532例血小板减少标本复查结果及形态学分析

目的 探讨XT-1800i血细胞分析仪血小板(PLT)检测结果偏低的原因,选择正确的方法进行复查,保证PLT检测质量.方法 对532例XT-1800i血细胞分析仪上PLT检测结果偏低的标本用手工法进行血小板计数,同时作外周血涂片镜检观察血小板形态.结果 219例患者结果仍偏低,复查前后差异无统计学意义(P＞0.05),血涂片血小板均匀分布,形态大致正常;313例复查后血小板数正常,其中306例血涂片上出现大、巨大血小板,7例标本血涂片上血小板存在着不同程度的聚集.结论 血液分析仪检测血小板结果偏低的标本应进行血涂片镜检和手工计数血小板.     

全自动血细胞分析仪与手工镜检分类新生儿白细胞相关性分析

目的：以手工显微镜白细胞分类法为标准方法,评价SysmexXS-800i全自动血细胞分析仪检测新生儿白细胞分类结果的准确性。方法：用Sysmex XS-800i全自动血细胞分析仪和手工显微镜分类检测68例新生儿血液标本,比较2种方法的相关性。结果：仪器与手工分类相关分析中性粒细胞、淋巴细胞、嗜酸粒细胞的相关系数（r）分别为0.887、0.842、0.663,相关性相对较好;单核细胞和嗜碱性粒细胞相关系数（r）分别为0.230、0.202,相关性不好;仪器分类单核细胞假阳性率为73.52%,嗜碱粒细胞假阳性率为26.47%。结论：SysmexXS-800i全自动血细胞分析仪对新生儿白细胞分类的误差较大,建议用手工法进行白细胞分类。     

迈瑞BC-5500血液分析仪白细胞不分类原因分析

目的：对迈瑞BC-5500全自动血细胞分析仪在检测标本时,白细胞不分类的情况进行分析,以提高操作人员的认识及应对措施。方法：随机抽取住院病人551例,在迈瑞BC-5500全自动血细胞分析仪上检测,同时对于不分类标本进行涂片染色,手工白细胞分类。结果：不分类标本中,小于3岁儿童患者所占比例〉90％。结论：对于3岁以内尤其1岁以内儿童白细胞不分类者应进行手工推片染色白细胞分类检查。     

URIT-3010全自动血细胞分析仪的多中心临床试验

目的探讨全自动血细胞分析仪的多中心临床试验方法。方法使用试验仪器(URIT-3010)和对照仪器(XE-2100和COULTER LH750)分别检测血液样本的白细胞(WBC)、红细胞(RBC)、血红蛋白(HGB)、平均红细胞体积(MCV)和血小板(PLT)项目,并计算两者相对误差的绝对值(Se)作为主要有效指标,得出Se的平均值及其95%置信区间(CI),再与国家食品药品监督管理局(SFDA)规定的容许误差进行比较。结果 WBC、RBC、HGB、MCV和PLT项目的Se平均值的95%置信区间上限均低于SFDA规定的容许误差。结论 URIT-3010等效于对照仪器XE-2100和COULTER LH750。     

Auto Vue Innova全自动血型仪在ABO及Rh(D)血型鉴定中的应用价值

目的 探讨Auto Vue Innova全自动血型分析仪在ABO正反定型及Rh(D)血型鉴定中的应用价值.方法 采用Auto Vue Innova全自动血型仪对4 655份血标本进行ABO正反定型及Rh(D)血型进行鉴定,并与手工试管法进行对比.结果 ①4 655份血标本中,Auto Vue Innova全自动血型分析仪在ABO正反定型一次性判读成功率为91.04％,手工试管法为94.95％,两者比较P＜0.05;在排除仪器及试剂卡原因引起的ABO正反定型判读失败后,对标本进行重新分析,ABO正反定型判读成功率提升至94.05％,与手工试管法比较P＞0.05;仪器对Rh(D)血型检测一次性判读成功率别为99.96％,手工试管法一次性判读成功率为100％,两者比较P＞0.05.②Auto VueInnova全自动血型分析仪每小时可检测ABO正反定型及Rh(D)血型标本56份,手工法平均为42份.结论 Auto Vue Innova全自动血型分析仪进行血型鉴定快速、准确,易于标准化,而且结果易查询、反应图像可长期保留,但仪器及试剂卡的故障可对标本的检测造成一定的干扰.     

