Sassi M, Dibej W, Abdi B, Abderrazak F, Hassine M, Babba H
Laboratoire du centre de maternité et de néonatologie de Monastir, 5000 Monastir, Tunisie; Faculté de pharmacie, université de Monastir, 5000 Monastir, Tunisie.
Laboratoire du centre de maternité et de néonatologie de Monastir, 5000 Monastir, Tunisie; Faculté de pharmacie, université de Monastir, 5000 Monastir, Tunisie.
Pathol Biol (Paris). 2015 Dec;63(6):248-51. doi: 10.1016/j.patbio.2015.09.003.
Thrombocytopenia is a current situation for making a blood smear in routine practice in a medical analysis laboratory. Recent automated hematology analyzers enumerate platelets and generate histograms and specific flags. Operators must be aware of the characteristics of their analyzer in order to avoid spurious results in the case where microscopy review is not possible.
We evaluated the diagnostic performance of various graphical anomalies in the detection of large platelets and platelet clumps.
Three hundred cases of thrombocytopenia were included in the study on the basis of a platelet count less than 150 × 10(9)/L. This evaluation is expressed by the results of the sensitivity, specificity, positive predictive value and negative predictive value compared to the microscopic review of blood smear.
Graphical performances are variable according to microscopic review of blood smears. Indeed, a not fitted curve is the most sensitive change on platelet histogram to the presence of large platelet. A high specificity to the presence of platelet clumps is announced when the platelet curve fails to return to the baseline. Moreover, characteristic findings on the DIFF scattergram are very specific to the presence of platelet clumps.
A normal platelet histogram can validate with great confidence thrombocytopenia in cases where a blood smear cannot be read immediately.
在医学分析实验室的常规操作中，血小板减少是制作血涂片时的一种常见情况。最近的自动血液分析仪能够对血小板进行计数，并生成直方图和特定标记。操作人员必须了解其分析仪的特性，以便在无法进行显微镜复查的情况下避免出现假结果。
我们评估了各种图形异常在检测大血小板和血小板凝块方面的诊断性能。
基于血小板计数低于150×10⁹/L，300例血小板减少症患者被纳入研究。该评估通过与血涂片显微镜复查相比的敏感性、特异性、阳性预测值和阴性预测值结果来表示。
根据血涂片的显微镜复查，图形表现各不相同。实际上，拟合不佳的曲线是血小板直方图上对大血小板存在最敏感的变化。当血小板曲线未回到基线时，提示对血小板凝块的存在具有高特异性。此外，DIFF散点图上的特征性表现对血小板凝块的存在非常特异。
在无法立即读取血涂片的情况下，正常的血小板直方图可以非常可靠地验证血小板减少症。
