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目的:探讨运用BC-5800全自动血液分析仪检测血小板(PLT)减少患者进行手工复检和涂片观察分析的原因。方法:咸宁市第一人民医院2010年1月—2011年2月期间经血液分析仪检测的PLT<100×109/L的患者382例。取全血涂片经瑞特-姬姆萨染色后镜检,观察PLT形态、数量、分布及凝集情况,并进行手工计数复检,再发布最终结果。结果:有39例假性血小板减少,外周血涂片PLT形态正常,平均每个油镜视野>20个,可见血小板聚集,小丛易见,偶见大丛,手工计数PLT>100×109/L。343例真性血小板减少,血涂片可见PLT数量减少,平均每个油镜视野0～15个,未见凝集,可见大血小板、畸形血小板,仪器检测结果为(56±36)×109/L,手工复检结果为(50±48)×109/L,P<0.05。结论:对于机做PLT减少或仪器提示异常的患者标本需经涂片观察和人工复检方能发布结果,以提高PLT结果准确性,减少误诊。
OBJECTIVE: To explore the reasons for the manual retest and smear analysis of patients with reduced platelet count (PLT) using the BC-5800 automatic hematology analyzer. Methods: 382 patients with PLT <100 × 109 / L were detected by hematology analyzer during the period from January 2010 to February 2011 in Xianning First People’s Hospital. Take the whole blood smear by Reiter - Giemsa staining microscopy, observe the PLT morphology, quantity, distribution and aggregation, and manual counting re-examination, and then publish the final results. Results: There were 39 cases of pseudo-thrombocytopenia and normal morphology of PLT in peripheral blood smear. The average number of PLTs was> 20 in each oyster. Platelet aggregation was observed. . 343 cases of true thrombocytopenia, blood smears showed a decrease in the number of PLT, an average of each oil field 0 to 15, no agglutination, showing large platelet, abnormal platelets, the instrument test results (56 ± 36) × 109 / L, Manual retest results (50 ± 48) × 109 / L, P <0.05. CONCLUSIONS: The results of PLT results and the accuracy of misdiagnosis can be improved for patients with PLT reduction or instrument abnormalities that can be released by smear observation and manual re-examination.