KX-21全自动血液分析仪的使用评价

目的对日本Sysmex公司KX-21全自动血液分析仪的主要指标进行评价.方法按照美国临床标准化委员会有关文件的要求,对KX-2l全自动血液分析仪的精密度、线性、携带污染率、可比性等内容进行评价.结果重复测定正常值和高值质控品的Hb、RBC、WBC、PLT的批内精密度在1.93%～4.68%和1 90%～4.03%之间,批间精密度在1 97%～4.88%和1.96%～4.64%范围内;KX-21测定Hb、RBC、WBC、HCT、PLT线性试验的相关系数均为0 999;测定Hb、RBC、HCT、WBC、PLT的携带污染率分别为0.58%、0.19%、0.196%、0.71%、0.49%;与SF-3000全自动血液分析仪测定Hb、RBC、HCT、WBC、PLT结果的相关性分析r值分别为0 9995、0.9897、0 9970、0.9996、0.9998.结论KX-2l全自动血液分析仪测定正常值和高值质控品均能获得良好的重复性、线性和携带污染率,与同类仪器测定结果具有很好的可比性.     

不同血细胞分析仪检测结果的比对分析

目的分析不同血细胞分析仪检测结果的可比性。方法以希森美康XN-1000型血细胞分析仪、配套试剂、原装配套校准品、质控品作为参比系统;迈瑞BC-5600型血细胞分析仪、配套试剂、原装配套校准品、质控品作为待评系统。依据行标WS/T406-2012要求收集血液样本40份,参考美国临床、实验室标准化协会(CLSI)EP9-A2文件,分别应用两台血细胞分析仪测定血小板计数(PLT)、红细胞压积(Hct)、血红蛋白(HGB)、红细胞计数(RBC)、白细胞计数(WBC),并予以分析。结果PLT、Hct、HGB、RBC、WBC相对偏差符合要求比例,分别为98.00%、95.25%、98.00%、96.00%、100.00%,五个测定参数相对偏差符合比例,均≥80%,临床评估可接受;线性回归分析可知,两台仪器具有良好相关性,差异无统计学意义(P0.05)。结论在使用多台仪器检测时,要加强实验仪器的质量控制,定期对不同的检测仪器进行校准和比对,以确保检测结果的准确性和一致性,从而更好的服务临床。     

两种全自动血液分析仪检测结果的一致性分析

目的对两种全自动血液分析仪检测结果进行比对分析,观察其检测结果的一致性。方法根据美国化学标准化委员会(NCCLS)标准文件EP9-A2的要求,用本科室的两台全自动血液分析仪对白细胞(WBC)、红细胞(RBC)、血红蛋白(HGB)、血小板(PLT)、红细胞压积(HCT)、红细胞平均体积(MCV)六个项目进行比对实验,验证两台仪器的一致性。结果两台仪器的精密度与相对偏差均在允许范围内,两台仪器的检测值用配对检验,差异无统计学意义(P>0.05),线性回归方程符合均要求。结论两台仪器检测结果具有较好的准确性和可比性,能够满足临床需要。     

SYSMEX全自动血细胞分析仪维修后的比对分析探讨

目的 为检测维修后全自动血细胞分析仪检测报告是否具有可比性,保障实验室报告的准确性,同时也为了保证患者安全,满足临床需求.方法 根据《医疗机构内定量检验结果的可比性验证指南》WS/T407-2012中第6条"可比性验证方法和程序"中标准操作规程,对我室4台全自动血细胞分析仪的WBC、RBC、Hb、HCT、PLT进行了不同检测系统间的可比性验证.结果 我室全自动细胞分析仪WBC低值、中值、高值比对偏差分别为4.76％、7.49％、6.49％.RBC低值、中值、高值比对偏差分别为2.94％、2.76％、2.90％.Hb低值、中值、高值比对偏差分别为3.03％、2.42％、3.05％.HCT低值、中值、高值比对偏差分别为2.65％、2.69％、2.96％.PLT低值、中值、高值比对偏差分别为9.56％、12.29％、9.09％.结论 维修后的4台不同型号的全自动细胞分析仪WBC、RBC、Hb、HCT、PLT均符合行业分析质量要求,具有可比性,在日常检验工作中应重视仪器间的比对,并选择正确的比对方案,以保证实验室报告的准确性.     

