探讨红细胞平均体积偏低影响血小板假性增高的有效报警指标

目的分析比较红细胞平均体积（MCV）偏低的标本对Sysmex XN-2000血细胞分析仪电阻抗法血小板计数（PLT-Ⅰ）相关指标的影响,寻找低MCV导致血小板（PLT）假性增高的有效报警指标。 方法收集Sysmex XN-2000血细胞分析仪荧光法和电阻抗法检测不同MCV标本的PLT计数结果,比较在不同分组条件下荧光法PLT计数（PLT-F）和PLT-Ⅰ的差值（ΔPLT）。分析细胞参数、细胞直方图形态和仪器报警信息与ΔPLT的相关性。 结果MCV＜80 fl组ΔPLT高于MCV≥80 fl组（P＜0.05）;MCV＜60 fl组ΔPLT高于MCV≥60 fl组（P＜0.05）;当PLT-Ⅰ介于150×10⁹/L与600×10⁹/L之间时,随着PLT-Ⅰ增大,ΔPLT也越大（P＜0.05）;PLT分布宽度（PDW）、红细胞平均血红蛋白浓度（MCHC）、红细胞分布宽度标准差（RDW-SD）与ΔPLT有一定相关性（P＜0.05）,但R²均小于0.95。“尾部不接近横坐标”和“尾部抬高并形成第二峰”两种PLT直方图现象、红细胞直方图“峰左移”现象、仪器报警信息“PLT异常分布”、“PLT增加”、“红细胞大小不均”、“细胞碎片”和“小红细胞”在ΔPLT＜100×10⁹/L组中占的比例低于ΔPLT≥100×10⁹/L组（P＜0.01）。 结论低MCV影响Sysmex XN-2000血细胞分析仪PLT-Ⅰ结果;MCV越小对PLT-I影响越大;PLT-Ⅰ介于150×10⁹/L与600×10⁹/L之间时,随着PLT-Ⅰ增大,低MCV对PLT-Ⅰ的影响越大。结合PLT和红细胞的直方图及仪器报警信息有助于判断Sysmex XN-2000血细胞分析仪PLT-Ⅰ的可靠性,为临床工作中及时发现低MCV影响PLT-Ⅰ提供综合参考指标和判断依据。

Explore the effective alarm index of low mean volume of red blood cells affecting false increase of PLT

ObjectiveTo analyze and compare the effect of low MCV specimens on the platelet count related indicators of the resistance method of Sysmex XN-2000 hematology analyzer, and search for the effective alarm indicators of PLT false increase caused by low MCV. MethodsThe PLT results of different MCV samples were collected by Sysmex XN-2000 hematology analyzer fluorescence method and resistance. The fluorescence method and resistance method difference of platelet detection (ΔPLT) under different grouping conditions were compared, and the correlation of cell parameters, cell histogram morphology and instrument alarm information with platelet difference (ΔPLT) was analyzed. ResultsΔPLT in MCV＜80 fl group is higher than MCV≥80 fl group (P＜0.05); ΔPLT in MCV＜60 fl group is higher than MCV≥60 fl group (P＜0.05); when PLT-Ⅰ is between 150×10⁹/L and 600×10⁹/L, ΔPLT increases with the value increases (P＜0.05); PDW, MCHC, RDW-SD and ΔPLT have a certain correlation (P＜0.05), but R² is less than 0.95. The ratio of "Tail is not close to the abscissa" and "the tail is raised and forms the second peak" two kinds of platelet histogram phenomenon, red blood cell histogram "peak left shift" phenomenon, instrument alarm message "platelet abnormal distribution (PLT Abn Distribution)","Thrombocytosis","Anisocytosis","Fragments" and "Microcytosis" account was lower in ΔPLT≥100×10⁹/L group than ΔPLT＜100×10⁹/L group (P＜0.01). ConclusionsLow MCV affected the PLT-Ⅰ results by the Sysmex XN-2000 hematologyanalyzer. The lower the MCV, the greater influence of PLT-I. When the PLT-Ⅰ≥70×10⁹/L, low MCV has greater influence on PLT-Ⅰ with the increase of PLT-Ⅰ. Combining the platelet histogram, the platelet instrument alarm message, the red blood cell histogram and the red blood cell instrument alarm message are helpful to judge the reliability of the resistance method of Sysmex XN-2000 hematologyanalyzer. It provides a comprehensive reference index and judgment basis for the timely discovery of low MCV affecting platelet count in clinical work.