中国医学科学院学报

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中国医学科学院学报

中国医学科学院学报 ›› 2021, Vol. 43 ›› Issue (4): 507-512.doi: 10.3881/j.issn.1000-503X.13746

• 论著 • 上一篇    下一篇

41 ℃温浴对高效价冷凝集素样本血常规检测结果的影响

解鸿翔1,2,沈燕1,庞珍珍1,孙彬1,王珍妮1,谢姝惠3,周永列1()   

  1. 1浙江省人民医院 杭州医学院附属人民医院检验医学中心 检验中心,杭州 310014
    2山东第一医科大学第一附属医院 山东省千佛山医院检验科,济南 250014
    3台州学院医学院检验系,浙江台州 318000
  • 收稿日期:2021-01-16 出版日期:2021-08-30 发布日期:2021-09-03
  • 通讯作者: 周永列 E-mail:lab_zyl@126.com
  • 基金资助:
    国家自然科学基金(81600110);山东省自然科学基金(ZR2020MH116);浙江省医药卫生科技计划项目(2021KY017)

Feasibility of Preheating at 41 ℃ to Correct Red Blood Cell Parameters in the Presence of High-titer Cold Agglutinins

XIE Hongxiang1,2,SHEN Yan1,PANG Zhenzhen1,SUN Bin1,WANG Zhenni1,XIE Shuhui3,ZHOU Yonglie1()   

  1. 1Center of Laboratory Medicine,Zhejiang Provincial Peoples’ Hospital,People’s Hospital of Hangzhou Medical College,Hangzhou 310014,China
    2Department of Clinical Laboratory,The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital,Jinan 250014,China
    3Department of Laboratory Medicine,Taizhou University Medical School,Taizhou,Zhejiang 318000,China
  • Received:2021-01-16 Published:2021-08-30 Online:2021-09-03
  • Contact: ZHOU Yonglie E-mail:lab_zyl@126.com
  • Supported by:
    National Natural Science Foundation of China(81600110);Natural Science Foundation of Shandong Province(ZR2020MH116);Medical and Health Science and Technology Program of Zhejiang Province(2021KY017)

摘要:

目的 探讨41 ℃水浴30 min纠正血常规检测中冷凝集现象的可行性。方法 选取工作中遇到的2例含有高效价冷凝集素的样本,分别在室温、37 ℃和41 ℃水浴不同时间后进行血常规分析,观察血常规各项检测参数的变化;同时对标本进行涂片染色镜检,观察红细胞分布情况。收集74例无冷凝素的血常规标本,将标本41 ℃水浴后检测结果与室温检测结果进行一致性和可比性验证。结果 2例冷凝集标本在室温检测时红细胞计数(RBC)和红细胞压积(HCT)明显降低,平均血红蛋白含量(MCH)和平均血红蛋白浓度(MCHC)异常升高,血红蛋白(HGB)与RBC比例明显异常,涂片染色镜检见红细胞大量聚集成团。37 ℃水浴不同时间后,RBC、HCT、MCH和MCHC均得到明显改善,但镜检仍有红细胞聚集成团现象。41 ℃水浴30 min后,两例标本RBC明显升高,HCT、MCH和MCHC亦趋于正常,镜检可见红细胞均匀分布。74例标本在41 ℃水浴30、60 min后的检测结果分别与室温下检测结果相比,各项目相对偏差符合率均≥80%,结果具有可比性。结论 对于含有高效价冷凝集素的标本可以考虑41 ℃水浴后再进行血常规检测,以获得准确的检测结果。

关键词: 冷凝集素, 红细胞参数, 全血细胞计数

Abstract:

Objective To explore the feasibility of preheating in 41 ℃ water bath for 30 minutes to correct the red blood cell parameters in the specimens containing high-titer cold agglutinins(CAs). Methods Two specimens containing high-titer CAs were selected during work,and the parameters of complete blood count at room temperature or after preheating in 37 ℃ or 41 ℃ water bath were compared.The smears were stained,and the distribution of red blood cells was observed with a microscope.Further,74 specimens without CAs were collected for complete blood count,and then the test results at room temperature and after preheating at 41 ℃ were compared. Results At room temperature,the specimens containing high-titer CAs showed significantly reduced red blood cell count(RBC)and hematocrit(HCT),abnormally increased mean corpuscular hemoglobin(MCH)and mean cell hemoglobin concentration(MCHC),abnormal percents of hemoglobin(HGB)and RBC,and aggregation of a large number of red blood cells.After being preheated at 37 ℃ for a certain time,the specimens demonstrated obviously improved parameters while still aggregation of a small number of red blood cells.After being preheated at 41 ℃ for 30 minutes,the specimens showed significantly increased RBC,normal HCT,MCH,and MCHC,and evenly distributed red blood cells.The 74 specimens without CAs showed the comparability was ≥80% between room temperature and preheating at 41 ℃ for 30 minutes or 60 minutes. Conclusion We can preheat the specimens containing high-titer CAs in a water bath at 41 ℃ to obtain accurate red blood cell parameters.

Key words: cold agglutinins, red blood cell parameters, complete blood count

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