Sysmex UF-1000i尿流式分析仪检测住院患者尿标本类酵母菌的临床评价

目的评价Sysmex UF-1000i尿流式分析仪检测尿标本类酵母菌的分析性能。方法应用尿流式分析仪检测我院住院患者尿标本,对仪器检测类酵母菌阳性尿标本进行镜检、培养鉴定;同时随机选择同期仪器检测阴性标本作对照。结合临床,判断患者尿路类酵母菌定植或感染。结果 2010年10月-2010年12月间共检测6019份尿标本,尿流式分析仪检测类酵母菌阳性127份,经培养证实82份为真阳性。同期仪器检测阴性标本121份中有12份培养阳性。以培养作为金标准,尿流式分析仪分析尿中类酵母菌试验敏感性为87.23%、特异性为70.78%、准确度为77.02%、阳性预测值为64.57%,阴性预测值为90.08%。菌种前三位的是以光滑念珠菌(43.40%)、白念珠菌(21.69%)、热带念珠菌(14.15%)。阿萨希毛孢子菌也存在一定比例(5.66%)。尿中类酵母菌真阳性患者多数患有多种基础疾病,以2型糖尿病(25.61%)、慢性泌尿系统疾病(18.29%)和颅脑脊髓损伤(17.07%)为主;实施的医疗措施以抗细菌药物(52.44%)、留置导尿管(35.37%)多见(P<0.05)。尿流式分析仪检测阴性而培养阳性12例患者均为尿路念珠菌定植。尿流式分析仪检测阳性并且培养阳性82例患者中,69例(84.15%)为类酵母菌尿路定植;13例(15.85%)为尿路感染,其中1(1.22%)例发展为热带念珠菌血症。结论 Sysmex UF-1000i尿流式分析仪对尿标本类酵母菌有较强的筛查价值。实验室应对仪器类酵母菌检测阳性标本进行镜检后确认。临床医师应对类酵母菌检测阳性患者结合其临床表现,采取不同的治疗措施。     

Sysmex XE 2100血细胞分析仪红细胞报警的临床诊断价值

目的评价Sysmex XE 2100全自动血细胞分析仪红细胞报警的临床诊断价值。方法收集我院住院以及门诊患者500例(500份)静脉血标本,用Sysmex XE 2100全自动血细胞分析仪做血常规检测,对400例(份)出现报警信息的标本进行血涂片镜检,评价血细胞分析仪检测红细胞报警的诊断价值。结果血细胞分析仪红细胞报警的特异度为74%,灵敏度为100%,阳性预测值为91.25%,阴性预测值为100%,与金标准镜检的符合率为93%,一致性指标K=0.82,K>0.75。结论 Sysmex XE 2100全自动血细胞分析仪对异常红细胞报警系统的性能良好,特异性好,灵敏度高,符合临床应用要求。     

3种常用溶液配制ABO反定型红细胞的探讨

目的对3种常用溶液配制ABO反定型红细胞悬液进行比较。方法利用生理盐水、低离子溶液、Sysmex血液分析仪用稀释液3种溶液制备2%的红细胞悬液,(4±2)℃冰箱保存,每天对红细胞的凝集强度、红细胞数量和质量、上清液游离血红蛋白进行观察,每3天监测一次细菌生长情况等。观察用3种溶液制备的反定型红细胞的有效期限。结果用Sysmex血液分析仪专用稀释液配制的反定型红细胞有效期仅6 d,用生理盐水配制的反定型红细胞有效期不到24 h,低离子溶液配制的反定型红细胞当天溶血。结论用Sysmex血液分析仪专用稀释液可制备简便的ABO反定型红细胞,有效期6 d;低离子溶液不适用于配制的反定型红细胞;生理盐水配备的反定型红细胞应每天配制。     

Evaluation of bone marrow aspirates using the automated hematology analyzer Sysmex XN-3000

Introduction

This study evaluated the feasibility of the Sysmex XN-3000 automated hematology analyzer for the assessment of total nucleated cells (TNC) and bone marrow (BM) cell density in routine bone marrow aspiration (BMA) samples.

Methods

A total of 54 BMA samples from 39 hematological patients were evaluated. The number of megakaryocytes was calculated by a specific gating algorithm using the body fluid mode of the WBC differential (WDF) channel. Lipid contents were calculated through a newly developed algorithm utilizing the WDF channel. The ratio of lipid particles over TNCs by the WNR channel was compared with the BM cellularity assessed by the BM biopsy. The myeloid/erythroid (M/E) ratio was calculated by measuring the number of myeloid cells in the WDF channel and the number of nucleated red blood cells (NRBCs) in the WNR channel.

Results

XN-3000 counts and microscopic results showed a linear correlation in TNC (R² = .98, p < .001), megakaryocytes (R² = .59, p = .002), NRBC (R² = .84, p < .001), and M/E ratio (R² = .59, p < .001). There were significant differences in the lipid/TNC ratios of hypercellular, normocellular, and hypocellular BMs measured by XN-3000 (p < .001). Receiver-operating characteristic analysis detected cut-off values of the lipid/TNC ratio of >0.4054 for hypoplasia and <0.157 for hyperplasia. The sensitivity and specificity for hypoplasia were 100% and 88%, and for hyperplasia were 89% and 86%, respectively.

Conclusion

XN-3000 provides a quantitative assessment of BM cellularity, supporting the qualitative assessment by myelogram and BM biopsy.     