IRF对白血病化疗后骨髓造血功能的监测意义

在全自动血细胞分析仪中,根据网织红细胞(Ret)荧光强度与胞内RNA含量成比例关系,将Ret分为低、中、高三种荧光强度类型(LFR、MFR、HFR).     

XN-9000血细胞分析仪3种计数血小板方法结果差异分析

目的:用日本Sysmex公司XN-9000全自动血细胞分析仪分析临床标本,探讨电阻抗法,光学法,荧光法计数血小板的准确性以及影响血小板计数准确性的相关因素。方法:采用电阻抗法、光学法,荧光法和手工法计数血小板分别为PLT-I,PLT-O,PLT-F和PLT-M,分别用PLT-I,PLT-O,PLT-F对PLT-M作Bland-Altman图。结合CLIA188室间评估指标(血小板的允许误差限值为T±25%),分析2种方法的一致性;并统计分析对照组及血小板直方图异常标本的红细胞碎片计数(FRC%)、小红细胞百分率(MicroR%)、网织血小板比率(IPF%)的95%可信区间,观察其对仪器法检测结果的影响。结果:正常对照组60例PLT计数电阻抗法、光学法,荧光法和手工法比较都具有较好的一致性。小红细胞组60例PLT计数电阻抗法计数血小板最高,偏差随着FRC%和或MicroR%的增多而变大,血小板直方图异常越明显,而光学法、荧光法和手工法之间具有较好的一致性,此时FRC%和MicroR%明显高于正常对照组,IPF%无明显差别。幼稚(大)血小板组60例PLT计数电阻抗法和光学法结果可信度低,且光学法最低,而荧光法与手工法一致性较好,此时IPF%明显升高。结论:XN-9000分析仪计数血小板在正常血液标本中,3种方法与手工法一致性好,结果均可靠。在小红细胞和或红细胞碎片干扰标本及血小板形态异常标本中,电阻抗法结果不可靠,可用荧光法或手工法进行复查。而光学法抗小红细胞和红细胞碎片能力较强,对幼稚血小板会漏检。     

血细胞分析仪实验数据比对分析

目的 评价现用不同型号的血细胞分析仪在日常工作中检测结果的准确性及一致性.方法 以本科室Gen-s System2血细胞分析仪为比对仪器,选择高、中、低值三个档次的新鲜全血标本40份,每台仪器平行测定2次,取平均值进行多个参数分析,以Gen-s Systern2评价其他血细胞分析仪检测结果(WBC、RBC、HGB、PLT、HCT).结果 (1)4台血细胞分析仪的精密度好;(2)WBC、RBC、HGB、PLT、HCT五个指标分别进行配对t检验,均P＞0.05,差异无统计学意义;(3)各台仪器与比对仪器参数的相关系数r＞0.975,相关性好;(4)由回归曲线与回归方程可主要了解各台仪器系统误差的大小.结论 (1)应用新鲜全血对血细胞分析仪进行比对试验.能及时发现仪器间的系统误差;(2)同一实验室用新鲜全血对血细胞分析仪进行定期对比实验及校正,能提高和保证同一实验室血细胞分析仪检测结果的准确度和一致性.     

医学论文命题六忌

目的 探讨血细胞分析仪(COULTER AC．TDIFF)对白细胞分类的影响。方法 对200例血标本，进行仪器检测，同时进行手工复片镜下分类，把结果进行比较。结果 仪器将部分中性粒细胞误分类为单核细胞，单核细胞百分率态愈高，误分率愈高。结论 检验人员不能完全依赖仪器，必要时应进行手工复片镜检分类。     

2型糖尿病患者血小板参数的检测及临床应用

目的 探讨血小板参数在2型糖尿病及存在并发症患者中的变化及临床应用。方法 选择无血管并发症和有血管并发症的2型糖尿病患者各80例，应用Beckman Coulter LH-750全自动血细胞分析仪检测血小板计数（PLT）、血小板平均体积（MPV），并对结果进行统计学分析。结果 与正常对照组比较，伴血管病变的2型糖尿病患者血小板参数差异有显著性，无血管病变的2型糖尿病患者血小板参数差异无显著性。结论 血小板参数的变化在2型糖尿病患者血管并发症的发生中有重要临床价值。     

