SYSMEX XN-2000全自动血细胞分析仪对有核红细胞分析的应用评价

目的探讨Sysmex XN-2000全自动血细胞分析仪(简称XN-2000)计数外周血有核红细胞(NRBC)的方法学特性和临床应用价值。方法应用XN-2000对116例外周血标本进行NRBC检测,同时用显微镜(镜检法)对同一份外周血的NRBC百分率进行计数。以镜检法为参考标准,比较不同方法的计数结果。结果 XN-2000检测NRBC的敏感性为98.78%,特异性为94.12%,假阳性率为2.47%,假阴性率为3.03%,检测结果重复性好,低值变异系数(CV)为5.4%,中、高值CV均小于5%。与显微镜镜检法计数外周血中NRBC数量有极好的相关性(r=0.976),且两者差异无统计学意义(P0.05)。结论 XN-2000能快速、准确、有效地自动计数外周血NRBC。     

SYSMEX XN-1000全自动血液分析仪计数有核红细胞的准确性评价

目的探讨SYSMEX XN-1000全自动血液分析仪(简称XN-1000)计数有核红细胞(NRBC)的准确性。方法应用XN-1000对66例外周血标本进行NRBC检测,同时用流式细胞仪(FCM)和显微镜(镜检法)对同一份外周血的NRBC百分率进行计数。以镜检法为金标准,比较不同方法的计数结果。结果 XN-1000与镜检法检测NRBC有较好的相关性(r=0.927),但低于FCM与镜检法NRBC的相关性(r=0.956),XN-1000与FCM检测NRBC的相关性较高(r=0.994)。XN-1000、FCM计数结果与镜检法的结果间差异均无统计学意义(P0.05)。XN-1000检测NRBC%较FCM法有更高的诊断特异性(95.7%)。结论 XN-1000能快速、准确、有效地自动计数外周血NRBC。     

CELL-DYN-Sapphire与XN-9000血液分析仪有核红细胞计数准确性的比较及应用

目的分析比较CELL-DYN-Sapphire血液分析仪(简称CD-Sapphire)和XN-9000血液分析仪(简称XN-9000)有核红细胞(NRBC)参数的检测性能,并根据其性能制定各自的复片镜检规则。方法选取住院患者113例,分别采用CD-Sapphire和XN-9000检测NRBC,并经涂片和瑞氏染色后行人工显微镜镜检,结果以分类计数100个白细胞(WBC)看到的NRBC个数表示(个NRBC/100个WBC)。以人工镜检结果为金标准,评估2种仪器检测NRBC的准确性并制定镜检规则。结果 CD-Sapphire和XN-9000检测NRBC敏感性分别为95.83%和98.61%,特异性分别为56.10%和90.24%。相关性分析显示CD-Sapphire和XN-9000计数NRBC与镜检法均呈正相关(r值分别为0.867、0.974)。Bland-Altman差异图显示,CD-Sapphire与镜检法计数结果差异的95%一致性界限为(-11.05～17.41)个NRBC/100个WBC,XN-9000计数结果差异的95%一致性界限为(-5.08～6.64)个NRBC/100个WBC。在同样满足假阴性率≤5%的复检规则的要求下,CD-Sapphire和XN-9000的NRBC镜检阈值分别为≥1.38个NRBC/100个WBC和≥1.26个NRBC/100个WBC,假阳性率分别为55.56%和22.20%。结论 CD-Sapphire和XN-9000检测外周血NRBC均有较好的检测性能,不同实验室可根据各自需求来选择适合的血液分析仪。     

SYSMEX XN-9000全自动血液分析仪有核红细胞镜检规则的建立与评价

目的探讨SYSMEX XN-9000全自动血液分析仪(简称XN-9000)有核红细胞(NRBC)镜检规则以及白细胞(WBC)计数校正的方法。方法收集716例XN-9000检出0个NRBC/100个WBC的标本,所有标本经瑞氏染色后在显微镜下进行外周血NRBC计数。以镜检法为金标准,评估仪器法计数NRBC的准确性并制定相应的镜检规则及WBC计数的校正公式。结果仪器法与镜检法NRBC计数结果呈明显正相关(r~2=0.981)。Bland-Altman分析显示仪器法与镜检法差异的95%一致性界限为(-0.59±2.73)个NRBC/100个WBC,共有23例(3.21%)标本在一致性界限范围外,二者具有良好的一致性。以人工镜检NRBC计数作为金标准绘制受试者工作特征(ROC)曲线,当设定仪器计数结果≥1.1个NRBC/100个WBC作为镜检规则时,敏感性(87.3%)和特异性(76.5%)最佳,ROC曲线下面积为0.88,但NRBC检出的假阳性率为12.7%,假阴性率为23.5%,不符合ISO 15189的要求(假阴性率≤5%);当设定仪器计数结果≥0.3个NRBC/100个WBC为镜检规则时,假阳性率为49.6%,假阴性率为2.3%,符合要求。当仪器自动校正的WBC计数结果与镜检法校正后的WBC计数结果间偏差5%[1/3允许总误差(TEa)]时,结果应以镜检法为准,仪器计数结果需重新校正,校正公式为WBC=(100×WBC仪器+NRBC仪器×WBC仪器)/(100+NRBC镜检)。结论 XN-9000能快速、准确、有效地自动计数外周血NRBC。当镜检结果与仪器检测结果差异较大时,需重新校正WBC计数。     

