MAKERBIOTECHNOLOGY0XS全自动五分类血液分析仪介绍AUG2008MAKERBIOTECHNOLOGYXS三种型号1MAKERBIOTECHNOLOGYXS-1000iandXS-800i•荧光流式技术试剂界面质控系统2与XE/XT系列高端血液分析仪一脉相承20ul微量全血小五分类MAKERBIOTECHNOLOGY3微量用血:全血/预稀释均为20µL1mmRBC/HGBSample(4µL)TopenddiscardportionWBCSample(11µL)WholeBloodAspiration(20µL)Tailenddiscardportion1000i800iMAKERBIOTECHNOLOGY检测原理4白细胞:(DIFF通道)核酸荧光染色+流式+激光红细胞:(RBC/PLT通道)鞘流阻抗法血小板:(RBC/PLT通道)鞘流阻抗法血红蛋白:(HGB通道)SLS比色法MAKERBIOTECHNOLOGY5633nm650nm以上核酸量(DNA和RNA)侧向荧光使用半导体激光的Flowcytometry(FCM)半导体激光染色后的白细胞白细胞测定原理核和颗粒侧向散射光细胞体积前向散射光MAKERBIOTECHNOLOGYWBC总数•CBC模式:•FSC(前向散射光)•反映细胞大小•CBC+DIFF:•Ssc(侧向散射光)•反映细胞内容物复杂程度•Sfl(侧向荧光)•反映细胞核酸含量•6WBC=NEUT#+LYMPH#+MONO#+EO#+BASO#聚集的血小板MAKERBIOTECHNOLOGY白细胞分类:DIFF通道74DL完全溶解红细胞血小板在白细胞膜上打孔4DS对核酸染色纵坐标:侧向荧光(SFL)反映核酸含量横坐标:侧向散射光(SSC)反映细胞内容物复杂程度MAKERBIOTECHNOLOGYIG%#/OTHER%#(研究)•异常淋巴细胞•幼稚粒细胞8幼稚粒细胞异常淋巴嗜酸中性单核淋巴嗜碱MAKERBIOTECHNOLOGY更多的信息:报警原理9MAKERBIOTECHNOLOGYWBC报警信息意义判定项目判定方法/判定式WBCAbnormalWBCAbnScattergram白细胞散射图异常从DIFF散射图上来判断NeutropeniaNeutrophiliaLymphopeniaLymphocytosisMonocytosisEosinophiliaBasophiliaLeukocytopeniaLeukocytosis中性粒细胞减少中性粒细胞增多淋巴细胞减少淋巴细胞增多单核细胞增多嗜酸细胞增多嗜碱细胞增多白细胞减少白细胞增多NEUT#,NEUT%NEUT#,NEUT%LYMPH#,LYMPH%LYMPH#,LYMPH%MONO#,MONO%EO#,EO%BASO#,BASO%WBC#WBC#NEUT#1.00x109/L,(or设定的%)NEUT#11.00x109/L,(or设定的%)LYMPH#0.80x109/L,(or设定的%)LYMPH#4.00x109/L,(or设定的%)MONO#1.00x109/L,(or设定的%)EO#0.70x109/L,(or设定的%)BASO#0.20x109/L,(or设定的%)WBC#2.50x109/LWBC#18.00x109/LSuspectBlasts?ImmatureGran?LeftShift?AbnLympho?NRBC?AtypicalLympho?原始细胞未成熟粒细胞核左移异常淋巴细胞有核红细胞异型淋巴细胞散射图散射图散射图散射图散射图散射图从DIFF散射图上来判断从DIFF散射图上来判断从DIFF散射图上来判断从DIFF散射图上来判断从DIFF散射图上来判断从DIFF散射图上来判断10MAKERBIOTECHNOLOGY白细胞散射图异常11Ne/EoLym/GstLy/Mo2Ly/BaMo/Ne1Ne/GstMo/EoMAKERBIOTECHNOLOGY原始细胞12原始细胞MAKERBIOTECHNOLOGY未成熟粒细胞13幼稚粒细胞MAKERBIOTECHNOLOGY核左移14杆核MAKERBIOTECHNOLOGY异型淋巴细胞•注意:•当成熟白细胞能较好的分类,一般OTHER区域为异型淋巴细胞•当结果出现不分类的情况,一般OTHER区域主要是原始细胞15异型淋巴细胞MAKERBIOTECHNOLOGY异常淋巴细胞•注意:异常淋巴主要是指幼稚淋巴,白血病时出现的病理淋巴细胞等16异常淋巴MAKERBIOTECHNOLOGY有核红细胞17有核红细胞MAKERBIOTECHNOLOGY红细胞报警信息意义判定项目判定方法/判定式RBCAbnormalRBCAbnDistributionDimorphicPopulation红细胞直方图异常双形性细胞群RL,RU,MP,DWFlagMP(直方图的双峰性)对分析参数进行代数计算和数量比较在高和低点有间距并成“峰形”分布AnisocytosisMicrocytosisMacrocytosisHypochromiaAnemiaErythrocytosis红细胞大小不同小球性红细胞大球性红细胞低色素贫血红细胞增多RDW-SD,RDW-CVMCVMCVMCHCHGBRBCRDW-SD65fLorRDW-CV20%MCV70fLMCV110fLMCHC290g/LHGB100g/LRBC6.50x1012/LSuspectRBCAgglutination?Turbidity/HGBInterference?IronDeficiency?红细胞抗凝浑浊/HGB受干扰11缺铁性贫血1MCHC,MCH,RBC,RU(%)MCHC1MCV,MCHC,RDW-CV1对分析参数进行代数计算和数量比较MCHC365g/L1对分析参数进行代数计算和数量比较HGBDefect?HGB异常RDW-CV,MCV对分析参数进行代数计算和数量比较Fragments?红细胞碎片RDW-SD,PU,PU(%),MCV,RL对分析参数进行代数计算和数量比较18MAKERBIOTECHNOLOGY•红细胞直方图异常•触发规则:•RL(%)10%or•RU(%)5%or•RDW-SD无法计算or•多峰or•RU225fl或WBC#50x109/L•双峰•触发规则:•红细胞直方图不止出现一个峰19RBC100200250fl100%5%RLRU100200250fl100%20%RLRUSLMAKERBIOTECHNOLOGY•缺铁?•触发规则:•MCHC31.0g/dL&MCV75fl&RDW-CV15,0%20红细胞聚集?触发规则:MCHC40.0g/dL&MCH40pg&RBC3.50x1012/LorMCHC40.0g/dL&MCH40pg&RU%4%MAKERBIOTECHNOLOGYPLT报警信息意义判定项目判定方法/判定式PLTAbnormalPLTAbnDistribution血小板直方图异常PDW,PL(%),PU(%),PLT,P-LCR,MPV,PU对分析参数进行代数计算和数量比较ThrombocytopeniaThrombocytosis血小板减少血小板增加PLTPLTPLT60x109/LPLT600x109/LSuspectPLTClumps?PLTClumps(S)?血小板聚集血小板聚集DIFF散射图PDW,PL(%),PU(%),PMFV,PLT,PLCR,MPV,PU从DIFF散射图上来判断对分析参数进行代数计算和数量比较21MAKERBIOTECHNOLOGY22血小板直方图异常?触发规则:P-LCR45%&MPV13fl&PU24florPU23fl&PU20%orPL(%)10%orPU(%)40%orPDW-SD无法计算orPDW20florRL(%)9%PLPU100%20%10fl20fl30fl40fl12flMAKERBIOTECHNOLOGY23血小板聚集?触发规则:在散点图上特定的区域,散点达到一定数量聚集血小板MAKERBIOTECHNOLOGY•血小板聚集(S)?•触发规则:•PLT#60x109/L&PDW20fl&PU(%)20%or•P-LCR45%&MPV13fl&PU24fl24PU(%)10fl20fl30flPUPLMAKERBIOTECHNOLOGY25软件筛选异常标本(镜检规则自定义)MAKERBIOTECHNOLOGY26MAKERBIOTECHNOLOGY项目规则27MAKERBIOTECHNOLOGYIP规则28MAKERBIOTECHNOLOGY历史规则29MAKERBIOTECHNOLOGY自动判断30MAKERBIOTECHNOLOGY判断结果31谢谢您的关注32