红细胞沉降率参考方法、魏氏法和仪器法的应用比较

目的探讨红细胞压积（PCV）对红细胞沉降率（ESR）测定的影响及美国临床实验室标准化研究所（CLSI）H2-A4文件参考方法、魏氏法、LDY-CX40型仪器法3种检测ESR方法的可比性。方法按照CLSI参考方法调整1名健康人PCV后检测ESR;随机选择60例门诊和病房患者,分别采用CLSI参考方法、魏氏法与LDY-CX40型仪器法同时测定ESR。结果 PCV对ESR的影响为一倒抛物曲线：Y=611.81X2-698.12X＋200.31,决定系数（r2）=0.994 5;不同检测方法间配对t检验显示P〈0.01;参考方法、魏氏法、仪器法3者进行两两线性回归分析,r2均〉0.976（P〈0.01）;魏氏法和仪器法的结果均在CLSI制定的比较参考方法和工作方法的可接受范围内。结论 PCV对ESR的影响十分明显,应该将PCV调整在恒定的一个水平,才能获得一个更准确和更有价值的ESR结果;3种不同的检测方法之间差异有统计学意义,应该使用不同的参考区间。

Application comparison of ESR reference method, Westergren method and instrumental method

Objective To study the influence of packed-cell volume（PCV） in red blood cell to erythrocyte sedimentation rate（ESR） and the comparability between ESR reference method [Clinical and Laboratory Standards Institute（CLSI）,Document： H2-A4],Westergren method and ESR instrumental method（LDY-CX40）.Methods The ESR after adjusting PCV of a healthy subject was measured according to CLSI reference method.60 cases of inpatients and outpatients were selected randomly,and their ESR were measured by CLSI reference method,Westergren method and LDY-CX40 ESR instrumental method simultaneously.Results The influence of PCV to ESR could be expressed as a parabola curve： Y=611.81X2-698.12X ＋200.31,r 2=0.994 5.The different determination methods with paired t test showed P 0.01.The results of linear regression analysis were programmed between the three methods（r 2 0.976,P 0.01）.The results of Westergren method and ESR instrumental method were fully within the acceptable range of the comparative values of CLSI reference method.Conclusions The influence of PCV to ESR is very obvious.The PCV should be adjusted at an invariable level,and then the more accurate and more valuable ESR results can be obtained.There are statistical differences between the three methods,and they should use different reference intervals.