HemoCue Hb 301血红蛋白分析仪在献血者筛查中的适用性分析

目的分析比较HemoCue Hb 301血红蛋白分析仪在献血者筛查中的适用性。方法随机选取街头60例献血者血样本使用HemoCue Hb 301血红蛋白分析仪和全自动血细胞分析仪检测血红蛋白(Hb),以全自动血细胞分析仪结果为参考,进行比较分析;取医院体检人群30个中轻度贫血的标本用HemoCue Hb 301血红蛋白分析仪检测Hb与全自动血细胞分析仪的结果进行比对分析;在街头献血者初筛中试用一段时间与传统的硫酸铜比重目测法进行比较。结果 HemoCue Hb301血红蛋白分析仪检测结果与Sysmex-kx 21N全自动血细胞分析仪比较,无统计学意义。献血者和中轻度贫血的批内精密度为0.74%和1.08%。硫酸铜比重目测法献血者淘汰率为2.05%,HemoCue Hb 301血红蛋白分析仪检测献血者淘汰率为2.39%。结论 HemoCue Hb 301血红蛋白分析仪批内精密度和准确度高,偏倚度可接受,操作轻便、快速、容易标准化,能准确定量献血者的Hb含量,数据可查,更符合血站质量管理规范的要求。很适合于街头献血者的初筛,尤其是以集体献血模式为主的采供血机构。     

Sysmex XE-5000血液分析仪体液模式白细胞计数准确性的探讨

目的探讨Sysmex XE-5000全自动血液分析仪体液模式检测白细胞计数的准确性。方法采集该院住院患者的脑脊液、胸腔积液和腹水标本共46例,分别用Sysmex XE-5000全自动血液分析仪和BD FACSCalibur流式细胞仪进行白细胞计数,将两者检测结果进行比较分析。结果第1组标本采用血液分析仪、流式细胞术计数法进行白细胞计数的结果比较,差异无统计学意义（P〉0.05）;第2组,2种计数法的结果比较,差异有统计学意义（P〈0.05）。相关性分析显示2种方法的结果具有很好的相关性。结论 Sysmex XE-5000全自动血液分析仪体液模式的白细胞计数,其结果有良好的准确性,可满足临床工作的要求。     

XN-9000全自动血液分析仪性能评价

目的：系统评价Sysmex XN-9000全自动血液分析仪性能。方法以国际血液学标准化委员会（ICSH）、美国临床和实验室标准协会（CLSI）及WS/T 406-2012临床血液学检验常规项目分析质量要求的评价标准对其性能进行评价。结果 XN-9000全自动血液分析仪检测的白细胞计数（WBC）、红细胞计数（RBC）、血红蛋白（HGB）、红细胞压积（HCT）、平均红细胞体积（MCV）、平均红细胞血红蛋白含量（MCH）、平均红细胞血红蛋白浓度（MCHC）、血小板计数（PLT）的精密度、线性、正确度及准确度良好,其检测WBC、RBC、HGB、PLT的携带污染率均＜0.5%,其检测WBC、RBC、HGB、HCT、PLT的结果与Sysmex XE-5000全自动血液分析仪的可比性良好,并对这5个项目的不确定度进行了计算。结论 Sysmex XN-9000全自动血液分析仪分析性能良好。     

Sysmex XN-1000型全血细胞分析仪的性能评价

目的探讨Sysmex XN-1000全自动血细胞分析仪检测血液标本的性能进行评价研究。方法根据中华人民共和国卫生行业标准(WS/T 406-2012)规定的验证方法,对Sysmex XN-1000检测白细胞、红细胞、血红蛋白和血小板的本底计数、携带污染、精密度、线性和正确度进行系统评价,评价试验的结果与行业标准规定的临床血液学检验常规项目(全血细胞计数)的分析质量要求相比较。结果 Sysmex XN-1000全自动血细胞分析的本底计数、携带污染、精密度、线性和正确度均在行业标准质量要求的允许范围内。结论 Sysmex XN-1000全自动血细胞分析性能评价合格,适用于临床实验室的血液常规检测。     

两种计数法检测网织红细胞对比分析

目的观察Sysmex XT-2000i全自动血液分析仪与手工计数法检测网织红细胞数结果准确性及影响因素。方法采用Sysmex XT-2000i全自动血液分析仪及手工法分别对350例患者进行网织红细胞测定。结果两种计数网织红细胞方法对比差异无统计学意义(P>0.05),相关性良好,r=0.953,而Sysmex XT-2000i全自动血液分析仪计数高中低值网织红细胞的重复性均优于人工显微镜目测计数。结论 Sysmex XT-2000i全自动血液分析仪检测法较手工法Ret计数方便、快捷、精密度高、准确性好、检测参数多、干扰少等优点,在大、中型医疗机构中可广泛应用。     

