全自动血细胞分析仪与血涂片细胞形态学在血常规检测中的联合应用价值

Applied Value of Automatic Blood Cell Analyzer Combined with Blood Smear in the Blood Routine Examination

目的探讨联合应用全自动血细胞分析仪和血涂片细胞形态学在血常规检测中的临床价值。方法选取濮阳市安阳地区医院2020年9月至2021年9月82例行血常规检查的受检者为研究对象,共计纳入血液样本82份,各样本均依次采用全自动血细胞分析仪和血涂片细胞形态学进行检测,统计两种检测方式单独及联合检测的阳性检出结果,以复检结果为最终依据,分析两种检测方式单独及联合检测的临床价值,比较不同检验方式检测出各细胞阳性率。结果复检结果显示阳性检出率81.87%、阴性检出率18.29%,全自动血细胞分析仪检验阳性检出率70.73%、阴性检出率29.27%,血涂片细胞形态学检验阳性检出率74.39%、阴性检出率25.61%,联合检验阳性检出率78.05%、阴性检出率21.95%,检验结果比较,差异无统计学意义(P>0.05)。联合检验特异度100.00%、灵敏度95.52%、阳性预测值100.00%、阴性预测值83.33%、准确度96.34%高于血涂片细胞形态学(66.67%、82.58%、91.8%、47.62%、80.49%)和全自动血细胞分析仪(60%、77.61%、89.66%、37.5%、66.82%)单独检验结果,差异有统计学意义(P<0.05);但两种检验方式单独检验结果比较,差异无统计学意义(P>0.05)。联合检验在血红蛋白、红细胞、白细胞、淋巴细胞、单核细胞、中性粒细胞、嗜酸性细胞和嗜碱性细胞阳性检出率方面均高于全自动血细胞分析仪和血涂片细胞形态学检验,差异有统计学意义(P<0.05);但两种检验之间比较,差异无统计学意义(P>0.05)。结论全自动血细胞分析仪和血涂片细胞形态学单独应用于血常规检验中均存在一定的假阴性和假阳性结果,联合检验的形式可以有效弥补单一检验的不足,提高检验的准确度,为相关疾病的诊疗提供更加可靠的依据,临床应用价值显著。

Objective To discuss the clinical value of automatic blood cell analyzer combined with blood smear in the blood routine examination.Methods A total of 82 subjects of taking the blood samples(82 samples)and blood routine examination from September 2020 to September 2021 were investigated.The automatic blood cell analyzer and blood smear were performed;the positive detection rates based on single and combined examination were counted;the re-check results were referred.The clinical value and positive cell rates based on single and combined examination were analyzed.Results The recheck results indicated the positive and negative detection rates were 81.87%and 18.29%.The positive and negative detection rates of automatic blood cell analyzer were 70.73%and 29.27%.The positive and negative detection rates of blood smear were 74.39%and 25.61%.The positive and negative detection rates of combined examination were 78.05%and 21.95%,no significant differences were observed(P>0.05).The diagnosis specificity,sensitivity,positive predictive value,negative predictive value and accuracy of combined examination(100.00%,95.52%,100.00%,83.33%,96.34%)were significantly higher than blood smear(66.67%,82.58%,91.8%,47.62%,80.49%)and automatic blood cell analyzer(60%,77.61%,89.66%,37.5%,66.82%)(P<0.05).There were no significant differences were observed between two single examination groups(P>0.05).The positive detection rates of hemoglobin,erythrocyte,leukocyte,lymphocyte,monocyte,neutrophile granulocyte,eosinophil and basophil based on combined examination were significantly higher than automatic blood cell analyzer or blood smear(P<0.05),but no significant differences were observed based on single examination(P>0.05).Conclusion The automatic blood cell analyzer or blood smear may have the false negative and positive rates,thus the combined examination can remedy the weakness,increase the detection accuracy and provide basis on the disease diagnosis and treatment.It is worthy of clinical application.