CAJ | 학술논문

目的：探讨血细胞分析仪计数血小板（PLT）假性减少的原因及处理对策。方法对 Beckman LH780自动血细胞分析仪计数 PLT <100×109/ L 的351例样本进行手工稀释计数及涂片染色镜检，按血小板直方图类型分组，A组（正常血小板直方图）：297例；B 组（小血小板直方图）：13例；C 组（大血小板直方图）：11例；D 组（血小板聚积直方图）：19例；E 组（红细胞碎片直方图）：11例，对血细胞分析仪计数与手工稀释计数进行比较，并与涂片染色镜检进行相符程度比较。结果①与手工稀释计数比较，A、B 组血细胞分析仪 PLT 计数无显著差异（ P ﹥0.05）；C、D 组血细胞分析仪 PLT 计数减少，有显著性差异（ P <0.01）；E 组血细胞分析仪 PLT 计数增高，有显著性差异（ P <0.01）。②手工稀释计数比血细胞分析仪计数与涂片染色镜检结果相符程度高。③30例血小板假性减少的样本中，7例 EDTA 依赖性假性 PLT 减少（EDTA - PTCP）；8例采血不顺造成；4例冷凝集；大血小板及红细胞碎片11例。结论血细胞分析仪计数血小板有可能出现血小板计数假性减少，对血小板直方图异常的样本必须进行手工稀释计数和涂片染色镜检来提高血小板报告的准确性。
목적：탐토혈세포분석의계수혈소판（PLT）가성감소적원인급처리대책。방법대 Beckman LH780자동혈세포분석의계수 PLT <100×109/ L 적351례양본진행수공희석계수급도편염색경검，안혈소판직방도류형분조，A조（정상혈소판직방도）：297례；B 조（소혈소판직방도）：13례；C 조（대혈소판직방도）：11례；D 조（혈소판취적직방도）：19례；E 조（홍세포쇄편직방도）：11례，대혈세포분석의계수여수공희석계수진행비교，병여도편염색경검진행상부정도비교。결과①여수공희석계수비교，A、B 조혈세포분석의 PLT 계수무현저차이（ P ﹥0.05）；C、D 조혈세포분석의 PLT 계수감소，유현저성차이（ P <0.01）；E 조혈세포분석의 PLT 계수증고，유현저성차이（ P <0.01）。②수공희석계수비혈세포분석의계수여도편염색경검결과상부정도고。③30례혈소판가성감소적양본중，7례 EDTA 의뢰성가성 PLT 감소（EDTA - PTCP）；8례채혈불순조성；4례냉응집；대혈소판급홍세포쇄편11례。결론혈세포분석의계수혈소판유가능출현혈소판계수가성감소，대혈소판직방도이상적양본필수진행수공희석계수화도편염색경검래제고혈소판보고적준학성。
Objective To explore the causes and treatment strategies for pseudo - reduction of platelet count by blood cell analyzer. Methods A total of 351 blood samples for platelet count less than 100 × 109 / L measured by Beckman LH780 automatic blood cell analyzer were re - examined by handmade dilute count and smear staining for microscopy. They were divided into 5 groups according to platelet histogram,297 specimens with normal platelet histogram were allocated in group A;13 specimens with small platelet histogram in group B:11 specimens with large platelet histogram in group C:19 specimens with platelet aggregation histogram in group D,and 11 specimens with red cell fragments histo-gram in group E. The platelet count by blood cell analyzer and handmade dilute count were compared with smear staining examination under mi-croscopy for degree of coincidence. Results ① In comparison with handmade dilute count,the difference between group A and group B was not statistically significant( P ﹥ 0. 05),the difference between group C and group D was statistically significant( P < 0. 01),and the platelet count with blood cell analyzer was higher in group E,and the difference between group E and other groups was statistically significant( P < 0. 01). ②There was high degree of coincidence in results between handmade dilution count and smear staining examination under microscopy . Conclusion Platelet count by blood cell analyzer may be pseudo - reduced. In order to raise the accuracy of platelet count,the samples with abnormal platelet histogram need to be checked by handmade dilute count and smear staining examination under microscopy.