<80 fl、MCV≥80 fl),分别采用手工法、电阻抗法和光学法进行血小板计数,以手工法为金标准对结果进行分析。结果当MCV<70 fl时,电阻抗法[(341.423±92.312)×10^(9)/L]与手工法[(315.162±63.765)×10^(9)/L]血小板计数结果比较差异有统计学意义(P<0.05),光学法[(320.633±77.014)×10^(9)/L]和电阻抗法比较差异有统计学意义(P<0.01);当70 fl≤MCV<80 fl和MCV≥80 fl时,电阻抗法和光学法与手工法血小板计数结果比较差异均无统计学意义(均P>0.05)。不同分组3种方法的血小板计数结果均呈高度相关(均r>0.80)。当MCV<70 fl时,进一步以红细胞分布宽度(RDW)分组,RDW≥17%为异常,电阻抗法[(393.367±85.101)×10^(9)/L]和光学法[(365.710±71.033)×10^(9)/L]与手工法[(338.142±55.393)×10^(9)/L]血小板计数结果比较差异均有统计学意义(均P<0.01);RDW<17%为正常,电阻抗法[(316.342±86.147)×10^(9)/L]和手工法[(296.666±63.981)×10^(9)/L]血小板计数结果比较差异有统计学意义(P<0.05),光学法[(298.863±71.045)×10^(9)/L]和手工法比较差异无统计学意义(P>0.05)。结论当MCV<70 fl、RDW<17%时,小红细胞干扰会导致电阻抗法血小板计数结果偏高,应采用光学法或手工法复检;但MCV<70fl、RDW≥17%时,小红细胞大小不均也可影响光学法血小板计数结果,应采用手工法复检。

Objective To explore the application of platelet count of optical method in patients with microcytic anemia.Methods A total of 10^(9) EDTA-K2 anticoagulant specimens were selected from outpatients and inpatients with microcytic anemia of Guangdong Second Traditional Chinese Medicine Hospital from December 2019 to March 2020,according to the mean corpuscular volume(MCV)which were divided into three groups(MCV<70 fl,70 fl≤MCV<80 fl,MCV≥80 fl).The platelet count was respectively detected by the manual method,electrical impedance method,and optical method,with the manual method as the gold standard.Results When MCV<70 fl,the platelet count results of the electrical impedance method[(341.423±92.312)×10^(9)/L]and manual method[(315.162±63.765)×10^(9)/L]had a statistically significant difference(P<0.05),the platelet count results of the optical method[(320.633±77.014)×10^(9)/L]and electrical impedance method had a statistically significant difference(P<0.01).When 70 fl≤MCV<80 fl or MCV≥80 fl,there were no statistically significant differences in the platelet count results among the electrical impedance method,optical method,and manual method(both P>0.05).The platelet count results of the three methods among different groups were highly correlated(all r>0.80).When MCV<70 fl,the results were further analyzed according to red blood cell distribution width(RDW).When RDW≥17%as abnormal,the platelet count results of the electrical impedance method[(393.367±85.101)×10^(9)/L],optical method[(365.710±71.033)×10^(9)/L],and manual method[(338.142±55.393)×10^(9)/L]had statistically significant differences(both P<0.01);when RDW<17%as normal,the platelet count results of the electrical impedance method[(316.342±86.147)×10^(9)/L]and manual method[(296.666±63.981)×10^(9)/L]had a statistically significant difference(P<0.05),the platelet count results of the optical method[(298.863±71.045)×10^(9)/L]and manual method had no statistically significant difference(P>0.05).Conclusions When MCV<70 fl and RDW<17%,the platelet count result of electrical impedance method would be higher due to the interference of small red blood cells,which should be recounted by the optical method or manual method.However,when MCV<70 fl and RDW≥17%,the platelet count result of optical method may also be affected by the uneven size of small red blood cells,so the manual method is recommended.