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目的通过观察特发性血小板减少性紫癜(ITP)患者血小板计数异常直方图,分析判断血球计数仪计数血小板结果的准确度,是分析后质控的重要步骤,减少误诊和漏诊。方法应用血球计数仪和显微镜计数法分别计数80例临床已确诊的ITP患者血小板,并且观察血小板直方图、MCV、红细胞计数值。两种方法所测的血小板结果进行配对t检验。结果通过观察ITP患者异常血小板直方图:RBC计数和MCV都正常组,血球计数仪法与显微镜计数法比较,血球计数仪血小板计数出现假性减低,p<0.01,是由于异常蛋白的干扰引起血小板聚集,见图3;RBC计数>6.0×1012/L,MCV<70fL时,血球计数仪法出现假性减低和假性增高同时存在,由于小红细胞的干扰大于异常蛋白的干扰,假性增高显著,p<0.01,见图4;RBC计数>6.0×1012/L,MCV<70fL,此组患者治愈后,血球计数仪法只出现假性增高,是由于异常蛋白干扰消除,只存在小红细胞的干扰,p<0.01,见图5。结论 ITP患者血小板计数直方图出现异常时,必须用显微镜计数法复查,ITP患者异常血小板直方图可以作为结果的准确度和疗效观察的指标。
OBJECTIVE: To observe the histogram of platelet count abnormalities in patients with idiopathic thrombocytopenic purpura (ITP) and to analyze the accuracy of the platelet count in counting the hemocytometer is an important step in post-analysis quality control to reduce misdiagnosis and missed diagnosis. Methods 80 cases of clinically diagnosed patients with ITP were counted by hemacytometer and microscopy. Platelet histogram, MCV and erythrocyte count were observed. Paired t tests were performed on platelet results measured by the two methods. Results By observing the abnormal platelet histogram of ITP patients, the RBC count and MCV were both normal. The haemocytometer method was compared with the microscope counting method. The haemocytometer platelet count was falsely reduced, p <0.01, which was due to the abnormal protein interference Aggregation, see Figure 3; RBC count> 6.0 × 1012 / L, MCV <70fL, the haemocytometer method false reduction and false increase exist at the same time, the small red blood cell interference is greater than the abnormal protein interference, the false increase was significant , p <0.01, see Figure 4; RBC count> 6.0 × 1012 / L, MCV <70fL, after healed in this group of patients, hemocytometer method only appeared false increase, due to the elimination of abnormal protein interference, Interference, p <0.01, see Figure 5. Conclusions ITP patients platelet count histogram abnormalities must be reviewed by microscopic counting method, ITP abnormal platelet histogram can be used as an indicator of the accuracy of the results and the efficacy of the observation.