田萍萍 郑梅淋 陈燕媚

【摘要】 目的：分析外周血血细胞形态学镜检复核对血液系统疾病诊疗的临床价值。方法：选取2017年8月-2018年10月血常规标本经全自动血液分析仪检查结果异常的患者236例、血常规标本经全自动血液分析仪检查结果正常的健康体检者236例，显微镜下进行血细胞涂片形态学检查。结果：236例健康体检者的血常规标本经血细胞形态学检查假阴性率为1.7%，236例患者的血常规标本经血细胞形态学镜检复核假阳性率为36.9%。白细胞正常、降低或增高，伴随嗜碱性粒细胞百分率、嗜酸性粒细胞百分率、淋巴细胞百分率、单核细胞百分率、中性粒细胞百分率指标中某一项显著增高时，血细胞形态学检查异常率较高。结论：对全自动血液分析仪筛查后可疑样本进行外周血血细胞形态学镜检复核对血液系统疾病的诊疗具有重要意义。

【关键词】 血液系统疾病 血细胞形态学 白细胞 血液分析仪 血常规检查

doi：10.14033/j.cnki.cfmr.2019.30.029 文献标识码 B 文章编号 1674-6805（2019）30-00-03

[Abstract] Objective： To analyze the clinical value of microscopic examination of peripheral blood cells in diagnosis and treatment of hematological diseases. Method： From August 2017 to October 2018， 236 patients with abnormal results of blood routine specimens examined by automatic blood analyzer and 236 healthy people with normal results of blood routine specimens examined by automatic blood analyzer were selected. Blood cell smear morphology was examined under microscope. Result： The false negative rate of blood routine specimens was 1.7% in 236 healthy people， and 36.9% in 236 patients. The abnormal rate of blood cell morphology was higher when the white blood cells were normal， decreased or increased， accompanied by a significant increase in basophil percentage， eosinophil percentage， lymphocyte percentage， monocyte percentage and neutrophil percentage. Conclusion： It is of great significance for the diagnosis and treatment of hematological diseases to check the morphology of peripheral blood cells of suspicious samples after screening by automatic hematology analyzer.

[Key words] Diseases of blood system Blood cell morphology White blood cells Blood analyzer Blood routine examination

First-authors address： Xiamen Haicang Hospital， Xiamen 361000， China

外周血血细胞形态学检查是基础的临床医学检验技术，具有簡便、经济、实用等明显优势。目前，全自动血液分析仪的运用极大提高了临床医学检验的工作效率，但误差情况依然无法避免[1]。血液涂片染色镜检的诊断准确性较高，外周血血涂片检查是最直观有益的血液系统疾病检查手段[2]。对此，本研究通过对全自动血液分析仪检测异常的血标本进行外周血血细胞形态学检查，重点探究血液系统疾病诊疗中血细胞形态学观察的临床价值，现报告如下。……