摘要
目的以推片复检方式对实验室血小板(PLT)计数降低假阳性案例进行分类、鉴别,并探索相关技术调整和纠正,为患者提供更为准确的检测结果。方法选取唐都医院2021年1月至12月的血常规标本进行分析,对仪器检测PLT<80×10^(9)/L和80×10^(9)/L≤PLT<100×10^(9)/L合并仪器提示PLT凝集的标本进行推片复检,在显微镜下观察PLT的形态及分布情况。对190例PLT计数假性降低标本采用PLT-I、PLT-F及仪器旁采集无抗凝剂管等方法进行了进一步对比实验和分析。结果2021年1月至12月的血常规标本中,推片复检的标本1288例,其中PLT真性减低的标本1098例,占比85.25%;观察到PLT聚集的标本72例(采集不当的标本2例,证实为抗凝剂依赖性PLT假性减低的标本70例,包含PLT卫星现象1例),占比5.59%;查见大PLT的标本118例,占比9.16%。各类PLT计数降低标本的对比和处理结果与人工镜检结果相符。结论血细胞分析仪检测PLT计数受到多种因素的影响而出现假性降低,应严格执行实验室复检规则,采用适当技术和方法予以处理和纠正,并持续改进,以保证检验结果的准确性。
Objective To classify and identify the false-positive cases of decreased platelet(PLT)count in laboratory by means of blood smear review,and to explore relevant technical adjustment and correction,so as to provide more accurate test results for patients.Methods The routine blood samples from Tangdu Hospital from January to December 2021 were selected for analysis.The samples with PLT<80×10^(9)/L and 80×10^(9)/L≤PLT<100×10^(9)/L combined with instrument indicating PLT agglutination were reexamined by blood smear,and the morphology and distribution of PLT were observed under microscope.A total of 190 samples with false decreased PLT count were analyzed by PLT-I,PLT-F and non-anticoagulant tube.Results Among the routine blood samples from January to December 2021,1288 routine blood samples were reexamined by blood smear,among which 1098 cases had decreased PLT authenticity,accounting for 85.25%.PLT aggregation was observed in 72 cases(2 cases were improperly collected,70 cases were confirmed to be anticoagulant dependent pseudothrombocytopenia,including 1 case of PLT satellite phenomenon),accounting for 5.59%.Large PLT was found in 118 cases,accounting for 9.16%.The comparison and treatment results of various types of specimens with decreased PLT count were consistent with the results of manual microscopic examination.Conclusion The false reduction of PLT count detected by blood cell analyzer is affected by many factors.The rules of laboratory reexamination should be strictly implemented,appropriate techniques and methods should be adopted to deal with and correct,and continuous improvement should be made to ensure the accuracy of the test results.
作者
翟鸿烨
袁晖
刘茜
郭维
杨肖飞
王婕妤
黄婧
张利军
ZHAI Hongye;YUAN Hui;LIU Qian;GUO Wei;YANG Xiaofei;WANG Jieyu;HUANG Jing;ZHANG Lijun(Department of Clinical Laboratory,Tangdu Hospital,Air Force Medical University,Xi'an 710038,China)
出处
《空军军医大学学报》
CAS
2023年第3期252-254,261,共4页
Journal of Air Force Medical University
基金
国家自然科学基金面上项目(81670792,82070298)。
