Hodnocení výsledků KO Bouřková L, OKH FN Brno Obecná pravidla pro měření pravidelná kontrola KO i dif kontrola Správnosti (firemní materiál) kontrola přesnosti (vitální krev) správná údržba přístroje • kontrola správného odběru EDTA (evt. Mg2+ nebo citrát) Pozor na: stáří vzorku, vzhled vzorku - chilózní, ikterický Kontrola kvality krevních obrazů • http ://www. h e m ato I oq v. cz/ Doporučení ČHS ČLS JEP: Vnitřní kontrola kvality měření krevních obrazů na hematologických analyzátorech Zpracovali: L. Bouřková, M. Matýskova, J. Kratochvíla Revize: R. Jelínek, J. Kratochvíla, M. Matýskova Vydání: 2013 Platnost od: 1.3.2013 Obecná pravidla pro hodnocení specifická pravidla pro daný analyzátor: v v w princip mereni - rozsah hodnot měřených parametrů (linearita - hlášení přístroje - měřený / počítaný parametr, grafy klinická hlediska: diagnóza léčba historie pacienta (LIS, četnost měření) Normální vzorek Sequence #: 703 Autoloader Pati ent/Human Specimen ID: 020003255 Name: X-B WBC RBC PLT In In In In WBC 7.88 10*9 - WVF .992 SEG 4. 73 %S 60.1 BAND 0.00 B n 0. 00 IG 0.00 % TO 0.00 BLST 0.00 %BL 0.00 MONe .483 %Me 6.12 EOS .186 %E 2.37 BASO .051 %B .641 LYMe 2.43 %Le 30.8 VAP L 0.00 %VL 0.00 RBC 5.22 10e12 . RBCo 5.12 HGB 9. 38 wo! . HCT 49.0 1 MCV 93.9 £ MCH 1 .80 fiol MCHC 19.2 wot . RDW 12.4 \CV RETC 71 .7 10e9 . %R 1 .38 IRF .221 NRBC 0.00 I0e9 . NR/W 0.00 PLTo 229. mn PLTi 239. MPV 9.59 tt CD61 ---- PDW 16.7 10(653) PLTs ---- PCT 2.19 PLTI ---- r38t06 RETC In Test Selection: CBC+RETC Param Set(Chart Page): 1 Limit Set: 1 Run Date/Time: 04.10.99 13:34 Mono Polp I w ■ ■ i voIwm (ÍL) Infekce Sequence #: 7967 Autoloader r04t02 Patient/Human Specimen ID: 031273 Name: X-B In WBC 1 Out wbc 31 .0 10*3 . SEG 17.8 BAND 9.14 IG 2.06 BLST 0.00 MONe .637 eos .043 baso 0.00 1 .29 Ar — 0.00 rbc 3.39 10*12.. hgb 6. 49 ■ol/l hct 33.2 i mcv 98.0 t mch 1 .91 w mchc 19.5 mMl rdw 15.3 retc ---- !0ef l irf ---- nrbc 0.00 10*3 j. PL To 305. mil KPV 9.00 t< PDW 14.7 10IGSC! PCT 2.74 RBC In wvf %bl %Me %e %b %Lě %VL PLT In RETC In Test Selection: CBC Param Set(Chart Page): 1 Limit Set: 1 Run Date/Time: 30.04.99 08:58 VBC Differential Bono Poly I .990 57.5 29.5 BAND 6.65 IG 0.00 2.06 .139 0.00 4.16 0.00 RBCo 3.45 %r ---- nr/w 0.00 305. 