两种方法检测尿沉渣中管型结果对比分析

目的：比较UF-1000i尿沉渣分析仪与尿沉渣显微镜两种检查方法在尿液管型检测中的优缺点。方法收集600例患者的尿液标本,用UF-1000i尿沉渣分析仪与显微镜两种仪器检测尿沉渣中的管型,比较分析结果。结果 UF-1000i尿沉渣分析仪检测尿中管型的检出率为12.7%,特异度为94.9%,灵敏度为92.3%,假阴性率5.1%,假阳性率7.7%;尿沉渣显微镜检查尿中管型的阳性率为8.7%。结论 UF-1000i尿沉渣分析仪检测尿中管型时存在较多的假阳性和假阴性,如果将尿沉渣分析仪与显微镜检查联合应用,可以提高管型检测的准确率,为临床诊断提供可靠依据。     

Correlation between the cell population in the automated hematology analyzer high‐fluorescence region and atypical lymphocyte flags

Introduction

During routine blood measurements using an automated hematology analyzer, two easily confused types of suspect flags related to lymphocytes often appear: atypical and immature lymphocytes. The aim of this study was to investigate the correlation of high fluorescence cell (HFC) parameter and lymphocyte flags determined from an automated hematology analyzer.

Methods

A total of 93 patients affected by various pathologic conditions (viral infection, immunological disease, oncological disease and tumor) were divided into an “atypical lymphocytes” group (“atypical” for short), an “immature lymphocytes/blasts” flag group (abnormal), a mixed‐flag group that includes “atypical lymphocytes” (mixed), and a non‐flag group (non‐flag).

Results

The numbers of HFCs in the atypical, abnormal, mixed, and non‐flag groups were 1.8% (0.9%‐5.5%), 0.7% (0.1%‐5.0%), 2.3% (1.2%‐5.0%), and 0.8% (0.7%‐1.2%), respectively. The HFCs of “atypical” appeared as a separate cluster with clear boundaries. The HFCs of “abnormal” as an unclear boundaries, and it was difficult to accurately distinguish between the HFCs from the immature lymphocytes and the normal lymphocytes. The lower limit of HFC when the atypical lymphocyte flag appeared was 0.04 × 10⁹/L. The number of HFCs was similar to atypical lymphocytes detected by microscopy and CD19⁺CD20⁻CD27⁺⁺ cells by flow cytometry at 78% and 76%, respectively. The number of HFCs detected in “atypical” and CD19⁺CD20⁻CD27⁺⁺ cells showed good consistency (r = .715), whereas the consistency was poorest for “abnormal” (r = .176).

Conclusion

It demonstrates that HFCs reflects atypical lymphocytes better than immature lymphocytes/blasts.

     

均相酶免技术与治疗药物监测

均相酶免疫技术是一种基于液相均相竞争性反应体系的免疫测定技术,目前,基于该技术建立的药物浓度测定方法以其独特优势已成功应用于临床治疗药物和兴奋剂等小分子以及蛋白质等大分子的检测,但大多依靠进口试剂。本文对均相酶免疫技术的研究现状、技术原理、技术优点进行了综述,重点介绍了该技术在治疗药物监测方面的临床应用以及需要注意的问题,并对该技术的应用前景进行了展望。该技术具有检测速度快、特异性强、自动化程度高等优点,但面临进口试剂价格昂贵、运送周期长等问题,因此我国对该技术的自主研发平台及试剂需求显得尤为迫切。     

Influence of treatment and response status on infection risk in multiple myeloma

The clinical course of 60 patients with multiple myeloma was examined for risk factors associated with infection. The overall incidence of infection was 1.46 per patient-year. The greatest risk period for the occurrence of infection was the first two months after the start of initial chemotherapy. The incidence of infection during this period was 4.68 infections per patient-year compared with 1.04 infections per patient-year for subsequent months. Serum creatinine levels of 2 mg/dl or more (p < 0.03) and decreased polyclonal serum immunoglobulins (p < 0.01) predicted increased risk of early infections. Patients infected during the first two months of initial chemotherapy had the same rate of infection during the subsequent clinical course as did patients free of infection during the early treatment period. Thus, the early risk period does not represent only the attrition of susceptible patients. Patients who achieved an objective response had a decrease in infection risk during the time of the response (0.44 infections per patient-year). While response to chemotherapy prolongs life in multiple myeloma, the initiation of chemotherapy is associated with a definable risk period for infections.     

Multiple myeloma in a patient with sickle cell anemia: Interacting effects on blood viscosity

Described here is a case of multiple myeloma in a patient with sickle cell anemia. Viscometric studies were made by comparing the patient's whole blood, plasma and washed red blood cells with those of a normal control subject and a patient with sickle cell anemia. Results showed that the increased viscosity of the patient's whole blood as compared with that of the control patient with sickle cell anemia was mainly due to erythrocytic Interaction with the circulating abnormal immunoglobulin. It is postulated that the increased frequency of vaso-occlusive crisis that occurred in our patient in the months before the diagnosis and treatment of multiple myeloma, was due to this cell-protein interaction with the resulting enhancement of whole blood viscosity and the sickling phenomena.