摘要
目的 对四种不同样本保存方法用于强直性脊椎炎（AS）患者流式细胞术测定B27表达情况的临床效果进行评估;从而探讨一种更好的流式细胞术B27样本保存方式的可能性.方法 收集武汉大学人民医院2009年10月-2012年11月间门诊及住院AS 155例患者外周血标本作为研究对象,将上述样本分别按照不同的保存方式分为室温保存全血细胞（RTWB）、冻存单个核细胞（FMNC）、冻存去红细胞的白细胞（FWBC）、冻存血小板（FPLT）、新鲜全血样本（IWB）和新鲜血小板（IPLT）;采用流式细胞术（FCM）对上述几种方法保存的样本HLA-B27表达情况进行测定;分别计算出上述不同样本保存方法用于AS诊断的诊断效能指标（灵敏度、特异度、误诊率、漏诊率、阳性预告值、阴性预告值）,以评估不同样本保存方法对AS临床诊断价值的影响.结果 FMNC,FWBC,FPLT与IWB和IPLT用于AS病诊断的灵敏度、特异度、误诊率、漏诊率、阳性预告值和阴性预告值分别均为87.1％,88.5％,11.5％,12.9％,86％和89.4％,诊断效能指标完全一致;而RTWB敏感度和特异度分别为77.4％和80.8％,明显低于新鲜标本（χ^2=11.23,8.11,P＜0.05）,误诊率和漏诊率分别为19.2％和22.6％,高于新鲜标本（χ^2=10.53,7.85,P＜0.05）.结论 该研究表明采用一定方式冻存的外周血样在流式细胞术HLA-B27测定用于AS病的诊断中能够达到与新鲜样本一样的诊断效能,FPLT样本进行FCM B27测定结果可靠且操作简单、高效,更适合临床诊断.
Objective To evaluate the effect of the various methods of storing patient blood of flowcytometric measurement （FCM） of HLA-B27 antigen in the diagnosis ankylosing spondylitis （AS）. Methods Compared four storage methods：three methods of analyzing lymphocytes （whole blood stored at room temperature, frozen mononuelear cells, and frozen white blood cells [WBCs] after lysing red blood cells [RBCs]）, and one method using frozen platelets （FPLT）. Determined the HLA-B27 in the Peripheral blood of 155 cases with AS using HLA-Bg7 monoclonal antibody by FCM. Data were compared to those by SSP-PCR. Reasults There was no significant difference between FMNC, FWBC, FPLT, IWB and IPLT in the diagnosis AS by FCM （87.1%,88.5%,11.5%,12.9%,86% and 89.4% respectively）. The specificity and sensitivity of room temperature-stored whole blood （RTWB） were respectively 77.4% and 80.8% respectively, significantly lower than the fresh specimens （X2 = 11.23,8.11 ,P〈0.05）. The misdiagnosis and missed diagnosis rate of RTWB were respectively 19.2% and 22.6% respectively,higher than the fresh specimens （X2 =10.53,7.85,P〈0.05）. Conclusion This data sug gested that FPLT is a rapid and reliable storage method for HLA B27 determination of FCM.
出处
《现代检验医学杂志》
CAS
2014年第2期110-114,共5页
Journal of Modern Laboratory Medicine