7» - COMPLEXITY Low-Mi PL 0* - SXZX Optical PLT PL3 - in D»8«dinc« PLT Volv* (fL) VoIom Starý vzorek equence #: 1440 Autoloader r93t08 pi-c i nu-i-i Type/SubType: Patient/Human peeimen ID: JJ5312 a m e: Teat Selection: CBC+RETC farám Set(Chart Page): 1 Limit Set! 1 Run Date/Time: 28/10/98 17:16 VIC Differential Nono Poly I LSI n* OS ASO Y He AFX B C GB CT CV CH 8.30 10«], M WVF %BD 3.39 2.11 . 551 0.00 .489 .105 .017 1 . 05 0.00 3.19 INC/ui 9.82 fl/dL 30.3 » ft 95.0 30.8 n CHC 32.4 a/*. W 15.8 I ETC 80 . 8»'0*3 jl RF ■490 C 0.00 10t3 ul 361 . 10f3'ui 10.9 a 15.3 lOíGSC) . 395 » .090 nvWDC 40.8 25.4 OAND %BL %E %B 6.64 0.00 5.09 1 .2G .204 19.8 IG 0 . 00 RBCv 3-34 %R 1 .90s NK/W 0 00 PLTt 329- IR »£T» MM [UNO M [Baa ITASGET ;msno ;mso iwoaro ?• - r.nNPfxrrrv LMř-Ml F L • nrrc » I. 1 I >i Satelitoza trombocytu Sequence •: 9427 Open Tube Specimen Type/SubType: Patient/Human Specimen ID: gruyters Name: Test Selection: CBC Param Set(Chart Page): 1 Limit Set: 1 Run Date/Time: 26/01/99 17:44 * Inval i dData *»c MttmgUil Polp z WBC 3.20*1M/l WVF .954* .» ~ _ 0.00* %N 0.00* LYM 2.00* %L 62.6* mono . 663* %M 20.7* bos .512* %e 16.0* BASO .023* %B .732* RBC 5.00 11*12/1 RBCo 4.84 HGB 9.50 ii: . HCT .455 l/l MCV 91 .0 fl MCH 1 .90 fMl MCHC 20.9 Ml/l RDW 12.4 ICY RBTC ---- itof/i %R ---- IRF ---- NRBC 0.00*1M/l NR/W 0.00* PLT 156. IOrt/1 PLTi 162. MPV 8.48 fl PDW 16.9 10(8$l) PCT 1.32 ll/L VARLYM Volt»« (fl) volrmt (fL) Monoblasty Mononukleoza Sequence I: 2830 Open Tube Specimen Type/SubType: Patient/Human Specimen ID: Name: Test Selection: CBC Param Setffrom Chart Page): 1 Limit Set: 1 Run Date/Time: 03/06/98 10:13 Sequence t: 3556 Autoloader Specimen Type/SubType: Patient/Human Specimen 10: 05374 Name: Test Selection: CBC Param Set(from Chart Page): 1 Limit Set: 1 Run Date/Time: 08/09/97 14:33 •Inval ldData nc jiMtnatui MOftO Polf I nc 3i!f«rtn'.ul »ao Pol; I WBC 15.0 IM/l WVF .977 3.25s 21.7S LYM 3.19« %L 21.3* MONO 8.36« 55.9* EOS .024 %B .159 BASO .136 %B .906 BAND IG BLAST RBC HGB HCT MCV MCH MCHC RDW RETC IRF NRBC 3.63 1M2/1 PBO: 3.70 6.91 Ml/L .308 l/l 84.9 II 1.90 fMl 22.4 Ml/L 14.5 XCT ----IM/l %R ---- 0.00 IMA NP/W 0.00 36.1 25.9 IM/l PLJ 8.93 II 18.9 11(01) .231 ill WBC 16.9 IM/l WVF .983 4.21 Hi 24.9 BAND 0.00 m 0.00 0.00 %IG 0.00 BLST 1.11 %BL 6.52 MONe .703 %Me 4.15 EOS .097 VE .570 BASO .056 .333 LYMe 10.5 62.0 VARL .258 VVL 1.52 RBC 5.36 ifcll/l RBCo 5.11 HGB 9.40 ml/l HCT .460 l/l MCV 85.9 11 MCH 1.76 fMl MCHC 20.4 ml/l RDW 15.5 m RETC ---- IM/l %R ---- IRF ---- .77 FP? VARLYM NRBC O.OOslM/l NR/W 0.00s MPV PDW PCI 248. IM/l 8.34 II 18.0 11(8») 2.07 Hil 241. .90 —?