血常规检验中采取全自动血细胞分析仪联合血液涂片细胞形态学检测的结果分析

Analysis of Results from Combining Automated Hematology Analyzers and Blood Smear Cytomorphology in Routine Blood Tests

目的探讨以全自动血细胞分析仪、血液涂片细胞形态学联合实施血常规检验的价值。方法择取2022年12月至2023年12月郑州大学第五附属医院收治的82例疑似小儿支原体肺炎患儿,共纳入82份血液样本,均实施全自动血细胞分析仪、血液涂片细胞形态学检测,将胸部CT结合临床症状作为金标准,分析两种检测方式单一应用和联合应用诊断效能及对各细胞阳性率的检出情况。结果82例受检者胸部CT结合临床症状发现67份血液样本呈阳性,15份呈阴性;全自动血细胞分析仪检出58份血液样本呈阳性,24份呈阴性;血液涂片细胞形态学检出61份血液样本呈阳性,21份呈阴性;两种不同方式联合检测检出64份血液样本呈阳性,18份呈阴性。全自动血细胞分析仪检测敏感度、特异度、准确度、阳性和阴性预测值分别为77.61%、60.00%、74.39%、89.66%、37.50%;血液涂片形态学检测敏感度、特异度、准确度、阳性和阴性预测值分别为83.58%、66.67%、80.49%、91.80%、47.62%;联合检测敏感度、特异度、准确度、阳性和阴性预测值分别为95.52%、100.00%、96.34%、100.00%、83.33%;两种检测方式单一比较差异无统计学意义(P>0.05);联合检测诊断效能高于单一检测,差异具有统计学意义(P<0.05);受试者工作特征(ROC)曲线分析表明,联合检测曲线下面积(AUC)为0.721,约登指数为0.683,具有更高诊断效能。联合检测各细胞阳性率均高于单一检测,差异均有统计学意义(P<0.05),两种检测方式单一比较差异无统计学意义(P>0.05)。结论以全自动血细胞分析仪、血液涂片细胞形态学联合实施血常规检验,相对于单一检测,诊断效能较高,可为疾病诊疗提供依据。

Objective To explore the value of combining automated hematology analyzers and blood smear cytomorphology in routine blood tests.Methods Eighty-two blood samples from children with suspected Mycoplasma pneumoniae infection,treated at the Fifth Affiliated Hospital of Zhengzhou University from December 2022 to December 2023,were analyzed.All samples underwent testing using both automated hematology analyzers and blood smear cytomorphology.Chest CT combined with clinical symptoms was used as the gold standard.The diagnostic efficacy and positive rates of different cell types were compared between single and combined testing methods.Results Among the 82 subjects,chest CT combined with clinical symptoms identified 67 positive and 15 negative blood samples.Automated hematology analyzers detected 58 positive and 24 negative samples,while blood smear cytomorphology identified 61 positive and 21 negative samples.Combined testing detected 64 positive and 18 negative samples.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value for automated hematology analyzers were 77.61%,60.00%,74.39%,89.66%,and 37.50%,respectively.For blood smear cytomorphology,the values were 83.58%,66.67%,80.49%,91.80%,and 47.62%,respectively.Combined testing showed values of 95.52%,100.00%,96.34%,100.00%,and 83.33%,respectively.The differences in single testing methods were not statistically significant(P>0.05).Combined testing demonstrated higher diagnostic efficacy compared to single testing methods,with statistically significant differences(P<0.05).Receiver operating characteristic(ROC)curve analysis indicated that the area under the curve(AUC)for combined testing was 0.721,and the Youden index was 0.683,indicating higher diagnostic efficacy.The positive rates of various cells were higher with combined testing compared to single methods,with statistically significant differences(P<0.05).Conclusion Combining automated hematology analyzers and blood smear cytomorphology in routine blood tests has higher diagnostic efficacy compared to single testing methods,providing valuable information for disease diagnosis and treatment.