影响Sysmex-1800i血液分析仪血小板计数因素复检原则的探讨

目的：探讨并建立合适的影响Sysmex-1800i仪器血小板计数的复检原则。方法：利用Sysmex-1800i血细胞分析仪对450例血液样本进行分析，分为红细胞不同的MCV组、血小板内在因素组、采血因素组。并对各组血小板进行显微镜手工计数及相应的血涂片复查。结果：①MCV≥80n和70n≤MCV〈80n时，仪器与手工法结果间差异无统计学意义（P〉0．05）；60fl≤MCV〈70fl时，仪器法与手工法间差异有统计学意义（P〈0．05）；MCV〈60fl，仪器法与手工法间差异有统计学意义（P〈0．05）。②血小板直方图异常及大血小板，仪器法与手工法间差异有统计学意义（P〈0．05）：血小板聚集时仪器所测数值与血片所见血小板数量差异显著。③不同采血方式血细胞分析检测结果的影响如在可接受的范围之内．利用EDTA—k2真空负压管采集静脉血具有结果稳定、样本量多、便于复查等诸多优点，在优先静脉采血的同时可根据临床实际情况选择样本类型及采血容器。当出现血小板减少的数据，应重采静脉血，并进行手工血小板计数。结论：红细胞MCV≤70fl或者血液标本不合格及血小板结果和临床不相符时，有必要进行人工血小板计数。

Influence factor on the rules of duplicate examination of Sysmex-1800i blood analyzer for platelet count

Objective： To discuss and establish proper duplicate examination rules of Sysmex-1800i blood analyzer for platelet count. Methods： We used Sysmex-1800i blood analyzer to detect 450 blood samples which were divided into three groups, group of red blood cell with different MCV,group of platelet with different internal factor and varied methods of taking blood group. Counted the platelet by manual under the microscope and reviewed by blood smear. Results：①MCV ≥ 80 fl and 70 fl≤MCV〈80 fl, there was no difference between instrument and hand for platelet count （P〉0.05）, but when 60 fl≤ MCV〈70 fl, the difference existed （P〈0.05）. MCV〈60 fl, also, there was difference between the two methods （P〈0.05）. ②Difference was observed between the methods of instrument and hand when big platelet or abnormal platelet histogram （P〈0.05）. When platelet aggregation there was significantly different between platelet count measured by equipment and blood smear. ③lf the results of blood analysis could be accepted under different methods of taking blood, it has advantages of stable results, plenty of samples and easy to review by using the EDTA-k2 vacuum blood collection tube. Venous blood, while giving priority to the clinical situation can select the sample type and blood containers. When thrombopenia was detected, the venous blood should be taken again and count the platelet by hands. Conclusion： MCV ≤ 70 fl of the red blood cell, the samples was not qualified, the results and the clinical findings do not match, it is necessary to count the platelet by hands.