血涂片复检在采用仪器法测定结果可靠性评估中的价值

目的探讨血细胞涂片复检在采用仪器法分析复查中的必要性和可靠性,强调手工涂片复检的重要性。方法采用仪器法对随机抽查的746例标本结果进行筛查,并严格按照血涂片制备方法和细胞形态学分类方法对筛查的结果进行手工复检,复检原则参照国际血细胞复检规则相关条款。结果根据复检规则对检测结果进行统计学分析,得到真阳性率为4.6%,假阳性率为20.4%,真阴性率为74.0%,假阴性率为1.1%,复检率为25%。仪器法测定的敏感度为28.8%,特异度为98.6%,阳性预测值为81.0%,阴性预测值为78.4%,准确性为78.6%。结论血细胞形态学检查在血常规分析中具有十分重要的意义,仪器法检测的方法学具有其局限性,对于形态、结构异常的细胞不能作出准确判断和定位,一旦仪器检测提示异常,应及时涂片镜检复查,以保证检验结果的准确性和可靠性。

Evaluation the Value of Blood Smear Review Test in the Reliability of Result by Instrument Test

Objective To study the essentiality and reliability of blood smear review in the instrument test,emphasize the importance of manual smear review test. Methods 746 samples were tested by blood cell analyzer, then it was reviewed by manual smear method according to the principle of the international smear review criteria. Results Comparing with the results of manual smear review test, the true positive rate of instrumental method was 4. 6%, false positive was 20. 4%, true negative rate was 74. 0% ,false negative rate was 1. 1%,review rate was 25%. The sensitivity of instrumental method was 28. 8% ,the specificity was 98. 6%, positive predict value was 81. 0% .negative predict value was 78. 4%, accuracy was 78. 6%. Conclusion The blood cell morphology test is very important in blood routin,instrumental test has its own limitations, which can not judge the abnormal morphological cell properly, we should review the smear in time once the instrument alarm.