Tessier-Marteau Anne, Geneviève Franck, Godon Alban, Macchi Laurent, Zandecki Marc
Laboratoire d'hématologie, CHU d'Angers.
Ann Biol Clin (Paris). 2010 Jul-Aug;68(4):393-407. doi: 10.1684/abc.2010.0451.
Hematology analysers provide now quick, accurate, and reproducible cell blood counts. However, depending on detection methods, spurious counts may occur. If undetected, such spurious counts may lead to inappropriate medical care and to unneeded explorations. Focusing first on platelet counts, situations leading to spurious decrease include several preanalytical considerations, the major one corresponding to EDTA-induced platelet aggregation and to platelet satellitism around polymorphs. In other instances, related to the presence of small particles mimicking platelets, including fragmented red blood cells, lipids, cryoglobulins, fibrin strands, or cytoplasmic fragments of leukocytes, spurious elevation of platelet count may occur. According to the analyser and to the methods used for the determination of the cell blood count, flags or messages related to these spurious changes differ. For each spurious change, the authors describe the mechanism leading to the anomaly, the way the analysers generate flags, and what should be done to provide accurate results.
血液分析仪现在能够提供快速、准确且可重复的血细胞计数。然而，根据检测方法的不同，可能会出现假性计数。如果未被检测到，这种假性计数可能会导致不适当的医疗护理以及不必要的检查。首先关注血小板计数，导致假性降低的情况包括几个分析前的因素，其中主要的一个是与乙二胺四乙酸（EDTA）诱导的血小板聚集以及多形核细胞周围的血小板卫星现象有关。在其他情况下，由于存在模仿血小板的小颗粒，包括破碎的红细胞、脂质、冷球蛋白、纤维蛋白丝或白细胞的细胞质碎片，可能会出现血小板计数的假性升高。根据分析仪以及用于血细胞计数测定的方法，与这些假性变化相关的标记或信息会有所不同。对于每种假性变化，作者描述了导致异常的机制、分析仪生成标记的方式以及为提供准确结果应采取的措施。
