外周血细胞形态学检测的临床价值

目的:评价血细胞形态学检测在血液系统疾病中的临床价值。方法:收集2004年至2006年间我院住院患者白细胞(WBC)数据,包括中性粒细胞百分率(N%)、淋巴细胞百分率(L%)、单核细胞百分率(M%)、嗜酸性粒细胞百分率(E%)、嗜碱性粒细胞百分率(B%)、红细胞(RBC)、血红蛋白(HGB)、红细胞平均体积(MCV)、红细胞体积分布宽度(RDW)等指标异常标本968例(实验组),另收集300例健康人群(门诊及体检)血常规各项指标均正常的标本(对照组)。结果:若N%、L%、M%、E%、B%增高或M%与B同时增高,无论WBC总数是否改变,镜下均可观察到中性粒细胞核左移(或右移)、中毒颗粒、空泡以及有核红细胞、幼稚细胞、异型淋巴细胞;若红细胞大小不等、中心浅染区扩大或消失以及红细胞体积增大时,RBC、HGB、MCV、MCH、MCHC、RDW等指标异常。健康人群组细胞异常检出率低。结论:全自动仪器为临床检验节省了大量的人力和物力,但都不能完全省去镜检,特别是临床有发热、贫血、淋巴结肿大、不明原因出血等疑似血液系统疾病时,均有必要行镜下血细胞形态学观察。

The Clinical Value of Morphological Measurement about blood Cells

Objective To evaluate the clinical value of morphological measurement about blood cells in blood system diseases.Methods Collects the abnormal datas of white blood cells(WBC) from 2004 to 2006 in 968 cases(the experimental group) in our hospital,including the percentage of neutrophils(N%),lymphocyte(L%),monocytes(M%),eosinophils(E%),basophils(B%) and the red blood cells(RBC,1012/L),Hemoglobin(HGB,g/L),mean corpuscular volume(MCV,fl),red blood cell volume distribution width(RDW,单位),and so on.another 300 cases(outpatient and medical groups) are normal blood samples(the control group).Results If N%,L%,M%,E%,B% higher or M%and B increased at the same time,regardless the changes of the total number of WBC,can we find the nuclear backspace of neutrophil cells shift to left(or shift to right),toxic hepatitis,vacuolation,and nucleated erythrocyte,naive cells,abnormal lymphocytes;if the size of RBC various,the shallow areas of centerexpands or disappear and the volume increased,the datas of HGB,MCV,MCH,MCHC,RDW will become abnormal.Low detection rate of abnormal cells in control group.Conclusion Automatic equipments have saved large amount of human and material resources for clinical test,but we can not rely on them completely,especially we suspect somebody blood system diseases go with fever,anemia,enlarged lymph nodes,unexplained bleeding,and so on.we need observe the blood cells by ourselves with microscope.