血细胞分析仪的校正及可比性分析

目的对2台CD-1700与2台F-800血细胞分析进行可比性分析,检测结果的可信性. 方法取门诊患儿手指末梢全血,同时用两种分析仪测定,结果比较分析. 结果 F-800的HCT测定结果有偏差,是系统误差造成,分别将2台机调校系数调至1.18和0.956后结果显示4台血细胞分析仪所测WBC、RBC、HGB、HCT、PLT值无显著性差异. 结论使用4台血细胞分析仪中任何1台测定血常规,其测定结果都具有可比性.     

血细胞分析仪的校正及可比性分析

目的：对2台CD-1700与2台F-800血细胞分析进行可比性分析，检测结果的可信性。方法：取门诊患儿手指末梢全血，同时用两种分析仪测定，结果比较分析。结果：F-800的HCT测定结果有偏差，是系统误差造成，分别将2台机调校系数调至1.18和0.956后结果显示4台血细胞分析仪所测WBC、RBC、HGB、HCT、PLT值无显著性差异。结论：使用4台血细胞分析仪中任何1台测定血常规，其测定结果都具有可比性。     

新鲜血液样本在不同血液分析仪上进行室内质控的探讨

目的 :探讨使用新鲜血液样本在不同血液分析仪上进行室内质控的方法。方法 :选用CD 16 0 0型血液分析仪做参考机 ,用同一份新鲜血液样本在参考机上测定后 ,用CD 35 0 0型血液分析仪、K 45 0 0型血液分析仪、CA6 2 0型血液分析仪进行测定 ,将结果与参考机结果进行比较 ,以相差百分比绘制质控图 ,根据标准判断结果是否出控。结果 :各型血液分析仪检测结果可达到以下要求 :RBC :CD 16 0 0所测结果± 4% ,WBC :CD 16 0 0所测结果± 6 % ,HGB :CD 16 0 0所测结果± 3% ,PLT :CD 16 0 0所测结果± 13%。结论 :利用新鲜血液样本在不同仪器上进行室内质控 ,是一项简便易行的质控方法     

两种采血方法进行血常规检验在临床应用中的研究

目的 了解血液分析仪测定静脉血和末梢血血常规结果的差异.方法 同时采集80例参加体检人员的静脉血和末梢血,用SYSMEX XS-800i血液分析仪测定血常规结果,进行重复性实验和对比实验,比较静脉血和末梢血的差异.结果 血液分析仪测定静脉血和末梢血血常规结果显示,两组WBC、RBC、HGB、MCH、MCHC、PLT均有明显差异;末梢血各参数的CV值大于静脉血.结论 应采用静脉血取代末梢血检测血常规.     

NCCLS EP 9-A在野战检验装备AC-910EO+评价中的应用

目的 通过比对野战检验装备血细胞分析仪AC-910EO+和实验室常规使用的sysmex XN-2000,评价两种血细胞分析仪检测结果的一致性.方法 按照美国临床实验室标准委员会(NCCLS) EP9-A的要求,以XN-2000为对比仪器,以AC-910EO+为待评仪器,分别对40例患者的EDTA抗凝的静脉血进行全血细胞分析,对两台仪器就WBC、RBC、HGB和PLT4个主要指标进行方法比对和偏移估计.结果 两台仪器在WBC、RBC和HGB这3项指标上具有很好的相关性,其回归方程及相关系数分别为Y=0.984X-0.164(r =0.999)、Y=0.986X +0.102(r =0.998)、Y=1.027X+0.256(r =0.998),而且他们在各医学决定水平浓度的预期偏差均符合CLIA' 88的标准,能够为临床所接受;但PLT这个指标两台仪器的回归方程为Y=0.804X +47.521相关系数为r=0.965,且在医学决定水平浓度的预期偏差除高值外均不能为临床所接受.结论 野战检验装备AC-910EO+能够用于执行野战卫生保障任务,但PLT的检测结果应该客观分析,仅能作为临床参考.     

