Determination of reference intervals of hemogram with advanced clinical parameters by indirect method on Sysmex XN-1000

M. A. Bildirici, Sedat Gülten, Neslihan Cihan Çalışgan
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Abstract

Abstract Objectives The reference interval is the primary tool used to interpret laboratory test results. Each laboratory should determine reference intervals (RIs) that reflect their population. In this study, it was aimed to determine the RIs of hemogram routine and advanced clinical test parameters for our hospital and region by indirect method and to compare these calculated RIs with the limits recommended by the current manufacturer and the literature. Methods The hemogram results of patients aged 18–65 years who applied to Kastamonu Training and Research Hospital between July 2020 and June 2022, were included in the study. Hemogram analyzes were performed on Sysmex XN-1000 (Kobe, Japan) hematology auto analyzers. The RIs were determined by indirect method from the obtained data using the non-parametric percentage estimation method. Harris-Boyd method was used to decide on subgroup separation based on gender. Results All parameters had non-parametric distribution. RBC, HGB, HCT, MCH, MCHC, PLT, RDW-CV, RDW-SD, PCT, Monocytes count, Eosinophils count, Monocytes % and MacroR parameters which required gender-spesific RIs were determined separately for genders. Conclusions When the results are evaluated, it shows that the manufacturer’s recommendations together with the studies in the literature do not fully reflect the RIs of our population. Therefore, it is very important for each laboratory to determine its own RIs due to the differences in population, diet, technical equipment used and reference group. In addition, we think that our study will make a significant contribution to the literature, since there is insufficient data in the literature on RIs for advanced clinical parameters.
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用Sysmex XN-1000间接法测定含高级临床参数的血象参考区间
参考区间是解释实验室检测结果的主要工具。每个实验室应确定反映其人口的参考区间(RIs)。本研究旨在通过间接方法确定我院及地区血图常规及高级临床试验参数的RIs,并将计算出的RIs与目前生产厂家推荐的RIs限值及文献进行比较。方法收集2020年7月至2022年6月在Kastamonu培训与研究医院申请的18-65岁患者的血象图结果。血谱分析采用Sysmex XN-1000 (Kobe, Japan)血液学自动分析仪。RIs采用非参数百分比估计法从获得的数据中间接确定。采用Harris-Boyd方法确定基于性别的子组分离。结果各参数均呈非参数分布。RBC、HGB、HCT、MCH、MCHC、PLT、RDW-CV、RDW-SD、PCT、Monocytes计数、嗜酸性粒细胞计数、Monocytes %和MacroR等需要性别特异性RIs的参数分别测定。当对结果进行评估时,它表明制造商的建议以及文献中的研究并不能完全反映我们人群的风险风险。因此,由于人群、饮食、使用的技术设备和参照组的差异,每个实验室确定自己的RIs非常重要。此外,我们认为我们的研究将对文献做出重大贡献,因为文献中RIs的高级临床参数数据不足。
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