两种方法检测异型淋巴细胞结果比较

目的对异型淋巴细胞人工镜检结果与Sysmex XS-800i血液分析仪异型淋巴细胞提示结果进行比较,评价Sysmex XS-800i血液分析仪异型淋巴细胞提示的价值。方法收集该院进行异型淋巴细胞计数的标本262例。手工检验异型淋巴细胞计数的标本同时送Sysmex XS-800i血液分析仪进行检测,将结果进行统计学分析。结果不同的人工异型淋巴细胞计数比例和Sysmex XS-800i提示信息符合率均较高,4组符合率不全相同,符合率差异无统计学意义(P>0.05)。结论 Sysmex XS-800i全自动血液分析仪对异型淋巴细胞提示的检出率及符合率较高,根据提示信息,检验人员应该及时进行人工镜检,将检测结果反馈给临床。     

Sysmex XN-1000全自动血液分析仪体液模块性能评价分析

目的对Sysmex XN-1000全自动血液分析仪的体液检测进行性能评价,以验证其检测体液标本的能力。方法 Sysmex XN-1000在体液模式下检测临床体液标本,按美国临床实验室标准协会文件的要求对Sysmex XN-1000血液分析仪进行空白计数、携带污染率、精密度、线性范围等参数进行性能评价,再与手工计数结果进行比对。结果 Sysmex XN-1000检测体液标本白细胞计数和红细胞计数的空白计数极低;携带污染率低于0.5%;精密度高(CV%7.5%);线性良好(相关系数r0.99),以上参数符合仪器检测要求。与手工计数法结果比较,差异无统计学意义(P0.05)。结论 Sysmex XN-1000全自动血细胞分析仪体液检测模块的主要评估指标均符合仪器厂家检测要求,能够满足临床实验室的工作需求,适用于临床体液标本的检测。     

Sysmex XE-5000全自动血液分析仪高荧光体液细胞计数在脑膜癌诊断中的应用

目的：评价 Sysmex XE-5000全自动血液分析仪高荧光体液细胞(HF-BF)计数性能,并分析其在脑膜癌诊断中的应用价值。方法通过精密度试验和方法学比较试验对 HF-BF 进行性能评价;回顾性分析厦门大学附属中山医院2010年6月至2012年9月295份脑脊液的 HF-BF 检测结果。结果Sysmex XE-5000全自动血液分析仪 HF-BF 计数精密度高、与细胞学检查一致性好。脑膜癌组每百个白细胞检测到的高荧光体液细胞数(HF-BF%)高于其他脑疾病组,两两比较差异有统计学意义(P <0.05)。当 HF-BF%为4.3%时,受试者工作特征(ROC)曲线下面积(AUC)为0.933,灵敏度为95.2%,特异度为92.7%,即 HF-BF%大于4.3%时,脑脊液检出肿瘤细胞的可能性大。结论Sysmex XE-5000全自动血液分析仪 HF-BF 参数是脑膜癌早期诊断的有效参考指标,具有较好的临床应用价值。     

对2种血红蛋白快速检测仪的质量评价

目的选择合适的血红蛋白仪对献血者进行检测,保证献血者安全,保证血液质量。方法以Abbott全自动血细胞分析仪结果为准,对2种血红蛋白快速检测仪结果与全自动血细胞分析仪结果比较其准确性与精密度,统计学方法采用t检验。结果A公司血红蛋白仪检测28份标本结果（x±s）109．93±14．78,B公司血红蛋白仪检测28份标本结果（X±s）86．00±7．95,与Abbott全自动血细胞分析仪结果（X±s）115．68±17．01比较,A血红蛋白仪检测结果无统计学意义,B公司血红蛋白仪存在差异,精密度分别为1．36％、6．42％。结论A优于B血红蛋白快速检测仪。     

HemoCue白细胞计数仪性能评价

目的通过HemoCue白细胞计数仪(简称HemoCue)与XT-1800i全自动五分类血液分析仪(简称XT-1800i)的比对,对HemoCue的性能作初步评定。方法通过双盲的方法对2台仪器检测的白细胞(WBC)总数进行比对,评价HemoCue的准确度、精密度等。结果 HemoCue测得的变异系数(CV)4.5%,相关系数(r)98%,说明该仪器具有优良的准确度、精密度;同时评价了该方法的检测时间窗口,在1~17 min时间范围内,检测结果无明显变化。结论 HemoCue与XT-1800i测得WBC数目相近,具有较好的可比性,且便携性好、操作简便、价格低,适用于应急救援现场、基层诊所等地进行WBC总数测定。     