—|—i—i—r" lor-IU FL ru - Dm BIC MIC ru - sou — Chronická lymfatická leukémie Sequence *: 3706 Autoloader r08t02 Patient/Human Specimen ID: 990914696018 Name: WBC 2 Out PLT In RETC In Test Selection: CBC Pa ram Set(Chart Page): 1 Limit Set: 1 Run Date/Time: 22/09/99 13:20 WBC Dift»rtntx»l Mono toLy I WBC 207. mil WVF .843 nvWBC NEU 8.76 lym 195.S mono 1.62 EOS 0.00 baso 1.34 %L %M %e %b 4.24 94.3s .782 0.00 .647 VARLYM .80 RBC hgb hct MCV mch MCHC RDW RETC IRF ■RBC 3.80 1*12/1 7.31 aol/l .376 IA 98.9 U 1 .92 fMl 19.5 mill 12.9 ICT ----1M/L RBCo 3.79 %R 0.00 mil NR/W 0.00 PLTo 47.8 mil MPV 9.81 U PDW 17.0 10(iSI) PCT .469 H/l PLTl 42.9 FL3 - D HA Bqp« vobmt <(L) Vzorek po dialýze Sequence #: 4453 Autoloader r91t07 Patient/Human Specimen ID: JX6223 Name: Test Selection: CBC+RETC Param Set(Chart Page): 1 Limit Set: 1 Run Date/Time X-B WBC RBC PLT RETC WC Dxffmntul In In - In In «InvalidData ' WBC 15.0*1M/l WVF .990* 5.78* 38.5* LYM 9.00« %L 59.9* MONO .214* Ml 1.43* BOS .022* IE .149* o- BASO 0.00* H 0.00* i I' ľ. I m VARLYM RBC ■1GB MCH 3.78s10e1!/l 8.08 II!'. .395 l/l 104. fl 2.13 i: MCHC 20.5 Mol/l RDW 21.9 I» RETC 95.3S1W/1 IRF .335 NRBC 0.00*IW/l 76.9 'Of!'I 16.6*11 PDW 39.8*10(01) 1.28*i. . RBCo 3.85 rstRBC %R 2.52s I NR/W 0.00* 90.3 IR Biipidinc« PLT Mm' liffimtltl HIC Mološi ■ n iomai MICRO mi ■TELO POLTCH iicio ly«ph pio 1MB IIIS3 I0K IDS! mi IASOSTIP EOSII m m TARGET USD toicju WEN Ht hi EB HUM :nr (IFF k lite: 29/06/00 12:08 Dono Pel; I 1 .JfrrV Ifcptdinc« PIC Volwu (fl) Volant (fl) lit Cooit litt Violation Resistant IK Interference with IK results Unable to Find Clear Separation Between IK Simulations lonr, Upper, or lower ail Upper legion Interference in PLTi Histogru lower. Upper, or lower and Upper legion Interference ii PLTt Hiitogru Po odstranění rstRBC Sequence #: 4472 Pat i ent/Human Specimen ID: JX6223 Name: RBC Autoloader r94t09 X-B In WBC WBC In Test Selection: CBC+R Param Set(Chart Page): 1 Limit Sfet: 1 Run Date/Time: 29/06/00 12:56 nc Dlffiruitiil Hono Poly I 6.47 IOti/l 5.55 LľM .531 MONO .364 EOS .028 BASO .001 WVF %L %E %B RBC 3.74 1N1!/1 RBCo 3 HGB 7.96 nol/l HCT .388 l/l MCV 104. fl MCH 2.13 fnl MCHC 20.5 nol/l RDW 21.9 Iff RETC IRF ~ iOrt/i NRBC O.OOslOe!/l %R -— NR/W 0.00s PLTo 75.2 itw/i 81.3 MPV 13.2*11 ---- PDW 19. 7*10(6») ---- PCT .992*11/1 ■ .