稀释液置换法在HmX血细胞分析仪脂血检测中的应用

目的探讨稀释液置换法在HmX血细胞分析仪检测脂血标本时的应用。方法收集30例无溶血、黄疸、脂血标本设为对照组；将30例标本去除上层血浆成分，加入同体积的脂肪乳制备成乳糜血，设为脂血组；再用相同的方法加入稀释液进行乳糜置换，设为稀释液组。3组标本用HmX血细胞分析仪测定血常规，对红细胞（RBC）、血红蛋白（Hb）、白细胞（WRC）、血小板（PLT）、平均红细胞体积（MCV）、红细胞压积（HCT）、平均红细胞血红蛋白含量（MCH）、平均红细胞血红蛋白浓度（MCHC）等8个项目以及WBC分类进行统计学分析，同时在人工显微镜下对WBC分类计数。结果3组之间RBC、WBC、MCV、HCT4个项目比较，差异无统计学意义（P〉0．05）；其余4个项目中，脂血组与对照组相比，Hb、MCH、MCHC升高（P〈0．05），PLT降低（P〈0．01），差异有统计学意义；稀释液组与对照组相比，除PLT明显降低（P〈0．01）外，其余项目差异无统计学意义（P〉0．05）。HmX的WBC分类结果，脂血组和稀释液组结果相似，83．3％（25／30）无结果，同时散点图呈现不分群异常，显示完全堵塞（PC2）的报警；16．7％（5／30）虽有分类结果，但提示结果不可信，需要人工复片；而人工WBC分类结果3组差异无统计学意义（P〉0．05）。结论稀释液置换法处理脂血标本后行HmX检测，除需人工计数PLT和WBC分类外，其余结果较为准确，是一种快速排除脂血干扰的实用方法。

Exploratory development on the dilution displacement method of lipemia by HmX cytoanalyze analyzer

Objective To explore the dilution displacement method for the detection of lipemia samples by HmX cytoanalyze analyzer. Methods A total of 30 samples without hemolysis,jaundice and lipemia were set as con- trol group. Then the upper plasma was removed, and equal volume of fat emulsion was added and performed as lipemia group. Subsequently the samples of lipemia group were treated with dilution displacement with the above method,and were set as diluent group. The three groups were determined by Beckman HxM cytoanalyze analyzer for red blood cell （RBC）, hemoglobin （ Hb）, white blood cell （WBC）, platelet （PLT）, mean corpuscular volume （MCV）, hematocrit （HCT）, mean corpuscular hemoglobin （MCH） and mean corpuscular hemoglobin concentration （MCHC） ,and WBC classification was detected by artificial microscope. Results There was no statistical significance among the three groups in RBC, WBC, MCV and HCT （P〉0.05）. Compared with the control group, Hb, MCH, MCHC increased （P〈0.05） and PLT decreased significantly （P〈0.01） in lipemia group. No significant differences existed in diluent group except that PLT was significantly lower （P〈0.05）. WBC classification showed the same re- sults. 83.3% （25/30 cases） got no results. Meanwhile, the scatter diagram showed no clustering anomaly and com- plete occlusion （PC2）. 16.7% （5/30 cases） got results,but it suggested that the unreliable results need artificial clas- sification. Artificial WBC classification results showed no significant difference among the three groups. Conclusion The dilution displacement method of HmX cytoanalyze analyzer is a practical method to quickly eliminate lipemia dis- turbance and can provide more accurate results,except for the PLT and WBC classification needing manual counting.