不同容器对末梢采血的影响

目的：探讨用真空采血管和一次性使用抗凝管采集末梢血对血常规检测的影响。方法分别用真空采血管和一次性使用抗凝管采集末梢血,真空管静脉采血,并用全自动血细胞分析仪测定,对WBC、RBC、HGB、PLT、HCT进行对比分析。结果真空采血管和一次性抗凝管采集末梢血检测血常规与静脉采血法相比,WBC计数均具有非常显著的差异性(<0.01),HCT具有显著性差异,对于RBC和HGB检测,一次性抗凝管采集末梢血与静脉采血法相比具有非常显著的差异性；两容器检测PLT结果与静脉采血法相比均无显著性差异；所有检测结果分布宽度均大于静脉采血法。结论本实验建议使用真空采血管采集末梢全血进行血常规检测,以得到相对真实的检测结果。     

不同采血方法在血常规检验中的应用价值研究

目的 研究不同采血方法对血常规检验的影响。方法 选取2015年10月~2017年10月我中心进行血常规检验的96例患者作为研究对象,随机分为A、B、C三组,每组32例。A组采用动脉采血方法,B组采用静脉采血方法,C组采用末梢采血方法。对比三组患者血常规检查情况,分析三种采血方法对血常规检验结果的影响。结果 A、B两组患者血常规检查WBC、RBC、PLT、Hb、HCT、MCV、MCH以及MCHC水平对比,差异无统计学意义（P＞0.05）;C组患者MCH水平与A、B两组比较,差异无统计学意义（P＞0.05）;C组患者WBC、MCV水平高于A、B两组,RBC、PLT、Hb、HCT、MCHC水平低于A、B两组,差异有统计学意义（P＜0.05）。C组患者血常规WBC、RBC、PLT、Hb、HCT、MCV、MCH以及MCHC平均CV值高于A、B两组,差异有统计学意义（P＜0.05）。结论 静脉采血和动脉采血的血常规检验结果相似,较为准确,便于临床应用,静脉采血可在临床推广使用。     

Calibration bias and imprecision for automated hematology analyzers. An evaluation of significance of short-term bias resulting from calibration of an analyzer with S Cal

A Coulter S + IV analyzer was used both before and after recalibration with S Cal to analyze a series of patient blood specimens and stabilized control specimens. A statistically significant bias was introduced as compared with results on the same analyzer calibrated to fresh whole blood, but the degree of bias did not appear to approach medical significance when compared with two external theoretical models for determining acceptable bias in hematology analysis. Long-term bias accumulation on analyzers calibrated to control or stabilized calibration material remains a problem that must be addressed by further study.     

~(131)I治疗对青少年分化型甲状腺癌患者外周血的影响

观察131I治疗青少年分化型甲状腺癌(DTC)对外周血的影响。31例青少年(≤20岁,随访时间6～18个月)DTC患者接受131I治疗后(剂量2.96～11.1GBq),利用全自动血液分析仪,对131I治疗前、治疗后1个月、治疗后6个月及随访末白细胞(WBC)、中性粒细胞(Neut)、红细胞(RBC)、血红蛋白(HBG)及血小板(PLT)进行检测,对131I治疗前后结果进行对比分析。服用131I治疗后1个月,患者PLT下降(P<0.01),WBC下降(P<0.05),RBC下降(P<0.05)、HBG降低(P<0.05),Neut未见明显变化(P>0.05);治疗后6个月患者WBC、Neut、RBC、HBG及PLT均接近治疗前水平(P>0.05),大剂量组(7.4～11.1GBq)患者随访末外周血各指标均与首次治疗前水平无差异(P>0.05)。131I治疗青少年DTC,对外周血有一过性影响,是一种安全的治疗手段。     

健康儿童末梢血血细胞参数参考值范围调查研究

目的 了解临沧地区6个月~5岁健康儿童末梢血各项血细胞检测参数的参考值范围,为本地区儿童保健及临床诊断提供参考。方法 使用ABXPentra MS60全自动五分类血球分析仪及原装配套试剂对2018年1月~10月到我院儿童保健科健康体检的儿童进行末梢血血细胞检测,将检测的原始数据通过瑞美软件导入Excel,利用Excel筛选出6个月~5岁的儿童3356例,分别比较不同年龄段男女儿童WBC、RBC、HGB、HCT、MCV、MCH、MCHC、PLT 8个项目的参考值范围。结果 ①5岁以下儿童WBC、PLT随年龄的增加而降低,HGB、HCT、MCV、MCH 、MCHC随年龄的增加而增加,RBC的变化不明显;②6月~1岁时,不同性别儿童RBC、HGB、MCV、MCH、MCHC、PLT比较,差异有统计学意义（P＜0.05）,WBC、HCT比较,差异无统计学意义（P＞0.05）;2~4岁时,不同性别儿童8项指标中大多数基本一致,仅个别指标存在差异;4~5岁时,不同性别儿童WBC比较,差异有统计学意义（P＜0.05）;不同性别儿童MCV、MCH在所有年龄段中比较,差异均有统计学意义（P＜0.05）;③同性别儿童不同检测项目在相邻两个年龄段间比较均存在一定的差异性,其中2~3岁与3~4岁儿童所有检测项目比较,差异均有统计学意义（P＜0.05）。结论 临沧地区5岁以下健康儿童血细胞检测参数因性别、年龄的不同,应该制定独立的血细胞分析医学参考值范围,为本地区的儿童保健提供更为精准的医疗保健服务。     