Accuracy of noninvasive and invasive point-of-care total blood hemoglobin measurement in an outpatient setting

Objective: The purpose of this study was to determine the accuracy of noninvasive hemoglobin measurement using pulse CO-oximetry (Pronto? SpHb?, Masimo Corp.) and a commonly used, invasive, point-of-care, automated spectrophotometer (HemoCue 201+?, HemoCue, Inc.), in comparison with hemoglobin measurements obtained from a laboratory hematology analyzer (measuring total blood hemoglobin) in the outpatient setting. Methods: Adult patients presenting to an outpatient research clinic were tested for total blood hemoglobin measurement by 3 methods: noninvasive pulse CO-oximetry (SpHb?), finger-stick blood sample on a point-of-care device, and venous sample on a laboratory hematology analyzer (reference device). Bias and standard deviation (SD) of SpHb? and HemoCue 201+? compared with the values obtained with the laboratory hematology analyzer were calculated and Bland-Altman graphs were generated. Results: Samples from 152 subjects were assessed (average age, 46 years; 69% female). The bias ± SD compared with the reference method was -0.5 ± 1.0 g/dL for SpHb? and 0.3 ±1.0 g/dL for HemoCue 201+?. The Bland-Altman plots assessing agreement of the test methods to the reference method had limits of agreement of -2.5 to 1.5 g/dL for SpHb? and -1.7 to 2.3 g/dL for HemoCue 201+?. A noninvasive measurement could not be obtained in 4 subjects after 2 attempts (2.5% failure rate), whereas the HemoCue 201+? measurements were obtained for all subjects. Conclusion: Noninvasive SpHb? testing had bias and SD similar to those of HemoCue 201+?. Because SpHb? measurement is noninvasive, it may offer additional patient and provider benefits.     

血常规标本存放条件对血细胞计数的影响

目的 探讨血常规标本存放条件对检测结果的影响.方法 所有全血标本室温或4 ℃条件下存放,连续5 d应用Sysmex KX-21全自动血细胞分析仪进行检测,并进行统计学分析.结果 室温下存放标本,白细胞(WBC)于48 h、红细胞(RBC)于96 h、血小板(PLT)于24 h、血红蛋白(Hb)于120 h、血细胞比容(...     

Determination of capillary hemoglobin levels using the HemoCue system in intensive care patients

Purpose

The study aimed to compare hemoglobin (Hb) values determined using the portable HemoCue system (HemoCue Hb 201+; HemoCue AB, Ängelholm, Sweden) with laboratory Hb level determination.

Materials and Methods

Adult patients hospitalized in our surgical intensive care unit who required an Hb level determination were included. To determine Hb level, one drop of arterial (A) or venous (V) blood was analyzed using HemoCue (HemoCue_[A/V]), and also with an automated analyzer in the laboratory (Hb reference method, or Hb Lab_[A/V]). Capillary blood (Cap) sample obtained simultaneously by fingerstick was analyzed using HemoCue (HemoCue_[Cap]). Factors that could interfere with the accuracy of fingerstick measurements were also studied. Paired Hb level measurements were compared by Bland and Altman analysis (Hb Lab_[A/V] vs HemoCue_[A/V] and HemoCue_[Cap]).

Results

One hundred fifty blood samples were obtained from 79 patients. The mean absolute differences between Hb Lab [A] and HemoCue [A], Hb Lab [V] and HemoCue [V] and Hb Lab [A/V] and HemoCue [Cap] were 0.1 g/dl (95% confidence interval, −1.9 to + 2.2 g/dl), 0.1 g/dl (95%CI, −2.5 to +2.6 g/dl) and 1.1 g/dl (95%CI, −3.6 to + 5.8 g/dl, respectively. Edema was the sole independent risk factor for discordance between HemoCue_[Cap] and Hb Lab_[A/V] (odds ratio, 6.65; 95% CI, 1.99-22.21; P < .001].

Conclusions

Hemoglobin level determination using HemoCue should not be used in critically patients, especially when capillary blood samples are used and/or in presence of edema.     

