大血小板影响光学法与电阻抗法血小板计数差异的比较分析

目的：单纯大血小板如何影响电阻抗法和光学法血小板计数的差异，为光学法血小板计数的合理应用和有效提高血小板计数的准确性提供支持。方法采用 Sysmex-XE5000全自动血液分析仪电阻抗法和光学法对132例红细胞参数正常的血常规标本进行研究分析，按照 P-LCR 分为大血小板组和正常血小板组。采用非配对 t 检验比较两组间的红细胞参数和血小板参数，采用配对 t 检验比较组内电阻抗法和光学法血小板计数结果。结果两组血小板参数存在极显著差异，大血小板组的 P-LCR、MPV、PDW 和 IPF％均明显高于正常血小板组，而红细胞参数无明显差异。大血小板组电阻抗法和光学法血小板计数差异有统计学意义（P ＜0．05），电阻抗法计数结果偏低，而正常血小板组则无明显差异。结论大血小板比率升高与未成熟血小板的增加有关。电阻抗法仅根据颗粒大小进行区分，容易将体积较大的大血小板排除，造成血小板计数减低。因此，当大血小板比率升高时，应采用光学法进行血小板计数，避免电阻抗法引起的假性减低。

Comparative study on influence of large platelet on platelet count difference of optical method and electrical impedance method

Objective To know how large platelets influnece the platelet count difference of the optical and impedance methods so as to provide the support for the reasonable application of optical method and effectively increasing the accuracy of platelet count.Methods 132 blood routine specimens with normal RBC parameters were anaylzed by both electrical impedance and optical methods with the Sysmex-XE5000 fully automativ hematology analyzer.The data were divided into the large platelet group and the normal platelet group according to the platlet-large cell ratio（P-LCR）results.The RBC and platelet parameters were compared be-tween the two groups with the unpaired t-test and the platelet count results detected by the optical and electrical impedance methods were compared within group with the paired t-test.Results The extremely significant differences of platelet parameters existed be-tween the two groups.The P-LCR,MPV,PDW and IPF % of the large platelet group were significantly higher than those of the normal platelet group,but the RBC parameters had no obvious difference.The significant difference of the platelet count also existed between the electrical impedance and optical methods in the large platelet group（P 〈0.05 ）,the platelet count results detected by the electrical impedance method was on the low side,but the normal platelet group had no significant difference.Conclusion P-LCR increase is related with the increase of immature platelet.The electrical impadence method conducts the differentiation according to the granular size,which is easy to exclude the large platelel with larger volume and leads to reduce the platelet count results.There-fore,when P-LCR is increased,the optical method should be adopted in conducting the platelet count for avoiding the false reduce caused by the electrical impedance method.