A new blood donation strategy: automated blood collection (ABC)

BACKGROUND: The aim of this study was to find out if Cobe Trima, a blood cell separator that automatically collects RBC, PLT and plasma, is adequate for routine multiple blood donation by apheresis. MATERIALS and METHODS: Eighty donors underwent multiple blood component donations by Cobe Trima. Blood counts were determined on the apheresis products to analyze their quality. RESULTS: Eighty procedures were performed collecting 193 products. The average platelet yield was 3.5x10(11) (+/- 0.46) in the 54 single product (SP) procedures and 7x10(11) (+/- 0.88) in the 26 double product (DP) procedures. WBC contamination of the PLT products was 1.7 x 10(5) (1.2-4.2). The mean platelet efficiency was 60 +/- 8.35% for SP and 66 +/- 9.59% for DP. The hemoglobin (Hb) content per unit was 46.21 g (+/- 7.84) in 8 DP and 40.82 g (+/- 6.41) in 34 SP procedures. CONCLUSION: The production of standardized blood components with good PLT yield and low WBC contamination plus high efficiency makes Trima one of the best blood cell separators of the new generation.     

静脉采血与末梢采血方法在血常规检验中的应用效果比较

目的 探究静脉采血与末梢采血方法在血常规检验中的应用效果。方法 选取2018年7月某单位同一天入职体检需要检测血常规的体检人员160例,采用随机抽签法分为对照组和观察组,每组80例。对照组采用静脉采血,观察组采用末梢采血。使用全自动血细胞分析仪进行检测,并对检测结果中反应红细胞形态及数量、白细胞形态及数量、血小板形态及数量进行统计分析。结果 观察组的RBC、HGB、HCT、MCHC、PLT较对照组高;而WBC、NE较对照组低,差异具有统计学意义（P＜0.05）。两组MCH、MCV等余检测指标比较,差异无统计学意义（P＞0.05）。结论 静脉采血的血常规检测结果较末梢采血更趋于真实值。     

Evaluation of the CELL-DYN® 3500 haematology instrument for the analysis of the mouse and rat blood

The objective of this study was to evaluate the performance of the CELL-DYN^® 3500 for rat and mouse blood analysis in a routine environment. The WBC (white blood cells), RBC (red blood cells), PLT (platelets) counts and the WBC differential were determined. In addition, the following aspects were studied: within-run precision, day-to-day precision, biasfree paired difference precision; extended ranges of linearity for RBC, HCT (haematocrit), WBC, PLT; carry-over, the fffect of blood ageing, cell stability with different anticoagulants; and the normal ranges, the out of range flagging and some typical pathology cases. The CELL-DYN^® 3500 is a multiparameter flow cytometer which counts and differentiates WBC, based on the principle of multi-angle polarised light scatter separation. RBC and PLT are determined by the impedance method. The WBC count is evaluated by both, optical and impedance methods. Reference methods used were according to the ICSH recommendations on blood cell analysis, including manual counts of WBC and platelets, a centrifugal microhaematocrit method and a haemoglobin measurement by spectrophotometry using the WHO haemoglobin standard. All cell counts were compared with the results obtained by our routine blood cell analyser (Contraves AL820), and the WBC differential was compared with the manual microscopic differentiation of the 400 WBC (200 cells differentiated by two technicians). The following coefficients of variation were obtained: within-run precision was 1.2% and 2.7% for WBC; 1.0% and 1.0% for RBC; 1.3% and 0.9% for haematocrit; 2.1% and 2.7% for platelets (rats and mice respectively). Day-to-day precision was performed using human trilevel control blood, and the CVs were found to be <1.7% for WBC, <1.4% for RBC, <1.2% for haemoglobin and <6.3% for platelets. The following ranges of measurement were found to be linear in the rat: WBC: 0.10–20.20×10³/μl; RBC: 0.016–14.3×10⁶/μl; haemoglobin: 0.08–26.8 g/dl; haematocrit: 5.0%–77%; platelets: 14.0–1670.0×10³/μl. Equal ranges were observed for mouse blood. Carry-over in rat blood was found to be 0.12% for WBC, 0.05% for RBC, 0.15% for haemoglobin and 0.46% for platelets. In mice, similar carry-over results were obtained. The correlation coefficients (Pearson, correlation coefficient) between the CELL-DYN^® 3500 and Contraves AL 820 using linear regression analysis were as follows: 0.988 and 0.997 for WBC; 0.986 and 0.920 for RBC; 0.995 and 0.984 for haemoglobin; 0.958 and 0.85 for haematocrit; 0.958 and 0.963 for platelets, for rats and mice, respectively. Correlation coefficients between the CELL-DYN^® 3500 and the manual differential of NEU (neutrophils) and LYM (lymphocytes) were higher than 0.8 in rats and higher than 0.9 in mice. Due to the relatively low absolute counts of MONO (monocytes), EOS (eosinophils) and BASO (basophils), only moderate correlation of methods was found. The CELL-DYN^® 3500 was judged to be reliable, accurate and easy-to-use for counting and identifying normal and most of the pathological blood specimens obtained from mice and rats. By using the CELL-DYN^® 3500, the time for blood sample analysis can be shortened significantly and provides extensive opportunities to characterise pathological samples.     