Hematological reference values of healthy Malaysian population

Health and disease can only be distinguished by accurate and reliable reference values of a particular laboratory test. It is now a proven fact that there is considerable variation in hematology reference intervals depending on the demographic and preanalytical variables. There are evidences that values provided by manufacturers do not have appropriate application for all populations. Moreover, reference ranges provided by different laboratory manuals and books also do not solve this problem. We are presenting here normal reference ranges of Malaysian population. These values were determined by using Sysmex XE-2100 and ACL 9000 hematology and coagulation analyzers. Results from this study showed that there were considerable differences in the reference values from manufacturers, western population or laboratory manuals compared with those from the local population.     

Sysmex UF-100检测儿童和成人红细胞4项参数参考值范围的对比研究

目的 :调查流式SysmexUF 10 0全自动尿液沉渣分析仪 (SysmexUF 10 0 )检测血液中RBC参数参考值范围。方法 :用SysmexUF 10 0对 36 4份不同年龄、性别的健康人全血RBC进行检测。结果 :RBC 4项参数经 t检验 ,成年男女组之间无显著性差异 (P >0 0 5 ) ,合并为成人组 ,儿童组与成年男性组 (P <0 0 5 )或成年女性组之间均有显著性差异 (P <0 0 5 )。其RBC参数参考值范围 :儿童组RBC MFsc 12 2 93± 3 0 2 [ch],RBC Fsc DW 15 4 4± 1 31[ch],RBC MFL 11 85± 0 5 3[ch],RBC FL DWSD 11 5 2± 1 16 [ch]。成人组 116 19± 3 39[ch],14 2 8± 1 37[ch],9 2 6± 0 5 5 [ch],10 2 9± 0 96 [ch]。结论 :SysmexUF 10 0检测血液中RBC 4项参数参考值 ,可为临床应用该仪器诊断贫血 ,提供评价标准     

Sysmex SE-9500血细胞分析仪白细胞分类及异常提示可信性分析

为探讨Sysmex SE-9500血细胞分析仪白细胞分类结果及异常提示的可靠性，取机测无异常提示100例，有至少一种异常提示的标本200例，做血涂片瑞氏染色后进行人工分类计数WBC，统计分析机测结果与人工镜检结果符合率。结果显示Sysmex SE-9500白细胞分类结果在一定范围内且无异常提示者比较可靠，可直接发报告，而对超过此范围或有异常提示的标本必须进行人工镜检，以保证工作质量。     

Sysmex XE-2100全自动血细胞分析仪对形态异常细胞提示功能评价

目的对Sysmex XE-2100全自动血细胞分析仪白细胞分类及形态异常细胞提示功能进行评价。方法对1200例各种住院病人标本，进行血片复检，评价其对异常细胞报警系统的性能。结果Sysmex XE-2100全自动血细胞分析仪对形态异常细胞提示系统具有很高灵敏度，其异常情况报警系统的灵敏度为100％，阴性预示值为100％，阳性预示值为79．55％，特异性是95．60％，可疑警号的假阳性率为12．83％，总检出有效率为96．25％。结论Sysmex XE-2100全自动血细胞分析仪对白细胞分类及形态异常细胞报警系统的功能良好，特异性好，灵敏度高，符合临床应用要求。     

Sysmex XS-800i全自动血细胞分析仪性能评价

目的：评价Sysmex XS-800i全自动血细胞分析仪的性能。方法：对Sysmex XS-800i的准确性、批内、批间精密度、携带污染率、线性、总重复性进行测定，并取60例健康体检标本同时用Sysmex XS-800i和Sysmex 2100测定WBC、RBC、Hb、PLT 4项指标并进行比对，并将这60例标本的Sysmex XS-800i分类结果与手工分类结果进行比较。结果：Sysmex XS-800i的准确性、批内、批间精密度、携带污染率、线性、总重复性均在允许范围内（仪器厂家提供），Sysmex XS-800i和Sysmex 2100对WBC、RBC、Hb、PLT的测定结果据统计学分析无显著性差异（P〉0．05），Sysmex XS-800i分类结果与手工分类结果进行比较，相关性较好。结论：Sysmex XS-800i是一种较理想的全自动血细胞分析仪。     

UF-100尿沉渣分析仪和CX40相差显微镜联合检测鉴别血尿来源的应用价值

目的探讨全自动尿沉渣分析仪和相差显微镜联合检测在鉴别肾源性血尿与非肾源性血尿中的应用价值。方法利用Sysmex UF-100尿沉渣分析仪和Olympus CX40相差显微镜联合检测79例不同来源血尿标本,通过检测和鉴别尿红细胞数、尿红细胞形态大小及尿红细胞前向散射光强度(RBC-Fsc),帮助判断血尿的性质及来源。结果43例肾源性血尿,尿RBC畸形率为85.39%(>80%),当RBC-Fsc≤70ch时,敏感性91.5%,特异性84.6%,诊断符合率93.3%;36例非肾源性血尿,RBC畸形率为13.8%,RBC-Fsc通常>84ch;其中11例混合性血尿,RBC畸形率为67.4%,126ch>RBC-Fsc>84ch。结论UF-100尿沉渣分析仪与CX40相差显微镜联合检测分析尿RBC数、尿RBC形态、RBC-Fsc及提供的定量信息和散点图、直方图数据等指标,能客观、准确地鉴别和诊断血尿的来源。