特发性血小板减少性紫癜患者血小板异常直方图的分析

目的通过观察特发性血小板减少性紫癜（ITP）患者血小板计数异常直方图,分析判断血球计数仪计数血小板结果的准确度,是分析后质控的重要步骤,减少误诊和漏诊。方法应用血球计数仪和显微镜计数法分别计数80例临床已确诊的ITP患者血小板,并且观察血小板直方图、MCV、红细胞计数值。两种方法所测的血小板结果进行配对t检验。结果通过观察ITP患者异常血小板直方图：RBC计数和MCV都正常组,血球计数仪法与显微镜计数法比较,血球计数仪血小板计数出现假性减低,p〈0.01,是由于异常蛋白的干扰引起血小板聚集,见图3;RBC计数〉6.0×10^12/L,MCV〈70fL时,血球计数仪法出现假性减低和假性增高同时存在,由于小红细胞的干扰大于异常蛋白的干扰,假性增高显著,p〈0.01,见图4;RBC计数〉6.0×10^12/L,MCV〈70fL,此组患者治愈后,血球计数仪法只出现假性增高,是由于异常蛋白干扰消除,只存在小红细胞的干扰,p〈0.01,见图5。结论 ITP患者血小板计数直方图出现异常时,必须用显微镜计数法复查,ITP患者异常血小板直方图可以作为结果的准确度和疗效观察的指标。

Idiopathic thrombocytopenic purpura in patients with abnormal platelet histogram analysis

Objective Analyze and judge the degree of accuracy of haemacytometer by observing the blood platelet abnormal histogram on ITP patient,which is the important step of quality control after analysis,and can reduce the chance of misdiagnosis and missed diagnosis.Methods Take count of 80 case of clinic ITP patients＇ blood platelet by haemacytometer and microscope respectively,and observe the blood platelet histogram,MCV,the count of red cell.Perform pairing and T test for the results of blood platelet detected by two methods.Results Observe the blood platelet abnormal histogram on ITP patient：RBC counting and MCV are in the normal group;compare the results of haemacytometer and microscope counting method,the blood platelet counting on haemacytometer appears false reduction,p〈0.01,the reason is the platelet conglomeration caused by interference of abnormal paraprotein,see figure 3;when RBC counting is greater than 6.0×10^12/L,and MCV is less than 70fL,the result of blood platelet counting method both appears false reduction and false increase at the same time;because the interference of small red cells larger than the interference of paraprotein,false increase is more conspicuous,p0.01,see figure 4;RBC counting is greater than 6.0×10^12/L,MCV is less than 70fL;after this group of patients have been cured,haemacytometer is going to appear false increase only,the reason is the interference of paraprotein has been cleared,but the interference of small red cells still exist,p〈0.01,see figure 5.Conclusion When the display of blood platelet counting histogram is abnormal,it has need to recheck it by microscope counting method;the blood platelet abnormal histogram on ITP patient can be index of degree of accuracy of results and curative effect observation.