血细胞直方图联合血液涂片分析在疟疾诊断中的应用

Application of blood cell histogram combined with blood smear analysis in the diagnosis of malaria

目的探讨BC⁃5300型血液细胞分析仪的血细胞直方图联合血液涂片显微镜下检测疟原虫的方法。为中国援建尼日尔综合示范医院在疟疾的诊断提供参考依据。方法选取450例样本,按血常规白细胞直方图是否异常以及发热情况分为A、B、C三组(发热患者,体温>38℃,且血常规白细胞直方图有异常表达或结果有异常报警信息为A组;非发热患者,体温<37℃,且血常规白细胞直方图有异常表达或结果有异常报警信息为B组;非发热患者,体温<37℃,且血常规白细胞直方图无异常表达或结果无异常报警信息为C组),并进行吉姆萨染色后显微镜下查找疟原虫。结果A组150例患者,显微镜下查出疟原虫142例,阳性率94.67%;B组150例患者,显微镜下查出疟原虫139例,阳性率92.67%;C组150例患者显微镜下找到5例疟原虫,阳性率为3.33%。A组、B组患者疟原虫发现率明显更高于C组患者,差异有统计学意义(t=239.797、250.353,P<0.05),A、B两组患者之间疟原虫发现率对比差异无统计学意义(t=0.506,P>0.05)。结论应用BC⁃5300型血细胞分析仪联合血液涂片显微镜检测疟原虫的方法能够对疟疾进行简便、快速的诊断,特别在疟疾的高发流行区域更具临床意义,值得在援外医疗工作中应用和推广。

Objective To explore the method of detecting plasmodium with blood cell histogram and blood smear microscope of BC⁃5300 blood cell analyzer.To provide a reference for the diagnosis of malaria in Niger General Demonstration Hospital aided by China.Methods 450 samples were selected and divided into A,B,and C three groupd based on whether the white blood cell histogram is abnormal and the fever.Patients with fever,body temperature>38℃,and blood routine white blood cell histogram with abnormal expression or results with abnormal alarm information are group A.Non⁃fever patients with body temperature<37℃and abnormal expression or abnormal alarm information in blood routine white blood cell histogram are group B.Non⁃febrile patients,body temperature<37℃,and blood routine white blood cell histogram without abnormal expression or results without abnormal alarm information are group C.Plasmodium was detected under a microscope after Giemsa staining.Results Among the 150 patients in group A,142 cases of Plasmodium were detected under the microscope,with a positive rate of 94.67%.Among the 150 patients in group B,139 cases of Plasmodium were detected under the microscope,with a positive rate of 92.67%.Five cases of Plasmodium were found in 150 patients in group C under the microscope,and the positive rate was 3.33%.The detection rate of malaria parasite in group A and group B was significantly higher than that in group C,the difference was statistically significant(t=239.797,250.353,P<0.05).There was no statistically significant difference in the detection rate of malaria parasites between groups A and B(t=0.506,P>0.05).Conclusion The method of using BC⁃5300 blood cell analyzer combined with blood smear microscope to detect malaria parasites can make a simple and rapid diagnosis of malaria,especially in the areas with high incidence of malaria,which has more clinical significance,and is worthy of application and promotion in foreign aid medical work.