SysmexXE-2100血细胞分析仪有核红细胞提示的可靠性分析

目的：评价Sysmex XE-2100血细胞分析仪检测外周血标本时有核红细胞（NRBC）异常提示Q-flag值的可靠性,并探讨其临床应用价值以及影响因素。方法：将NRBC提示阳性（Q-flag值100-300）的血标本100例及无NRBC提示异常（Q-flag值100以下）的血标本100例进行手工涂片瑞特染色镜检,以显微镜检结果为金标准,判断Q-flag值提示的可靠性。结果：SysmexXE-2100测定NRBC提示的灵敏度、特异性分别为98．7％、80．5％。结论：Q-flag值在有核红细胞的检测中有一定的应用意义。     

Evaluation of the nucleated red blood cell count in neonates using the Beckman Coulter UniCel DxH 800 analyzer

Introduction: Nucleated red blood cell (NRBC) count is closely associated with the prognosis of neonates. The analysis of NRBC has traditionally been measured manually. Recently, a newly developed automated hematology analyzer, the UniCel DxH 800 (DxH 800), was released. The goal of our study was to evaluate the performance of the DxH 800 NRBC method in neonates with the reference manual method and against previous generation hematology analyzers. Methods: NRBCs were counted in 162 neonatal blood samples using the DxH 800, LH 750, and ADVIA 2120 vs. the reference manual technique. The concordance rate, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were obtained. Results: The DxH 800 showed an R² value of 0.945 and the concordance rate of 93.8%. Further assessment revealed 85.3% sensitivity, 96.1% specificity, 85.3% PPV, and 96.1% NPV, resulting in the highest area under the curve (0.961). The LH 750 and ADIVA 2120 demonstrated R² values of 0.851 and 0.529, respectively. Conclusion: The results obtained indicate the UniCel DxH 800 to be an excellent test on neonatal blood and superior to the other analyzers. Therefore, the DxH 800 is an effective and highly sensitive system for the analysis of NRBCs on newborns.     

Comparison of four hematology analyzers,CELL‐DYN Sapphire,ADVIA 120, Coulter LH 750, and Sysmex XE‐2100, in terms of clinical usefulness

We evaluated the clinical usefulness (leukocyte distribution classification, morphologic classification, and morphologic flags) of the following four hematology analyzers: CELL‐DYN Sapphire (CD‐Sapphire) (Abbott Diagnostics, Santa Clara, CA, USA), ADVIA 120 (Bayer Diagnostics, Tarrytown, NY, USA), Beckman Coulter LH 750 (Beckman Coulter, Miami, FL, USA), and Sysmex XE‐2100 (TOA Medical Electronics Co., Kobe, Japan). Four hundred thirty samples from patients and 100 samples from healthy individuals were analyzed. For distributional classification, the sensitivity rates of CD‐Sapphire, ADVIA 120, LH 750, and XE‐2100 were 93.1, 95.9, 94.9, and 94.9%, respectively, and the efficiency rates were 80.7, 81.6, 84.1, and 84.2%, respectively. For morphologic classification, the sensitivity rates of CD‐Sapphire, ADVIA 120, LH 750, and XE‐2100 were 88.6, 93.2, 77.3, and 94.3%, respectively, and the efficiency rates were 80.9, 73.0, 79.5, and 74.2%, respectively. Comparing the findings in different morphologic flags, XE‐2100 showed the highest sensitivity for Blasts flag (90.9%); CD‐Sapphire showed the highest sensitivity for Immature granulocytes and/or Left‐shift flag (85.5%); ADVIA 120 showed the highest sensitivity for Atypical lymphocytes flag (60.0%); and LH 750 showed the highest sensitivity for Nucleated RBC flag (75.0%). Our results demonstrate that the four analyzers are comparable in overall performance.     

