文章摘要
杨麦贵,杨 铮,杨 阳,岳 波,郑善銮,樊爱琳,胡恩亮,马 恒,郝晓柯.全自动血细胞分析仪自动推片致淋巴细胞变异的探讨[J].,2018,(17):3255-3259
全自动血细胞分析仪自动推片致淋巴细胞变异的探讨
Study on Lymphocyte Variation of Automatic Blood Cell Analyzer Automatic Push Sheet
投稿时间:2017-10-31  修订日期:2017-11-27
DOI:10.13241/j.cnki.pmb.2018.17.011
中文关键词: EDTA-K2抗凝血  全自动推片  手工推片  异型淋巴细胞  光学显微镜
英文关键词: EDTA-K2 anticoagulant  Automatic push tablets  Manual push tablets  Shaped lymphocytes  Optical microscope
基金项目:国家自然科学基金项目(81470410)
作者单位E-mail
杨麦贵 第四军医大学西京医院全军临床检验医学研究所 陕西 西安710032 yangmg@fmmu.edu.cn 
杨 铮 第四军医大学研究生管理大队 陕西 西安710032第四军医大学基础部病理生理学教研室 陕西 西安710032  
杨 阳 北京陆军解放军第252医院 北京710000  
岳 波 第四军医大学西京医院耳鼻咽喉头颈外科 陕西 西安710032  
郑善銮 第四军医大学西京医院全军临床检验医学研究所 陕西 西安710032  
樊爱琳 第四军医大学西京医院全军临床检验医学研究所 陕西 西安710032  
胡恩亮 第四军医大学西京医院全军临床检验医学研究所 陕西 西安710032  
马 恒 第四军医大学基础部病理生理学教研室 陕西 西安710032  
郝晓柯 第四军医大学西京医院全军临床检验医学研究所 陕西 西安710032  
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中文摘要:
      摘要 目的:探讨全自动血细胞分析仪自动推片系统致乙二胺四乙酸(EDTA)-K2抗凝血淋巴细胞形态变异的机制。方法:采用全自动血细胞分析仪自动推片系统对选择西京医院门诊228例受试者,其中儿童80例、成人100例、经临床及骨髓穿刺细胞学确诊的淋巴细胞性白血病(CLL)21例、粒细胞性白血病15例和单核细胞性白血病12例,均用EDTA-K2(2.0 mg/mL)专用管采血2 mL,在1 h内完成仪器推片及手工推片、瑞-姬染色,经2位经验丰富的主管检验师显微镜检查分类比较。结果:228例受试者EDTA-K2抗凝血,仪器自动推片细胞分类Ⅱ型淋巴细胞(18.65±2.35)%明显高于手工推片(4.67±2.45)%,统计学处理具有显著性差异(P<0.01)。正常组与粒细胞性白血病和单核细胞性白血病患者抗凝血,仪器自动推片,淋巴细胞形态没有明显改变(4.36±2.17)%与手工推片(4.21±2.14)%比较没有差异(P>0.05),淋巴细胞性白血病(CLL)患者的淋巴细胞形态有明显的改变仪器为(85.25±5.26)%与手工推片(4.25±2.19)%有显著性差异(P<0.01),淋巴细胞体积增大,外形不规则,着色不均,边缘蓝色较深,胞核不规则,细致膨胀,淡紫红色,主要拟为Ⅱ型(不规则型/单核细胞型)异型淋巴细胞。结论:全自动血细胞分析仪自动推片系统对EDTA-K2活化膨胀的淋巴细胞失控而致淋巴细胞形态拟Ⅱ型异型淋巴细胞,手工推片已控制所以细胞形态不易改变,确切机制还有待进一步研究。
英文摘要:
      ABSTRACT Objective: To investigate the mechanism of morphine variation of EDTA-K2 anticoagulant lymphocytes in automatic hematology analyzer. Methods: A total of 228 subjects with Xijing Hospital were selected by automatic blood cell analyzer. Among them, 80 children and 100 adults were enrolled in this study. There were 21 cases of lymphocytic leukemia diagnosed by clinical(CLL) and bone marrow aspiration cytology, granulocytic leukemia 15 cases and mononuclear cell leukemia in 12 cases, were treated with ethylene- diamine tetraacetic acid (EDTA) -K2 (2.0 mg/mL) special tube blood 2 mL, in 1 h to complete the instrument push and hand push tablets, Rui - Ji dyeing, By two experienced supervisors of microscopy examination classified comparison. Results: The plasma type Ⅱ lympho- cytes (18.65±2.35)% were significantly higher than those of the manual tablets (4.67±2.45)% in the subjects with EDTA-K2 anticoagu- lant instruments. The difference was statistically significant (P<0.05)<0.01). There was no significant difference between the normal group and the granulocytic leukemia and monocytic leukemia patients (4.36±2.17)% compared with the manual push tablets (4.21±2.14)% (P<0.05). The lymphocyte morphology of patients with lymphocytic leukemia was significantly different (85.25±5.26)% and that of manual push tablets (4.25±2.19)% (P<0.01), lymphocyte volume increased , Irregular shape, uneven coloring, dark blue edge, irregular nucleus, meticulous expansion, lavender, mainly to be type Ⅱ (irregular type / monocyte type) shaped lymphocytes. Conclusion: Au- tomated blood cell analyzer automatic push film system on the activation of EDTA-K2 expansion of lymphocytes out of control caused by lymphoid morphology of pseudo-type Ⅱ type lymphocytes, manual push tablets have been controlled so the cell morphology is not easy to change, the exact mechanism remains to be further studied.
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