血细胞分析儿科复检规则的应用评价

目的对本室XS-800i血细胞五分类分析试行复检规则在儿科领域应用给予评价。方法参照国际实验血液学学会推荐的41条复检规则,结合儿科疾病诊疗的特点,参照SysmexXS-800i五分类血细胞分析仪异常报警提示信息,建立本室25条复检规则。随机选取1348份患儿抗凝全血标本,采用血细胞分析仪检测,同时进行血涂片人工镜检,对试行复检规则效果进行评估。定向选取184份标本对修订后的复检规则进行验证。结果试行版儿科复检规则评估复检率为30.2%,真阳性率为10.0%,假阳性率为20.2%,真阴性率为66.9%,假阴性率为2.9%。135份真阳性标本中第1位是异型淋巴细胞。272份假阳性标本中第1位是异型淋巴报警。修订复检规则将异型淋巴报警Q-Flags阈值从100调整到300,并增加红系IP信息报警"红细胞凝集"。修订复检规则验证结果表明真阳性率为20.7%,假阳性率为15.2%,真阴性率为62%,假阴性率为2.2%。结论通过对制定的儿科复检规则随机标本评估和复检规则临床实验有效验证,我室修订血细胞五分类分析复检规则可基本满足儿童医院专科特点,降低了常规血液检测假阳性率,血液病无漏诊。

Evaluation of review criteria of XS-800i automated hematology analyzer in pediatrics

Objective To evaluate the suggested hematology review criteria for XS-800i automated hematology analyzer in pediatric application.Methods 1348 blood specimens coagulated with EDTA-K2 from sick children were detected by Sysmex XS-800i automated hematology analyzer,and were examined artificially under microscopy at the same time.According to 41 rules of ISLH and XS-800i hematology analyzer suggestions,25 review criteria for artificial blood re-examination by microscopy were validated.Results Re-examination rate was 30.2%.The true positive rate was 10.0%.The false positive rate was 20.2%.The true negative rate was 66.9%.The false negative rate was 2.9%.Atypical lymphocytes>5% was major cause in true positive samples group for microscopy re-examination.Atypical lymphocytes flag was mostly the cause in 272 false true positive samples.The alarm threshold of Q-Flags for atypical lymphocytes was adjusted from 100 to 300.A review rule of hemo-agglutination about RBC was added.Evaluation data of new review criteria showed that the true positive rate was 20.7%,false positive rate was 15.2%,true negative rate was 62% as well as false negative rate was 2.2%.Conclusion Revised hematology review rule not only basically meets the re-examination rule characteristics in pediatric but also reduces the false positive rate.