SysmexXT一2000i异常散点图筛检疟原虫感染的探讨

目的通过观察SysmexXT一2000i血液分析仪上白细胞分类散点图异常变化的规律，探讨使用全自动血液分析仪筛检疟原虫的方法。方法用SysmexXT一2000i血液分析仪检测发热患者的血常规，结合血液分析其它参数情况，对白细胞分类散点图异常的标本制血涂片，镜检查找疟原虫。结果在1172例发热患者中查出8例疟原虫感染。所有8例疟疾患者的白细胞分类散点图均在单核细胞区右上方出现异常散点图，同时其中3例白细胞分类散点图还呈现嗜酸性粒细胞与中性粒细胞间的间距变小；3例白细胞分类散点图呈现嗜酸性粒细胞与中性粒细胞间无间距。结论当SysmexXT-2000i血液分析仪检测发热患者血常规白细胞分类散点图出现上述异常时，结合患者血细胞分析参数（血红蛋白降低或血小板减少）的变化，提示有疟原虫感染的可能。通过特征性散点图可筛检疟原虫感染，防止疟原虫漏检，但需镜检确认。

The Discussion of Malarial Parasite Infection with the Unusual WBC Scatter Diagram in Sysmex XT-2000i Blood Analyzer

Objective To explore a direct and quick method of screening malarial parasite using automated blood analyzer by observing the rule of abnormal change of the WBC classification scatter diagram in XT-2000i blood analyzer. Methods XT-2000i blood analyzer was used for analyzing complete blood cell of the patients with heat. Combining with other parameters, blood smear of the specimen with abnormal WBC classification scatter diagram to search malarial parasite were made. Results Among 1 172 patients with heat,8 patients were infected by malarial parasite. All the 8 specimens were showing abnormal scatter diagrams in the upper right of the mononuclear cell area of WBC classification scatter diagram. Meanwhile, 3 WBC classification scatter dia- grams were showing the gap between eosinophil clusters and neutrophil clusters becoming smaller;there were no gap between the two cluster in other 3 specimens. Conclusion Combining with the changes （ Hb ↓ or PLT ↓ ） in the blood parameter analysis, there was great possibility of the existence of the malaria parasite in specimens when the previous abnormal changes showing on the WBC classification scatter diagrams in XT-2000i blood analyzer and then blood smear must be made to have microscopic re- view. The method provided not only a direct way for quick screening malaria parasite but also effectively prevention the undetected ratio on malaria parasite.