抗凝全血标本存放条件对血细胞参数稳定性的影响

摘要

目的 探讨抗凝全血标本存放条件对血细胞分析仪分析参数稳定性的影响.方法 用Sysmex K-4500血细胞分析仪对EDTA-K2抗凝血标本进行长时间(144 h)不同时段、不同放置温度的血细胞参数稳定性检测,用Excel 软件做统计学分析.结果 室温(18℃~25℃)条件下,白细胞(WBC)可稳定72 h,血小板计数(PLT)可稳定96 h,血红蛋白(Hb)可稳定120 h,红细胞(RBC)、红细胞平均血红蛋白含量(MCH)只能稳定24~48 h,其余参数于24 h开始与4 h内检测结果比较差异均有统计学意义(P<0.01).低温(2℃~8℃)冷藏条件下,WBC、RBC、Hb、MCH可稳定96 h,血细胞比容(HCT)、PLT可稳定72 h,红细胞平均体积(MCV)、红细胞分布宽度(RDW)可稳定48 h,血小板分布宽度(PDW)、血小板平均体积(MPV)于24 h开始与4 h内检测结果比较差异有统计学意义(P<0.05或P<0.01),红细胞平均血红蛋白浓度(MCHC)于96 h检测结果降低(P<0.01).偏差分析结果显示,标本室温保存,WBC、PLT、Hb于96 h内,RBC于48 h内,检测的结果差异在允许误差范围内;标本冷藏保存,WBC于96 h内、PLT于48 h内、红细胞3项参数(RBC、Hb、HCT)于120 h内检测的结果差异在允许误差范围内.结论 抗凝全血标本采集后,应及时送检,检测完毕后,建议放置2℃～8℃冰箱保存.如遇特殊原因,标本不能及时送检,也应放置冰箱保存,48 h内检测结果基本可满足除MPV、PDW外的血液常规需要.同时以备临床和患者对血液常规结果有疑惑时进行复检核对.%Objective To observe the influence of storage conditions to the stability of parameters of anticoagulated whole blood samples,when being analyzed with hematology analyzer.Methods Sysmex K-4500 hematology analyzer was used for the detection of EDTA-K2 anticoagulant samples,stored for a prolonged period (144 h),at different time and at different temperatures to analyze blood cell parameter stability. Excel software was applied to complete statistical analysis. Results At room temperature (18-25 C) conditions,the white blood cell (WBC) was stable for 72 h,platelets (PLT) was stable for 96 h,hemoglcbin (Hb) was stable for 120 h,red blood cell (RBC) ,mean corpuscular hemoglobin (MCH) can only be stable for 24-48 h,other parameters in the 24 h period beginning with the 4 h test results were statistically significant difference (P＜0.01). Under refrigerator (2-8℃ ) condition,WBC,RBC,Hb and MCH was stable for 96 h, hematocrit (HCT) and PLT were stable for 72 h, mean corpuscular volume (MCV) and red cell volume distribution width (RDW) could be stable for 48 h;platelet volume distribution width (PDW),mean platelets volume (MPV) in the 24 h period beginning with the 4 h test results statistically significant difference (P＜0.05 or P＜0.01) ,mean corpuscular hemoglobin concentration (MCHC) in the 96 h test results were significantly lower (P＜0.01). Deviation analysis showed that,of specimens stored at room temperature,WBC,PLT, HGB for 96 h, RBC for 48 h,the test differences of resuits were in allowable error range,of specimens with cold storage,WBC in the 96 h period,PLT in the 48 h,the three parameters of red blood cells (RBC, HGB, HCT) in the 120 h difference in test results within the permissible error range. Conclusion Whole blood specimen collection, should be promptly inspected. After testing, it is recommended to place 2— 8℃ refrigerator. In case of special reasons,the specimens are not timely submission,it should be placed refrigerator,48 h test results in addition to the basic can meet MPV,PDW needs outside the conventional blood. At the same time,to prepare for routine clinical and patient blood were re-examination when the results are in doubt check.