假性血小板降低对临床患者检测值的影响  

Influence of Spurious Thrombocytopenia on Some Detecting Values in Clinical Patients

作　　者：江源[1,2] 李登清[1] 吴白平[2] 李妮娅[1] 

机构地区：[1]中南大学湘雅医学院医学检验系,湖南长沙410013 [2]湖南省肿瘤医院检验科

出　　处：《实用预防医学》2010年第3期569-571,共3页Practical Preventive Medicine

摘　　要：目的探讨临床患者检测中EDTA依赖性假性血小板减少现象的存在,以降低临床误诊率。方法采用sysmex-5000血液分析仪分析EDTA-PTCP阳性患者静脉血经EDTA抗凝后不同时间的血小板数量,同时检测同一患者静脉血用枸橼酸钠和肝素抗凝后的血小板数量并用手工计数方法检测该患者血小板数量。结果枸橼酸钠和肝素抗凝法及手工计数法与EDTA抗凝血30min以后上机检测法比较差异有统计学意义(t=13.24、14.36、14.22,P<0.05),EDTA抗凝血30min以后上机检测法与EDTA抗凝血10min内上机检测法比较差异有统计学意义(t=13.34,P<0.05),枸橼酸钠和肝素抗凝法及手工计数法与EDTA抗凝血10min内上机检测法比较差异均无统计学意义(t=0.06、0.07、0.21,P>0.05)。结论EDTA—PTPC阳性患者,静脉血经EDTA抗凝30min以后上机检测法与肝素和枸橼酸钠抗凝上机检测法及手工计数法有很大的差别。对于首次检测血小板数值减低的标本均应用手工计数血小板或涂片镜检,以确认是否存在抗凝剂所致血小板聚集现象,以降低假性血小板减少引起的误诊。Objective To study the phenomena of platelet aggregation in patients with EDTA-dependent pseudothrombocytopenia （PTCP）,and to reduce the rate of clinical misdiagnosis. Methods Use syemsx-5000 hematology analyzer to analyze EDTA-PTCP-positive patients＇ blood samples,count the platelet in blood samples anticoagulated with EDTA at different time points,test the same patients＇ blood samples anticoagulated with heparin and sodium citrate,and use the manual counting method. Results There were statistically significant differences between the results of counting platelets in blood samples anticoagulated with heparin and sodium citrate,and manual counting method and the results of counting platelets in blood samples anticoagulated with EDTA in 30min on a machine （t=13.24,t=14.36,t=14.22,P0.05）. There were statistically significant differences between the results of counting platelets in blood samples anticoagulated with EDTA in 30min on a machine and the results of counting platelets in blood samples anticoagulated with EDTA within 10min on a machine （t=13.34,P0.05）. No statistically significant difference was found between the results of counting platelets in blood samples anticoagulated with heparin and sodium citrate,and manual counting method and the results of counting platelets in blood samples anticoagulated with EDTA within 10min on a machine （t=0.06,t=0.07,t=0.21,P0.05）. Conclusions For EDTA-PTPC-positive patients,counting platelets in blood samples anticoagulated with EDTA in 30min on a machine is quite different from those anticoagulated with heparin and sodium citrate,and manual counting method. Manual counting method or blood smear method should be used in the patient with low value of platelets in the first detection in order to confirm the existence of the phenomenon of platelets aggregation induced by anticoagulants and to reduce the clinical misdiagnosis rate.

关 键 词：EDTA依赖性血小板减少 抗凝剂 抗凝时间 

分 类 号：R446.11[医药卫生—诊断学]