高脂血对两种方法测定血红蛋白的影响及其校正

目的 观察高脂血对两种不同方法测定血红蛋白(Hb)的影响,并寻求校正高脂血干扰Hb测定的方法.方法 用Sysmex XE-5000全血细胞分析仪(十二烷基磺酸钠比色法,SLS-Hb法)及SIEMENS ADVIA2120全血细胞分析仪(氰化高铁Hb测定法,HiCN法)对30份高脂血标本进行全血细胞分析,低速离心后分别用等量生理盐水和仪器配套稀释液替代上层浑浊血浆,混匀后进行Hb测定,同时根据文献报道的Hb估算公式估算Hb值.结果 两种方法测定的直接测定组Hb、平均红细胞血红蛋白(MCH)、平均红细胞血红蛋白浓度(MCHC)均明显高于生理盐水组、稀释液组和估算组.结论 高脂血均造成两种方法测定Hb假性升高,生理盐水或稀释液等量置换血浆能消除高脂血对Hb测定的影响,可避免高脂血因素的影响,并能对Hb比色测定结果进行校正.     

Anemia screening in potential female blood donors: comparison of two different quantitative methods

BACKGROUND: Anemia screening before blood donation requires an accurate, quick, practical, and easy method with minimal discomfort for the donors. The aim of this study was to compare the accuracy of two quantitative methods of anemia screening: the HemoCue 201⁺ (Aktiebolaget Leo Diagnostics) hemoglobin (Hb) and microhematocrit (micro‐Hct) tests. STUDY DESIGN AND METHODS: Two blood samples of a single fingerstick were obtained from 969 unselected potential female donors to determine the Hb by HemoCue 201⁺ and micro‐Hct using HemataSTAT II (Separation Technology, Inc.), in alternating order. From each participant, a venous blood sample was drawn and run in an automatic hematology analyzer (ABX Pentra 60, ABX Diagnostics). Considering results of ABX Pentra 60 as true values, the sensitivity and specificity of HemoCue 201⁺ and micro‐Hct as screening methods were compared, using a venous Hb level of 12.0 g per dL as cutoff for anemia. RESULTS: The sensitivities of the HemoCue 201⁺ and HemataSTAT II in detecting anemia were 56 percent (95% confidence interval [CI], 46.1%‐65.5%) and 39.5 percent (95% CI, 30.2%‐49.3%), respectively (p < 0.001). Analyzing only candidates with a venous Hb level lower than 11.0 g per dL, the deferral rate was 100 percent by HemoCue 201⁺ and 77 percent by HemataSTAT II. The specificities of the methods were 93.5 and 93.2 percent, respectively. CONCLUSION: The HemoCue 201⁺ showed greater discriminating power for detecting anemia in prospective blood donors than the micro‐Hct method. Both presented equivalent deferral error rates of nonanemic potential donors. Compared to the micro‐Hct, HemoCue 201⁺ reduces the risk of anemic female donors giving blood, specially for those with lower Hb levels, without increasing the deferral of nonanemic potential donors.     

Sysmex XE-2100血细胞分析仪定量分析外周血幼稚粒细胞性能评价

目的评价Sysmex XE-2100血细胞分析仪定量分析外周血幼稚粒细胞（1G）的性能。方法选取202份XE-2100IG报警值〉200的样本．分别采用XE-2100和镜检分析IG％,评价两者之间相关性,选取5份不同IG％水平的样本进行XE-2100批内精密度（重复性）评价,分别选取8份标本在4℃和室温进行样本稳定性评价。结果XE-2100分析IG％结果与镜检结果具有良好的相关性（γ=0．8382,P〈0．001）;5份不同IG％水平样本重复性的变异系数（CV）从4．93％N15．5％;XE-2100分析4℃和室温保存24小时内的样本结果稳定。结论XE-2100定量分析外周血幼稚粒细胞性能良好,基本满足临床实验室要求。     

