成人中性粒细胞碱性磷酸酶影响因素探讨

Investigation of influence factors of neutrophilic alkaline phosphotase in Adults

目的:探讨成人中性粒细胞碱性磷酸酶(neutrophilitc alkaline phosphatase,NAP)在不同条件下多种因素对NAP染色阳性率和积分的影响。方法:随机抽取398例健康成人新鲜静脉血,EDTA-K2真空管抗凝,制备血涂片;同时取其中157例新鲜末梢血,制备血涂片;另将同一EDTA-K2真空抗凝管中的血分成三份,分别置4℃、22-25℃、37℃条件下,在不同时间段制备血涂片;将上述血涂片依改良Gomori法进行NAP细胞组化染色,显微镜油镜观察100个中性粒细胞,以阳性率、积分记录结果。结果::EDTA-K2抗凝静脉血NAP阳性率和积分参考范围分别为:1％-50％,1～56;末梢血NAP阳性率和积分参考范围分别为:4％～56％,5-70。抗凝剂、试剂pH、标本保存温度与时间、温浴时间等均为NAP染色结果的重要影响因素,但NAP无性别和年龄差异。结论:多种因素均对NAP实验结果构成影响,各实验室应根据自身实验条件而建立参考范围且实验过程中应注意质量控制。

Objective:To investigate the effect of various factors on the NAP positive rate and score. Methods:Smears from Venous bloods with EDTA-K2 anticoagulant were prepared from 398 healthy adults, in which 157 adults were randomly selected to prepare capillary blood smears simultaneously. Venous blood with EDTA-K2 from same one sample were divided into 3 vacuum tubes to prepared smears after different periods in 4℃ ,22 - 25℃ and 37℃ respectively. All smears were stained according to the improved Gomori technic,100 neutrocytes were observed positive rate and scored with microscope with 100X times. Results:The reference interval of NAP positive rate and score of venous bloods with EDTA-K2 and capillary bloods were 1% - 50% ,1-56. and 4% -56% ,5-70 respectively. Anticoagulants,pH of reagents, storage temperature and time of sample, incubating time were the important influence factors of NAP technics, however age and sex were not. Conclusion: Many factors could affect the results of NAP, clinical lab should establish the reference interval depending on self-conditions and pay attention to the quality control.