The Journal of the Korea Contents Association (한국콘텐츠학회논문지)

The Korea Contents Association (한국콘텐츠학회)
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Methodology and Case Analysis of the Erroneously High Counts in Automated Hematology Analyzer(XE-2100) using WBC

자동 혈구분석기(XE-2100)를 이용한 WBC 과다측정의 확인방법 및 사례 분석

  • Published : 2009.04.28
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Abstract

During an 8 month period from January to August 2007, complete blood count (CBC) samples were taken from various wards and from the outpatient department at Samsung Medical Center. In order to determine whether or not the total white blood cells were over counted, results were obtained from both the 4Diff/channel and the white blood cell channel from the automated blood analysis equipment from S company for comparison. Among patients who were on long term treatments, the number of cases determined to be over counted by comparing the WBC counts during this 8 month period was 25. Clinical chemistry tests were also conducted on the same day on the 25 samples taken. 68% of the patients showed to exceed normal range of aspartate transaminase (AST) and alanine aminotransferase (ALT) indicating abnormal liver function, and the total bilirubin range were also in excess in 60% of the total samples taken. Further clinical information which was obtained from the patients showed 98% of the patients were administered with cefepime which is the 4th generation cephalosporin at the time when the WEC were over counted. It is assumed that a multiple of factors investigated caused the over count of the WEC rather than a single factor.

2007년 1월부터 8월까지의 8개월 동안 삼성서울병원에서 병동 및 외래에서 의뢰된 전 혈구검사 검체를 대상으로 하여 S사의 자동혈액장비의 4 Diff channel과 WBC channel의 결과 비교를 통해 총 백혈구의 과다측정 여부를 판단하였다. 장기적 임상치료를 밟는 환자 중 8개월간의 백혈구 수 비교를 통해 over count라고 판단된 증례는 총 25건이었다. 해당 검체와 동일한 날짜에 실시한 생화학적 검사 중 간 기능(liver function test)의 지표가 되는 AST와ALT에서 정강범위를 벗어나는 경우가 전체 환자의 68%였으며, 총 별리루빈 범위도 전체 검체 중 60%가 허용범위를 넘는 결과를 보였다. 백혈구가 과다 측정된 시점에 환자의 임상정보 결과 Cephalosporin계 4세대 항생제인 cefepime을 98%의 환자들이 투여 받은 상태에 있었다. 백혈구 과다측정은 하나의 원인보다 다양한 원인들이 복합적으로 작용하여 발생하는 것으로 사료된다.

Keywords

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