XN-9000全自动血液细胞分析仪有核红细胞计数与手工方法验证的探讨

目的探讨日本Sysmex公司生产的XN-9000全自动血液细胞分析流水线有核红细胞(nucleated red blood cell,NRBC)计数,与手工方法进行比较,验证仪器计数结果的准确性。方法对60例全自动血液细胞分析流水线检测出NRBC大于1%的患者的血液标本,制作血液涂片染色后通过传统的显微镜手工方法镜检,验证仪器结果。结果 60例临床标本的NRBC与显微镜计数的结果比较,所有检测值的可信度分析均在可信范围内;相关性比较中,NRBC(%)在1~10和10两组的仪器与手工方法的相关系数(r)分别为0.972 1和0.996 2,差异均无统计学意义(P0.05)。结论无论NRBC值的高低,XN-9000全自动血液细胞分析流水线检测NRBC计数,与手工方法结果比较,均在可信范围内,相关性也较好。仪器检测的NRBC准确可靠,可应用于临床标本的检测。     

XE-5000血液分析仪检测有核红细胞的评价

目的探讨Sysmex XE-5000血液分析仪(简称XE-5000)自动计数外周血有核红细胞(NRBC)的方法学特点,评价其临床应用价值。方法评析XE-5000重复性、线性范围、携带污染率,并对391份静脉血标本做常规测定,评价其对NRBC的报警、定量测定,并与手工涂片法进行对照。结果 XE-5000测定NRBC的重复性较好,线性范围较广,携带污染率较小。当NRBC比例>5.0%时,则引起白细胞计数和淋巴百分比计数假性增多。以显微镜复检为金标准,XE-5000与显微镜计数法计数外周血中NRBC数量有极好的相关性(r=0.997),其NRBC报警的敏感性为100.0%,特异性为85.4%。结论 XE-5000可灵敏、准确、精密地自动计数外周血中NRBC,适合临床检测NRBC。     

BC-6900全自动血液细胞分析仪检测外周血有核红细胞的准确性分析

目的 探讨BC-6900全自动血液细胞分析仪法(简称仪器法)检测外周血有核红细胞(NRBC)的方法 学特点,评价其临床应用价值.方法 同时用仪器法和显微镜检查法(简称镜检法)检测100例外周血标本中的NRBC,以镜检法为金标准,比较不同方法的计数结果 ,并从批内精密度、稳定性、携带污染率、人机比对方面分析BC-6900...     

血细胞分析仪自动计数外周血有核红细胞的应用研究

目的评价血细胞分析仪自动计数外周血有核红细胞(NRBC)的方法学特点,并探讨其临床应用价值。方法选择115例血液病及非血液病患者,用SysmexXE2100全自动血细胞分析仪及显微镜计数法计数其外周血中NRBC数量。结果SysmexXE2100与显微镜计数法计数外周血中NRBC数量有极好的相关性(r>0.97),并且2种方法的计数结果差异无显著意义(P=0.2018)。高值、中值和低值NRBC标本绝对计数的批内CV平均<6.5%。在(0～15)×109/L范围内计数NRBC有极好的线性(r=0.9998)。SysmexXE2100自动计数外周血中NRBC的灵敏度和阴性预测值均为100%。外周血中NRBC增高时,WBC显著高于去除NRBC的计数结果(P=0.0168)。结论SysmexXE2100血细胞分析仪可灵敏、准确、精密地自动计数外周血中NRBC,并且可在NRBC增高的标本中准确计数白细胞数量。除白血病、贫血等血液病患者外,非血液病(如肿瘤化疗)等患者外周血中也可出现NRBC。血细胞分析仪自动计数外周血中NRBC,有助于一些血液病及非血液病患者的筛查与诊断。     

