摘要
目的探讨白细胞计数(WBC)≤2.0×109/L时的分类计数、VCS物理参数及形态学报警信号,为低值白细胞样本复检提供依据。方法采集WBC≤2.0×109/L的72例患者的外周血样本,使用Gen.S全自动血细胞分析仪进行细胞分类计数,同时进行瑞氏染色,由具有良好的血细胞形态学基础的专业人员进行观察,保证油镜下分类100个白细胞。比较人工分类结果与仪器分类结果。结果 1.0×109/L≤WBC≤2.0×109/L的48例患者,人工分类结果与仪器分类结果比较,中性粒细胞、淋巴细胞、单核细胞差异均有统计学意义(t分别=5.58、7.59、15.38,P均<0.05)。仪器提供的66例患者VCS参数与正常人群150例VCS参数比较,中性粒细胞体积分布宽度(NDW)、中性粒细胞体积平均值(MNV)、淋巴细胞体积分布宽度(LDW)、淋巴细胞体积平均值(MLV)、中性粒细胞散射平均值(MNS)差异均有统计学意义(Z分别=18.64、4.64、6.19、-3.76、-13.48,P均<0.05)。以人工镜检为标准,仪器对低值样本的形态学报警信号的假阴性率分别为原始细胞20.00%、不成熟中性粒细胞1和/或不成熟中性粒细胞2 70.00%、不典型淋巴细胞66.67%、有核红细胞71.43%。结论人工镜检能够客观反映低值白细胞样本的细胞分类,减少形态学异常的漏检,为复检规则提供证据。
Objective To explore the differential counting, VCS physical parameters and morphology alarm signal of white blood cell count when it is less than or equal to 2.0×109/L. Methods The 72 cases of white blood cell count less than 2×109/L were selected and their blood samples were collected. The cell differential counting was detected using Gen.s auto-matic blood cell analyzer. After wright staining, the professional personnel with good blood cell morphology knowledge took charge of observing cell under the oil microscope to ensure 100 white blood cells to classification. The artificial classifica-tion and instrument classification were compared. Results The polymorph nuclear cells, lymphocytes, mononuclear cells that classified by artificial classification and instrument classification of 48 cases with WBC from 1.0 ×109/L to 2.0 ×109/L were significantly different（t=5.58, 7.59, 15.38, P〈0.05）. The neutrophil volume distribution width（NDW）, mean neu-trophils volume （MNV）, lymphocytes distribution width （LDW）, mean lymphocyte volume （MLV） and mean neutrophils scatter（MNS） that from 66 cases of low white cell count peripheral blood and 150 cases of normal people were significantly different（Z=18.64, 4.64, 6.19,-3.76, -13.48, P〈0.05）. The false-negative rate of blasts, Imm.NE1/Imm.NE2, variant lymphocytes and nucleated red blood cells （NRBC） were 20.00%, 70.00%, 66.67%and 71.43%respectively. Conclusion Smear can objectively reflect the cell classification of low white cell count peripheral blood, reduce the omission detection for morphological abnormality and provide evidence for reinspection.
出处
《全科医学临床与教育》
2015年第6期643-645,648,共4页
Clinical Education of General Practice
关键词
白细胞
涂片镜检
血细胞分析仪
white blood cell
smear microscope
hematology analyzer
