飞行员EDTA依赖性假性血小板减少症一例的诊断及文献复习  

Diagnosis of EDTA-dependent pseudothrombocytopenia in a pilot and literature review

作　　者：刘静[1] 陈立君[2] 黄进[3] 王恒湘[1] 肖明华[1] 

机构地区：[1]空军总医院血液科,北京100142 [2]空军总医院中西医结合正骨科,北京100142 [3]空军总医院药学部,北京100142

出　　处：《中华航空航天医学杂志》2010年第1期22-25,共5页Chinese Journal of Aerospace Medicine

摘　　要：目的 通过分析飞行员EDTA依赖性假性血小板减少症,为准确诊断血小板减少症提供依据. 方法 对1名用血细胞分析仪检出血小板减少症的飞行员,用手工法对血小板计数进行复查,将EDTA与枸橼酸、肝素抗凝血进行对比,血涂片染色观察血小板聚集情况. 结果 EDTA可诱发血小板聚集,导致假性血小板减少症,可通过枸橼酸、肝素抗凝血检测进行鉴别.采血后即刻用仪器检验或手工检验,有助于避免假性诊断.经手工核查排除假性血小板减少症后,该飞行员被认定飞行合格,飞行10h未发现出血现象和其他不适. 结论 对于飞行人员血小板减少症,应考虑EDTA诱导的假性血小板减少症的可能.建议在采血即刻即进行分析仪检验,或采用手工方法对血小板减少症进行复核,以此来避免误诊、误治及错误的飞行鉴定结论 .Objective To provide evidence for accurately diagnosing thrombocytopenia in pilot by analyzing ethylene diamine tetreacetic acid (EDTA) dependent pseudothrombocytopenia.Methods A pilot was diagnosed as thrombocytopenia by EDTA count with hematology analyzer and his platelet was rechecked by manual test.The smears of citrate-and heparin-treated blood were taken for comparing the platelet aggregation. Results EDTA could induce platelet aggregation and cause pseudothrombocytopenia and that could be distinguished by the manual test of citrate-or heparin-treated blood.Testing of EDTA-treated blood by instrument shortly after sampling or manual test would be helpful to avoid such phenomenon. The pilot was qualified after re-examination by manual test of platelet.He was not found any hemorrhage and other discomfort in 10-hour flight. Conclusions EDTA dependent pseudo-thrombocytopenia may be resulted from instrument examination.Platelet counting immediately after blood sampling or rechecking by manual test for the flying personnel.who was diagnosed as thrombocytopenia by EDTA-treated blood counting,is suggested to improve the accuracy of diagnosis and to avoid misdiagnosis and wrong medical evaluation.

关 键 词：血小板减少 依地酸 血小板聚集 血小板计数 

分 类 号：R856.9[医药卫生—航空、航天与航海医学]