不同医院全血细胞计数比对实验结果分析

目的分析3家医院不同分析仪全血细胞计数比对实验结果。方法以西安交通大学第二附属医院(简称交大二院)采用的日本希森美康公司XE-2100型全自动血细胞分析仪(简称XE-2100分析仪)作为参比仪器,以西京医院采用的日本希森美康公司XN-3000分析仪(检测XN-3000分析仪)及唐都医院采用的XE-2100作为实验仪器,按照美国临床和实验室标准化协会(CLSI)发布的EP9-A2文件的要求,对白细胞(WBC)、红细胞(RBC)、血红蛋白(Hb)、血小板(PLT)、红细胞比容(HCT)检测结果进行比对分析,计算检测结果相关系数(r),以美国临床实验室修正法规(CLIA′88)规定的室间质量评价总允许误差范围为标准,判断检测结果偏差是否可接受。结果交大二院XE-2100分析仪和西京医院XN-3000分析仪WBC、RBC、Hb、HCT检测结果的r值分别为0.998、0.998、0.984、0.981,相关性良好,PLT检测结果的r值为0.953,相关性不佳;WBC、RBC、Hb、HCT检测结果比较差异无统计学意义(P0.05),但PLT检测结果比较差异有统计学意义(P0.05)。交大二院XE-2100分析仪和唐都医院XE-2100分析仪WBC、RBC、PLT、Hb、HCT检测结果的r值分别为0.999、0.999、0.998、0.999、0.998,相关性良好;各参数检测结果比较差异无统计学意义(P0.05)。结论不同医院全血细胞计数部分参数检测结果相关性良好,检测结果可以互认。     

Accuracy of Noninvasive and Invasive Point-of-Care Total Blood Hemoglobin Measurement in an Outpatient Setting

Abstract

Objective: The purpose of this study was to determine the accuracy of noninvasive hemoglobin measurement using pulse CO–oximetry (Pronto® SpHb®, Masimo Corp.) and a commonly used, invasive, point–of–care, automated spectrophotometer (HemoCue 201+®, HemoCue, Inc.), in comparison with hemoglobin measurements obtained from a laboratory hematology analyzer (measuring total blood hemoglobin) in the outpatient setting. Methods: Adult patients presenting to an outpatient research clinic were tested for total blood hemoglobin measurement by 3 methods: noninvasive pulse CO–oximetry (SpHb®), finger–stick blood sample on a point–of–care device, and venous sample on a laboratory hematology analyzer (reference device). Bias and standard deviation (SD) of SpHb® and HemoCue 201+® compared with the values obtained with the laboratory hematology analyzer were calculated and Bland–Altman graphs were generated. Results: Samples from 152 subjects were assessed (average age, 46 years; 69% female). The bias ± SD compared with the reference method was ?0.5 ± 1.0 g/dL for SpHb® and 0.3 ± 1.0 g/dL for HemoCue 201+®. The Bland–Altman plots assessing agreement of the test methods to the reference method had limits of agreement of +2.5 to 1.5 g/dL for SpHb® and +1.7 to 2.3 g/dL for HemoCue 201+®. A noninvasive measurement could not be obtained in 4 subjects after 2 attempts (2.5% failure rate), whereas the HemoCue 201+® measurements were obtained for all subjects. Conclusion: Noninvasive SpHb® testing had bias and SD similar to those of HemoCue 201+®. Because SpHb® measurement is noninvasive, it may offer additional patient and provider benefits.     

Bland-Altman 分析法评价 GEM Premier 3000血气分析仪与BC-5800血液细胞分析仪检测血红蛋白及血细胞比容的相关性和一致性

【目的】使用Bland-Altman分析法评价床边血气分析仪检测血红蛋白（Hb）及血细胞比容（HCT ）结果与中心实验室检测结果是否具有相关性及一致性。【方法】对100份动脉血标本分别使用迈瑞BC-5800血液分析仪及GEM Premier 3000血气分析仪行Hb及 HCT检测,并对结果行相关性分析及Bland-Altman分析。【结果】两种方法所测得Hb的相关系数 r ＝0．807,P ＜0．01,回归方程为Y＝24．163＋0．742X ,两组方法所测得 HCT的相关系数 r ＝0．709,P ＜0．01,回归方程为 Y＝8．881＋0．635X ,两组数据均有较好的相关性。但经Bland-Altman法分析,Hb及HCT检测95％的可信区间均在临床可以接受的界限之外,一致性欠佳。【结论】GEM 血气分析仪与BC血液细胞分析仪方法测得指标均有较好的相关性,但一致性欠佳。床边即时检验尚无法完全替代传统检验方法。     

高白细胞对血细胞分析仪检测红细胞和血红蛋白的影响

目的探讨高白细胞(WBC)(>70×109/L)对XE2100和LH750血细胞分析仪测定红细胞和血红蛋白的影响。方法采集65例WBC>70×109/L(19例WBC≥250×109/L、19例150×109/L70×109/L)组两种方法测定WBC差异无统计学意义(P>0.05),而RBC和Hb差异有统计学意义(P<0.05);对照组WBC、RBC和Hb检测结果均一致。线性回归提示WBC对两种方法测定RBC和Hb的差异具有正相关性的影响。结论 XE2100与LH750检测高WBC(>70×109/L)患者血样的RBC和Hb差异有统计学意义,临床应用应引起重视。