血液分析仪计数血小板假性异常及其影响因素分析

目的探讨血液分析仪在计数血小板时出现假性异常情况的原因以及对策。方法 2008年11月至2011年11月对北京市天坛医院的544例患者血液标本资料进行回顾性分析,依据血小板的直方图与MCV以及MPV等参数,分为A组270例(为正常体积的血小板者),B组50例(为大血小板者),C组62例(为血小板出现聚集者),D组90例(为小红细胞出现干扰者),E组72例(为红细胞碎片出现干扰者);应用仪器法及手工法对血小板的计数结果进行对比。结果 A组的直方图均分布正常,仪器检测结果与显微镜计数结果相比,差异无统计学意义(P>0.05);而血小板的直方图呈异常分布的B、C、D、E组仪器检测结果与显微镜计数结果相比,差异有统计学意义(P<0.01)。结论应用血液分析仪对血小板检测的影响因素较多,不仅需要正确的操作,同时还需要排除各种因素的干扰,并且需要采取复核的必要措施,才能确保检测结果准确可靠。

Hematology Analyzers Counting Platelet Pseudo-abnormality and Its Influencing Factors

Objective To investigate reasons of pseudo-abnormality of the blood analyzer in the platelet count and the countermeasures.Methods From November 2008 to November 2011,blood specimens of 544 patients from Beijing Tiantan Hospital were retrospectively analyzed,on the basis of platelet histogram and the MCV and MPV parameters,the screening were divided into group A of 270 cases(normal volume platelets),50 cases in group B(large platelets),62 cases in group C(platelet aggregation),90 cases in group D(red cells appearing interference),72 cases in group E(red cell fragments appearing interference);instrument method and manual method were applied for platelet counting results comparison.Results In group A,histogram showed normal distribution,test results of the instrument and microscopic counting had no statistically significant difference(P>0.05);and group B,C,D,E of the abnormal distributed platelet histogram,the instrument test results were statistically significantly different from the microscopic counting results(P<0.01).Conclusion The application of hematology analyzer for blood platelet detection has a lot of influencing factors,which needs not only the correct operation,but also exclusion of the interference of various factors,and necessary measures should be taken for recheck,to ensure the accurate and reliable test results.