---- lutil liffereit ll IK lorpholH) SES ■ETA lOIUl ■ICRO hid MIO POLTCH lACRO mm PIO HTPOCH IIISO •MO BUST nu IASOSTIP EOSII »1 111 TARGET HI TOIGRAN SPHEIO IRK hi EST pit torn ::iii" OIFf ii: late: Volum (iL) Volon (ft) lower, Upper, or Lower and Upper legion Interference in PLT i Hiitogru Lower, Upper, or lower and Upper legion Interference in PLT i Kistogrii Reakce na EDTA Sequence #: 8950 Patient/Human Specimen ID: 030074152 Name: KATINKA JOHA PETERSEN Autoloader r06t03 Test Selection: CBC Param Set(Chart Page): 1 Limit Set: 1 Run Date/Time: 02.05.00 09:47 X-B In WBC BLST MONe EOS BASO LYMe VARL WBC In 14.8 mu 9.64 0.00 0.00 0.00* 1.27* .016 .010 3.92* 0.00* RBC 3.56 mill RBCo HGB 7.09 nol/l HCT 33.0 I MCV 92.8 fl MCH 1.99 ful MCHC 21.5 MOl/l RDM 11.3 IC! RETC — mn IRF ---- NRBC O.OOslOli/l 132.*IO(!/l 8.99*fl 15.2*I0(0SI) 1.18*11/1 n3 - im Ikpduic* RBC Manual Differential HC Morphology SEC in NORMAL MICRO MIO I1E10 POUCH MACRO mm no HYPOCH II1S0 1010 BLAST Nil IISOSTIP EOSII m in TARGE T BASO TOKIU SPHERO us: PIT EST K MORPH Cusent:_ A VoIum (fl) lie to Find Clear Separatio« letieei IOC Spoliations Significant Muter of Cells Reaoved froi lie Differential Analysis Interference litt PIT Results Ou to PIT duping Sequence #: 2568 Specimen Type/SubType: Patient/Human Specimen 10: IA5285 Name: Test Selection: CBC+RETC Param Set(from Chart Page): 1 Limit Set: 1 Run Date/Time: 22/01/97 12:17 Invalid Data nc »iif»t»ati»i hoho Pol; I WBC 6.46**3. WVF .961* 4.14* *N 64.1* LYM 1.87* *L 29.0* MONO .257* M 3.98* EOS .189* M 2.93* BASO 0.00* *E O.00*BAND RBC HGB HCT MCV MCH 5.19 ".HI. 15.7 |/á .454 .. 87.5 '. 30.2 PS MCHC 34.6 s:. RDW 12.1 \ RETC 43.6 IM. IRF .232 NRBC 0.00*l9e)i FL" 45.2*IOeS. 10.5*'. PDW 16.8*11(653) .476*«VL volmt (IL) ALL a fragmenty cytoplazmy Sequence #: 2699 Autoloader r38 Pat i ent/Human Specimen ID: 000213479091 Name: X-B In WBC LYM MONO EOS BASO RBC HGB HCT MCV MCH WBC RBC PLT 2 Out In In 3.36 I0e9/L WVF . 956 . 133 3 . 95 3.08s %L 91 . 7s . 136s %M 4.05s .010 %E . 296 0.00 %B 0.00 3.74 10C12/L RBCo 3. 78 RETC In •Invali BLAST VARLYM 5.81 lie .287 L/L 7 6.6 f L 1 . 55 ftol li ICY MCHC 20.3 RDW 17.9 RETC----10e9/L IRF ---- NRBC 0.00 10e9/L PL To 81 . 5*10e9/L MPV 5.41*fl 15.1 *I0(GSD) . 