Evaluation of a new reagent for preserving fresh blood samples and its potential usefulness for internal quality controls of multichannel hematology analyzers

We describe a new, easy-to-use reagent, Cyto-Chex (Streck Laboratories, Omaha, Neb), that preserves fresh whole blood in a non-cross-linking, nonformalin manner. Target values assigned to fresh blood were essentially met after preservation and storage of up to 31 days. Respective mean analytic inaccuracies and short-term intra-assay coefficients of variation (n = 30) were as follows: WBCs, 6.7% and 1.99%; RBCs, 0.7% and 0.76%; hemoglobin, -1.8% and 0.79%; hematocrit, -0.3% and 0.75%; mean corpuscular volume, -1.0% and 0.78%; and platelets, 6.9% and 3.12%. Linearity of dilution-sensitive analytes was satisfactory over a wide range of dilutions after preservation of blood samples. Ten independent laboratories using 10 different instruments determined day-to-day interassay imprecision during four 7-day periods after blood preservation. Mean interassay coefficients of variation for participating laboratories were WBC, 1.92%; RBC, 1.00%; hemoglobin, 1.29%; hematocrit, 2.00%; and platelets 3.29%. Cyto-Chex enables long-term monitoring of instrument accuracy and precision with retained blood specimens of healthy persons. Blood from patient cohorts with various hematologic disorders and with a wide range of numeric abnormalities and/or parameter aberrations can be preserved satisfactorily with this reagent. The reanalysis of preserved patient blood samples is an important adjunct to the use of commercial control material in quality control programs of multichannel hematology analyzers.     

Rapid identification of thrombocytopenia-associated multiple organ failure using red blood cell parameters and a volume/hemoglobin concentration cytogram

Thrombocytopenia-associated multiple organ failure (TAMOF) has a high mortality rate when not treated, and early detection of TAMOF is very important diagnostically and therapeutically. We describe herein our experience of early detection of TAMOF, using an automated hematology analyzer. From 498,390 inpatients, we selected 12 patients suspected of having peripheral schistocytosis, based on the results of red blood cell (RBC) parameters and a volume/hemoglobin concentration (V/HC) cytogram. We promptly evaluated whether the individual patients had clinical manifestations and laboratory findings were consistent with TAMOF. Plasma exchanges were then performed for each patient. All 12 patients had TAMOF. The mean values of RBC parameters were significantly higher in all of the patients than with the reference range, however, 3 patients had % RBC fragments within the reference range. The mean value of ADAMTS-13 activity was slightly lower in patients compared with the reference range. Of the 12 patients, remission was obtained in 9 patients (75%) within 4 to 5 weeks using plasma exchanges. Three patients died. An increased percentage of microcytic hyperchromic cells with anisocytosis and anisochromia indicated the presence of schistocytes, making it an excellent screening marker for TAMOF. Identification of TAMOF with RBC parameters and a V/HC cytogram is a facile and rapid method along with an automated hematology analyzer already in use for routine complete blood cell counting test.