运用标准差指数和变异系数指数评价实验室内不同血细胞分析仪检测结果的一致性

目的探索运用标准差指数(standard deviation index, SDI)和变异系数指数(coefficient of variation radio, CVR)对比分析同一实验室内不同血细胞分析仪检测WBC、RBC、血红蛋白(hemoglobin，Hb)、血细胞比容(hematocrit，HCT)和血小板(platelets，PLT)计数项目的室内质量控制比对检测结果的一致性，及其评价方法的新模式。 方法分析2014年5月1日至5月31日期间，宁夏医科大学总医院医学实验中心不同型号的5台血细胞分析仪检测WBC(流式细胞计数法)、RBC (鞘流DC检测法)、Hb(十二烷基硫酸钠血红蛋白检测法)、HCT(脉冲高度检测法)和PLT(鞘流DC检测法) 5项血常规项目三个水平的室内质量控制数据，计算出75组均值( )、标准差(standard deviation，SD)、及变异系数(coefficient of varation, CV)，以及各项目的SDI、CVR等;同时评价分析不同血细胞分析仪检测各项目的日间精密度分布及比对分析检测结果正确度的一致性。 结果根据5台血细胞分析仪2014年5月，连续31 d中，检测WBC、RBC、Hb、HCT、PLT项目1~3的三个水平共465个质控数据。5个项目各水平的SDI和CVR分别为-1.37~1.84和0.72~1.46、-3.35~2.59和0.83~1.21、-3.28~3.57和0.40~1.67、-2.79~1.88和0.53~1.61、-1.25~1.21和0.52~1.59。其中，RBC和HGB 3个水平室内质控结果SDI>2的数量最多，分别为5个和7个；HCT有1个SDI>2；WBC和PLT的SDI<2。WBC、RBC、Hb、HCT、PLT的SDI指标不合格率分别为0、33.33%、46.67%、6.67%、0。每台仪器检测5个项目CVR与所有实验室仪器CVR相比均<2。 结论运用SDI和CVR综合评价实验室内不同血细胞分析仪检测同一WBC、RBC、Hb、HCT、PLT项目结果的正确度和精密度的室内质量控制的可比性较好，可作为实验室内不同血细胞分析仪检测相同项目结果一致性评价的实验室内质量控制新模式。

Use the standard deviation index and coefficient of variation ratio to evaluate the consistency of different results on the application of different blood cells analyzer in the laboratory

ObjectiveTo analyse the comparison result of internal quality control of WBC, RBC, hemoglobin (Hb), hematocrit (HCT) and platelet (PLT) which were detected by different blood cell analyzers, and to evaluate the consistency of the results between different instruments within the same laboratory by standard deviation index (SDI) and coefficient of variation ratio (CVR), at the same time to provide a more accurate and reliable test results for clinicl. MethodsBy analyzing quality control data of the tests of WBC, RBC, Hb, HCT and PLT with five blood cell analyzers to calculate the coefficient of variation (CV), SDI and the CVR from May 1, 2014 to 31, each item has three levels level1 to 3 from Medical Experimental center, General Hospital of Ningxia Medical Univertisy. ResultsThe SDI and CVR index of the WBC, RBC, Hb, HCT and PLT were -1.37-1.84 and 0.72-1.46, -3.35-2.59 and 0.83-1.21, -3.28-3.57 and 0.40-1.67, -2.79-1.88 and 0.53-1.61, -1.25-1.21 and 0.52-1.59. The data were callected by analyzing 465 numbers totally from the five blood cell analyzers from May 1 to 31, 2014. The highest number of SDI>2 were RBC and HGB, which were 5 and 7, respectively. There was only one that was SDI>2 in HCT, and two that was SDI<2 in WBC and PLT. The unqualified rates of WBC, RBC, HGB, HCT and PLT were 0, 33.33%, 46.67%, 6.67% and 0. The CVR of five items in each instrument compared to all laboratory instruments were less than 2. ConclusionsIt is beneficial to carry on quality control of consistency and comparability of the results in the same test with different systems by using SDI and CVR index for accuracy and precision of laboratory evaluation, and it has good application results of laboratory quality assurance. The SDI and CVR can be used to a new model of internal quality control about the same item to test in different blood cell analyzers.