Usefulness of Reticulocyte Parameters for Diagnosis of Hereditary Spherocytosis in Children

Innovations in laboratory equipment have enabled a widening of the spectrum of hematological parameters obtained from single measurements of peripheral blood samples, including reticulocyte parameters. The usefulness of reticulocytes indices to confirm the diagnosis of pediatric anemia was analyzed in this study. The study group consisted of 163 children, aged 1 month–17 years, with anemia. Complete blood count extended with an analysis of reticulocyte parameters were measured using a Beckman Coulter LH 750. The mean sphered corpuscular volume (MSCV) in the group of children with hereditary spherocytosis (HS) was 66.71 ± 8.45 fL, whereas in other anemic patients MSCV was 87.76 ± 11.22 fL, p < 0.0001. In HS children the average mean corpuscular volume of red blood cells was higher than the MSCV value, while an inverse correlation was observed in the group of children with other anemias, p < 0.0001. A significant difference was found between the ratio of absolute reticulocyte count and IRF fraction (Ret#/IRF)—0.6 ± 0.28 in the HS group and 0.23 ± 0.16 in the non-HS group, respectively. Our results suggest that analysis of reticulocyte parameters is useful in the diagnosis of anemia and should be included in the routine CBC analysis in anemic children.     

Evaluation of the leukocyte differential on a new automated flow cytometry hematology analyzer

Introduction: The Hematoflow (Beckman Coulter, USA) is a new automated hematology analyzer, which provides a 16-part white blood cell count (WBC) differential. Methods: We evaluated the differential WBC count performance of the Hematoflow. 101 blood samples from patients were selected for comparison analysis. Results: The methodological comparison of the WBC differential parameters of neutrophils, lymphocytes, monocytes and eosinophils showed good correlations among 4 different analyses. More than 1% of blast cells were counted in 30 of 101 samples. A good correlation for blast cell counts obtained by Hematoflow was found with the reference manual method (r=0.9637, P 0.0001). For blast B, Hematoflow shows good correlation with reference method results but did not identify blast T. Conclusions: These results demonstrate that the Hematoflow has a comparable performance with the Sysmex XE-2100 and indicate that B cell lineage ALL can be identified by the use of the Hematoflow in an initial evaluation of acute leukemia.     

Initial performance evaluation of the UniCel® DxH 800 Coulter® cellular analysis system

The Beckman Coulter UniCel^® DxH 800 is a hematology analyzer incorporating new electronic and mechanical design with advanced algorithm technology to perform CBC, white blood cell (WBC) differential, nucleated red blood cell (NRBC), and reticulocyte analysis. Evaluation of this instrument was performed in our 800‐bed tertiary care hospital and specifically centered upon the correlation of WBC, NRBC, and platelet (PLT) enumeration when compared to a predicate analyzer, the Coulter^® LH 780, and flow cytometry (FCM) reference methods. Of particular interest were those samples with morphologically confirmed interference and extreme leukocytosis (evaluated with respect to red blood cell parameter correction). The sample set (n = 272) consisted of morphologically normal and hematologically abnormal patients. Correlation of the WBC, PLT, and NRBC showed r² values of 0.994, 0.985, and 0.910 for the DxH 800 vs. FCM, respectively. The presence of interfering particles did not affect the accuracy of the DxH 800 with respect to WBC counts. The DxH 800 showed accurate PLT and NRBC counts in the clinically significant low range when compared to FCM. Compared to the LH 780, flagging rates were significantly reduced (NRBC flag), or equivalent (WBC, PLT flag) on the DxH 800. The DxH 800 demonstrated higher sensitivity and specificity for PLTs and NRBCs and achieved a lower NRBC false negative rate compared to the LH 780. The UniCel^® DxH 800 represents a significant improvement to previous impedance analyzers in accurately detecting the presence of NRBCs at counts >1/100 WBC. Furthermore, it provides accurate PLT and WBC counts in the presence of interference and improved NRBC flagging efficiency when compared to the LH 780. Correction of red blood cell parameters is appropriate and accurate in cases of extreme leukocytosis.     