441 *lL/L %R ---- NR/W 0.00 131 . * ---- PLT ---- PLT1---- ~T-r-t-t-i-r FL3 - DNA D»p«d»nc« MC D»p«danc« plt A \ volum» (fL) Volum* (íl) Loier, Upper, or Lover and Upper Region Interference in PLT i Histograi PIC/POC Delta Sex: F Doctor: 0568/30/04/2010 User Defined A: User Defined B: User Defined C: User Defined D: WBC Uitlerentiai X-B WBC RBC PLT In In In In WBC J61+ 10e9/L WVF .299* 1.47* BLST 1.59 %BL MONe 2.79 %Me EOS .018* %E BAS0 0.00 %B LYMe 1.80 %Le VARL 0.00 %VL RBC HGB HCT MCV 96* MCH 34.8s 10e12/L wyelo IS polich macro f lyiiph H hypoch aniso 1/ mono I t bĺaY 9* NM basostip eosin Hfl lyh target usd toxgran sphero nrbc pi t f CT Altar, AHfiJiM" PIT MORPH / Ply Dale: FL3■DNA Impedance RBC Volume (IL) Volume (IL) Unable lo Find Clear Separation Between WBC Subpopulations Lower, Upper, or Lower and Upper Region Interference in PLTi Histogram PIC/PÖC Delta s diagnózou AML spojená s dysplázií po terapii DOB: 03/21/80 Sex: F Doctor: 0776/31/05/2010 User Defined A: User Defined B: User Defined C: User Defined D: X-B WBC RBC PLT RETC In In In In I Out WBC 7.41 10e9/L WVF .964 WBC Differential 5.16 0.00 0.00 BLST 0.00 MONe J16 EOS .173 BAS0 .031 LYMe 1.32 VARL 0.00 69.7 0.00 0.00 %BL 0.00 %Me 9.67 2.34 %B .420 0.00 FT? RBC 10e12il RBCo HGB gil HCT UL MCV ,rfl MCH 30.8 pg HCHC M .gl RDW IWitWV RETC 73JL lOeSfL SR 28J IRF ,448. NRBC 0.00s 10e9/L NR/W 0.00s 215. IObSIL 8.38 ft. 10(GSD) 1.80 mlA 246. Volume (IL) anizo ery sferocyty anizo, makro PLT hypogranulace NE .v 9 ľ I » A00776V5AB_031 A00776V5AB_032 A00776V5AB_033 A00776V5AB_034 A00776V5AB_035 A00776V5AB_036 A00776V5AB 037 A00776V5AB 038 A00776V5AB 039 A00776V5AB 040 A00776V5AB 041 A00776V5AB 042 k. A00776V5AB 043 A00776V5AB 044 A00776V5AB 045 A00776V5AB 046 A00776V5AB 047 A00776V5AB 048 r- Z: j* rí í? Ž- *° ■> 1 •Ä # ^^^P polychromázie y ^ĚB sférocyty D0lychrnma7ifi Pacient 2 • žena, 30 roků • ambulantní pacientka DOB Sex: F Doctor: 03/21/80 WBC Differential 0776/31/05/2010 User Defined A: User Defined B: User Defined C: User Defined D: X-B WBC RBC PLT RETC In In In In lOut WBC 7.41 10e9/L WVF .964 5.16 69.7 0.00 0.00 0.00 0.00 BLST 0.00 %BL 0.00 MONe .716 %Me 9.67 EOS .173 %E 2.34 BAS0 .031 %B .420 LYMe 1.32 VARL 0.00 0.00 FP? 10e12/L RBCo RBC HGB HCT UL MCV (L MCH 30.8 pg MCHC 3X6. fll RDW m "/oCV RETC 73JL 10e9/L IRF ,448. NRBC 0.00s 10e9/L 215. 10e9/L 8.38 fL 10(GSO) 1.80 mlA %R 28J. NR/W 0.00s 246. FL3 • DNA Impedance RBC Impedance PLT Manual Dilwenlial SEG it IETA V RBC Morphology NORMAL MICRO ľ BAND { IMYELO POLÍCH V MACRO y LYMPH %0 PBO HYPOCH ANISO * MONO k BLAST f POIK BASOSTlf EOSIN 3 VAR LÝK TARGET BASO 4 TOXGRAN SPHERO mi at PLT ESI ifjUKT PLT MORPH Commeiil jUiMwi+jJa DIFFbi: 01