LH750血细胞分析仪检测有核红细胞的准确性评价

目的评价LH750血细胞分析仪检测有核红细胞(NRBC)的准确性。方法应用LH750血细胞分析仪筛查350例标本的NRBC,之后涂片瑞氏染色,用显微镜分别人工计数350例标本的NRBC数量,计算两种方法 NRBC的阳性率、精密度与准确性。结果仪器检测法与手工方法比较,仪器检测结果具有较高的阳性率与精密度;以手工镜检法为金标准,血液分析仪进行外周血NRBC计数的灵敏度、特异性、准确性分别为100.0%、97.3%、97.7%。结论 LH750血细胞分析仪对NRBC有良好过筛功能,可灵敏、准确、快速地自动计数外周血NRBC,有效避免NRBC对白细胞计数及分类的干扰。     

Sysmex XE-2100定量分析外周血有核红细胞方法学探讨

目的 评价Sysmex XE-2100血细胞分析仪自动计数外周血中有核红细胞(NRBC)的方法学特点,并探讨其临床应用价值.方法 对115例血液病及非血液病患者,用Sysmex XE-2100和显微镜计数法计数其外周血中NRBC数量.结果 SysmexXE-2100与显微镜计数法计数外周血中NRBC数量有极好的相关性(γ>0.97),并且两种方法的计数结果无显著性差异(P=0.2018).高值、中值和低值NRBC标本绝对计数的批内CV平均<6.5%.在(0～15)×109/L范围内计数NRBC有极好的线性(γ=0.9998).结论 XE-2100血细胞分析仪可灵敏、准确、精密地自动计数外周血中NRBC,并且可在NRBC增高的标本中准确计数白细胞数量,同时有助于一些血液病及非血液病患者的筛查与诊断.     

Peripheral blood stem cell collection with a blood cell separator

Forty-three patients with malignant nonmyeloid diseases underwent peripheral blood stem cell collections on an apheresis system (Spectra, COBE BCT, Lakewood, CO). Collections took place during the white cell (WBC) recovery phase following conditioning chemotherapy. One hundred two procedures were done after chemotherapy alone, and 72 procedures after chemotherapy plus granulocyte-colony-stimulating factor (G-CSF). Four centrifugal separation factors were tested. One and one-half patient blood volumes were processed in each procedure. The mean volume of the collected component was 158 +/− 16 mL. After chemotherapy alone, the procedures provided a mean of 0.8 × 10(8) WBCs per kg and 2.3 × 10(4) colony-forming units-granulocyte macrophage (CFU-GM) per kg of recipient body weight. The mononuclear cell percentage in the components increased with the centrifugal separation factor from 85 to 96 percent. In parallel, platelet contamination increased from 2.1 to 3.8 × 10(11). The collect hematocrit ranged from 1.0 to 2.5 percent (0.01-0.025). The collection efficiency for mononuclear cells and CFU- GM also increased with the centrifugal separation factors from 52 to 70 percent for mononuclear cells and from 55 to 68 percent for CFU-GM. Collections performed after G-CSF-stimulated mobilization were characterized by a higher neutrophil contamination independent of centrifugal separation factor, which gave a mean mononuclear cell percentage of 64 percent in the collected component. The average yield for these procedures was 2 × 10(8) WBCs per kg and 28 × 10(4) CFU-GM per kg.(ABSTRACT TRUNCATED AT 250 WORDS)     

全自动血细胞分析仪与血细胞形态学检验在血常规检验中的应用价值

目的比较全自动血细胞分析仪和血细胞形态学检验在血常规检验中的应用价值。方法选择2019年6月至2019年7月在本院进行血常规检验的3 000例患者为研究对象,将所有患者的样本均分为A、B两份,分别采用全自动血细胞分析仪和全自动血细胞形态学数字图像分析仪检查。以人工显微镜检查结果作为金标准,比较两种检验方式的白细胞异常检测结果。结果 A组检测结果显示,3 000例患者样本的阳性率为3.67%,灵敏度为90.99%,特异度为99.69%;B组检测结果显示,3 000例患者样本的阳性率为3.67%,灵敏度为97.30%,特异度为99.93%。B组检测的灵敏度高于A组(P<0.05)。结论全自动血细胞形态学数字图像分析仪在白细胞异常检测中的灵敏度高于全自动血细胞分析仪,具有效率高、速度快的优势,但仍不能替代人工镜检。     