Simple,rapid, and automated method for detection of hyperaggregability of platelets using a hematology analyzer

Estimation of hyperaggregability of platelets is important for diagnosis and prevention of vascular events. We have developed and evaluated a simple and rapid method for detection of a hyperaggregable state of platelets by using an Abbott CELL-DYN(R) 4000 hematology analyzer. Citrated blood samples were collected from 62 patients with chronic cerebral infarction (CCI), of whom 19 patients were treated with ticlopidine, and from 9 healthy subjects. Platelet clumps were detected in the scatter plots for white blood cell populations with the hematology analyzer. Platelet clumps were positive in 20 of 43 (46.5%) CCI patients who were not treated with anti-platelet agents but not at all in 9 healthy subjects and in 19 CCI patients treated with ticlopidine. The detection of platelet clumps in citrated blood by the hematology analyzer was proved useful in detecting a platelet hyperaggregability in CCI patients. This method is simple, rapid, and automated and thus should be suitable for routine clinical use for monitoring indications and the efficacy of anti-platelet drugs.     

Evaluation of the coulter LH 750 haematology analyzer compared with flow cytometry as the reference method for WBC, platelet and nucleated RBC count

The Coulter LH 750 is a new haematology analyser with several new features: a count of nucleated red blood cells (NRBCs), automated WBC correction in presence of a flag indicating a cellular interference and a lower incidence of platelet or WBC interference flags when compared with the GEN.S, our current instrument. We had three main goals in our study: evaluating the LH 750 WBC counts when a GEN.S flag suggests a risk of WBC interference, ascertaining whether the platelet counts not flagged by the LH 750 were accurately assessed in samples flagged by the GEN.S and evaluating the NRBC assay provided by the LH 750. Flow cytometry, using CD45 and CD41, respectively for WBC and platelet labelling, was used as a reference method to assess the accuracy of the LH 750 counts. NRBC were identified by double labelling with propidium iodide (PI) and CD45, NRBCs being CD45-/PI+. A significant relationship was found between LH 750 and flow cytometric WBC counts, whether a WBC correction was made by the LH 750 (r = 0.9809, n = 54) or not (r = 0.9901, n = 23). A highly significant relationship was observed for platelets not only in the range from 0 to 450 x 10(9)/l (r = 0.981, n = 108) but also in cases of thrombocytopenia (range: 0-80 x 10(9)/l; r = 0.956, n = 51). In samples with NRBCs, the NRBC percentages given by the LH 750 and by flow cytometry were highly correlated (r = 0.977, n = 60) and WBC counts were accurate. In conclusion, the reduction in flagging by the LH 750, the accuracy of the results, and the availability of a NRBC count, constitute major advantages.     

Automated reticulocyte counting: evaluation of the Coulter® STKS Haematology Analyser reticulocyte counting function

This study evaluated reticulocyte counting with the automated reticulocyte function of the Coulter STKS Haematology Analyser. This is an upgrade option for Coulter STKS and MAXIM haematology analysers. Reticulocyte counts obtained with the automated reticulocyte counting function were compared with those obtained by visual counting. Reticulocyte counting with both methods gave excellent comparability with a correlation coefficient of 0.98. Results were consistent with the well documented imprecision of the manual method with a coefficient of variation (CV) of 16–22%. In contrast, the automated reticulocyte counting function was more precise with a CV of 12.3%. In both cases, counts were stable after storage for 24 h at room temperature and 4 °C. Our results suggest that the use of this upgrade will be beneficial for many laboratories.     

Evaluation of the monocyte counting by two automated haematology analysers compared with flow cytometry

The aim is to determine the monocyte count performance of the Bayer Diagnostics ADVIA120 and Coulter LH 750 automated haematology analysers and the results obtained by these two instruments were compared with those provided by Becton Dickinson FACScan flow cytometer using the combination of CD45/CD14 MoAb. Linearity and imprecision were also evaluated. The linearity of both instruments was good. Coulter LH 750 showed better precision (4.3%) than ADVIA 120 (9.0%) both within and between batch. A significant correlation (r = 0.973) was found between the LH 750 and the flow cytometry method, while a modest one was observed between the latter and the ADVIA 120 (r = 0.880). When comparing the percentage of monocytes by means of one-way anova and Tukey test, it was found that the LH 750 provided the closest results in comparison with flow cytometry, with no statistical difference between the means (mean difference MO% = 0.6); however the difference was statistically different between the ADVIA 120 and flow cytometry (mean difference MO% = -4.06). These data were confirmed by Altman-Bland and Deming regression analyses.