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在血小板减少症患者中,使用不同分析仪进行自动血小板定量检测并与免疫参考方法进行比较的性能。

Performance of automated platelet quantification using different analysers in comparison with an immunological reference method in thrombocytopenic patients.

作者信息

Trabuio Ernesto, Valverde Sara, Antico Francesco, Manoni Fabio, Gessoni Gianluca

机构信息

Laboratorio di Patologia Clinica, A-ULS 14 Chioggia, Italia.

出版信息

Blood Transfus. 2009 Jan;7(1):43-8. doi: 10.2450/2008.0039-08.

Abstract

BACKGROUND

Rapidly available and accurate platelet counts play an important role in the evaluation of haemorrhagic status and in assessing the need for platelet transfusions. We, therefore, evaluated platelet counting performance of haematology analysers using optical, impedance and immunological methods in thrombocytopenic patients.

MATERIALS AND METHODS

We considered 99 patients with a platelet (plt) count under 50 x 10(9) plt/L. We compared the platelet counts obtained using ADVIA 2120 (optical method), Cell-Dyn Sapphire (optical, impedance and immunological methods with CD61) and a reference, double staining (CD41+CD61) immunological method.

RESULTS

The platelet counts of all the considered methods showed good correlation with those of the reference method, despite an overestimation in platelet quantification. The degree of inaccuracy was greater for platelet counts under 20 x10(9) plt/L.

CONCLUSIONS

Clinicians who use platelet thresholds below 20 x10(9) plt/L for making clinical decisions must be aware of the limitations in precision and accuracy of cell counters at this level of platelet count. Inaccurate counts of low platelet numbers could create problems if attempts are made to reduce the threshold below 20 x 10(9) plt/L.

摘要

背景

快速获得准确的血小板计数对于评估出血状态以及判断是否需要输注血小板具有重要作用。因此,我们评估了血液分析仪在血小板减少症患者中采用光学、阻抗和免疫方法进行血小板计数的性能。

材料与方法

我们纳入了99例血小板(plt)计数低于50×10⁹ /L的患者。我们比较了使用ADVIA 2120(光学方法)、Cell-Dyn Sapphire(光学、阻抗和采用CD61的免疫方法)所获得的血小板计数,以及参考的双重染色(CD41+CD61)免疫方法。

结果

尽管血小板定量存在高估,但所有考虑方法的血小板计数与参考方法均显示出良好的相关性。血小板计数低于20×10⁹ /L时,不准确程度更高。

结论

对于使用低于20×10⁹ /L的血小板阈值来做出临床决策的临床医生而言,必须意识到在此血小板计数水平下细胞计数仪在精密度和准确性方面的局限性。如果试图将阈值降低至低于20×10⁹ /L,低血小板数量的不准确计数可能会引发问题。

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