Red blood cell storage and cell morphology

Aim: In this study, we performed weekly assessment of morphology‐related parameters through monitoring of CPD‐SAGM leuco‐filtered erythrocyte concentrates from blood withdrawal until the 42nd day of storage. Background: Liquid storage of red blood cells (RBCs) delivers a blood‐derived therapeutic, which is safe, available, effective and affordable for most patients who need transfusion therapy in developed countries. However, a growing body of accumulating controversial evidences, from either biochemical or retrospective clinical studies, prompted safety concerns about longer stored RBCs. Methods: Statistical image analysis through scanning electron microscope was coupled to osmotic fragility and erythrocyte sedimentation rate. Results: We could observe that by day 21 more than 50% of RBCs displayed non‐discocyte phenotypes. This observation was related to an increase in osmotic fragility, which was totally overlapped in day 0 controls and day 7 RBCs while only slightly augmented in day 14 samples. Cation dysregulation (pH internal/external alteration and potassium) might both reflect and trigger a negative feedback loop with metabolic fluxes and membrane cation pumps. Conclusion: Morphology parameters suggest that significant alterations to RBC morphology over storage duration occur soon after the 14th day of storage, as to become significant enough within the 21st day.     

Red blood cell alloimmunization among sickle cell Kuwaiti Arab patients who received red blood cell transfusion

BACKGROUND: Sickle cell disease (SCD) is common in the Arabian Gulf region. Most cases require a red blood cell (RBC) transfusion, increasing the potential for RBC alloantibody development. The incidence of RBC alloimmunization among Kuwaiti Arab SCD patients is not yet known. This study retrospectively assessed the effect of using two different matching protocols on the incidence of alloimmunization among multiply transfused Kuwaiti Arab SCD patients.
STUDY DESIGN AND METHODS: A total of 233 Kuwaiti Arab SCD patients were divided into two groups: Group 1 (n = 110) received RBC transfusion through standard ABO- and D-matched nonleukoreduced blood; Group 2 (n = 123) received RBCs matched for ABO, Rh, and K1 poststorage-leukoreduced blood. Multivariate analysis was performed on the factors associated with RBC alloimmunization and antibody specificity.
RESULTS: Sixty-five percent of patients in Group 1 developed clinically significant RBC alloantibody with an increased prevalence in females; in patients in Group 2, 23.6% developed RBC alloantibodies (p = 0.01). In Group 1, 72 patients (65.5%) had alloantibodies directed against Rh and Kell systems (p = 0.01). Multivariate analysis further confirmed the results, showing that blood transfusion type and sex have significant effects on the rate of alloimmunizations.
CONCLUSION: This study confirms the importance of selecting RBCs matched for Rh and Kell to reduce the risk of alloimmunizations among Kuwaiti Arab SCD patients.     

Comparison of two blood cell separators in collecting peripheral blood stem cell components

To ensure that a sufficient number of CD34+ cells are collected for an allogeneic blood progenitor cell transplant, the most effective blood cell separator should be used to collect peripheral blood stem cell (PBSC) components. We compared the effectiveness of two blood cell separators. We gave 29 healthy people 7.5 or 10 μg kg^?1 of granulocyte colony stimulating factor (G-CSF) daily for 5 days and collected one PBSC component with either a Fenwal CS3000 (n = 15) or a Cobe Spectra (n = 14) blood cell separator. The volume of blood processed was the same for each machine (8.4 ± 1.0 L; range = 4.9–9.4 L for the CS3000 and 8.9 ± 1.0 L; range 6.7–10.9 L; P = 0.71). The components collected with the CS3000 contained more mononuclear cells (39.6 ± 21.9 × 10⁹ compared with 26.9 ± 5.6 × 10⁹, P = 0.02) and fewer neutrophils (1.38 ± 1.88 × 10⁹ compared with 5.53 ± 8.71 × 10⁹, = 0.001). The total number of CD34+ cells collected with the two instruments was the same (470 ± 353 × 10⁶ for the CS3000 and 419 ± 351 × 10⁶ for the Spectra; P = 0.64) as was the number of CD34+ cells collected per litre of whole blood processed (55.9 ± 42.0 × 10⁶ L^?1 compared with 45.9 ± 37.9 × 10⁶ L^?1; P = 0.59). The mononuclear cell collection efficiency was greater for the CS3000 (82.4 ± 54.9% compared with 53.3 ± 14.1; P = 0.04) but the CD34+ cell collection efficiencies were the same (87.4 ± 61.1% for the CS3000 compared with 56.3 ± 23.5% for the Spectra; P = 0.07). In conclusion, both blood cell separators collected components which contained large numbers of CD34+ cells, but those collected with the CS3000 contained fewer neutrophils and the CS3000 was more efficient at collecting mononuclear cells.