一种显微计数新方法ADAM-rWBC在成分血残留白细胞检测中的应用

摘要

目的：评估一种基于显微计数新方法（ADAM-rWBC）在残余白细胞定量检测中的性能和应用可行性。方法以Sysmex KX21全自动血球计数法及Nageotte血细胞计数板法作为参比，分析ADAM-rWBC检测白细胞的定量准确性和可重复性，并评估其在成分血白细胞残留检测中的实际性能。结果对WBC浓度分别为40、10和1 cell/µl的3份滤白红细胞悬液样品进行平行检测，ADAM-rWBC的批间变异系数分别为8.8、11.3和31.1，准确度分别为100.0%、87.5%和37.5%；而Nageotte计数板法的批间变异系数则分别为20.4、31.8和15.3，准确度分别为50.0%、12.5%和37.5%。对36份全血标本（白细胞浓度范围为4辱与共4500~10700 cell/µl），采用ADAM-rWBC进行稀释定量与采用Sysmex kx21进行直接计数的结果间差异无统计学意义（P=0.655），且线性相关性较好（Slope=1.00±0.01, R2=0.832，P<0.001）。对34份滤白红细胞悬液进行残留白细胞测定，平行采用ADAM-rWBC和Nageotte计数法所获结果间的差异无统计学意义（P=0.18），两种方法定量值均低于3.0 cell/µl，符合白细胞残余量<12.5 cell/µl的质控要求。结论采用ADAM-rWBC进行白细胞定量测定准确可靠，相比于Nageotte计数法重复性和精度更佳，能满足成分血白细胞残余量检测的国标需求。%Objective Transfusion of blood components containing high amounts of leucocytes possibly causes side-effects in recipients. Therefore, the measurement of the residual leucocytes is certainly required for quality control of blood components. The study aimed to evaluate the performance of a new microscopic system (ADAM-rWBC) for residual leucocytes determination in blood components.Methods The quantitative accuracy, reproducibility and practical performance of ADAM-rWBC in detection of leucocytes was evaluated when compared with sysmex KX21 hematology analyzer and manual counting in the nageotte chamber.Results In a parallel detection of3 specimens which contained 40,10 and1 cell/μl, the inter-assay coefficient of variation (CV %) was8.8,11.3, and31.1 for ADAM-rWBC and20.4, 31.8, and15.3 for Nageotte. The accuracy was100%,87.5%, and37.5% for ADAM-rWBC and50%,12.5%, and37.5% for Nageotte, respectively. In the detection of36 complete blood samples (white leucocytes counting ranged from4500 to10 700 cell/μl), the WBC quantification results from ADAM-rWBC diluting- measurement were comparable (P =0.655) and well-correlated (Slope=1.00±0.01, R2=0.832, P <0.001) with that from Sysmex kx21 hematology analyzer. In detection of34 blood components after leucocytes depletion, no significant difference (P =0.18) was observed between ADAM-rWBC and Nageotte chamber, all sample presenting a WBC amount <3.0 cell/μl, which coincided with the standard requirement of <12.5 cell/μl.Conclusion The ADAM-rWBC was a accurate and reliablemethod for white leucocyte measurement. In comparison with manual counting, the ADAM-rWBC was more reproducible and was satisfied of convenience and be able to meet the national requrement.