肿瘤患者EDTA依赖性假性血小板减少的临床分析  

Correlation factors of ethylenediaminetetraacetic acid-dependent pseudothrombocytopenia in cancer patients

作　　者：邝妙欢[1] 欧阳文婷[2] 林建华[1] 刘万里[1] 

机构地区：[1]华南肿瘤学国家重点实验室中山大学肿瘤防治中心检验科,广州510060 [2]中山大学附属第一医院检验科

出　　处：《中华医学杂志》2010年第44期3144-3146,共3页National Medical Journal of China

摘　　要：目的 研究乙二胺四乙酸（EDTA）依赖性假性血小板减少症（EDTA-PTCP）在肿瘤患者中的临床特征,为分析其相关因素提供资料.方法 统计中山大学附属肿瘤防治中心2007年10月至2009年9月肿瘤患者中EDTA-PTCP患者的病史、肿瘤类型、治疗方法 、使用药物等,分析上述因素与EDTA-PTCP的关系.结果 本中心此2年约55 000例肿瘤患者中共有49例发生EDTA-PTCP,男24例（49.0%）,女25例（51.0%）.49例中10例（20.4%）有高血压史,5例（10.2%）有糖尿病史.共涉及17种肿瘤,每种1～11例不等.49例中13例（26.5%）在肿瘤治疗前检出EDTA-PTCP,36例（73.5%）在肿瘤治疗后榆出;36例中肿瘤治疗包括化疗11例（30.6%）、放疗＋化疗5例（13.9%）、肿瘤切除15例（41.7%）、介入治疗5例（13.9%）;16例化疗患者中,地塞米松使用最多（87.5%,14/16）;20例手术患者（包括肿瘤切除15例、介入治疗5例）中青霉素类抗生素使用最多（75.0%,15/20）.18例（36.7%）检出1次EDTA-PTCP;31例（63.3%）检出2次以上,EDTA-PTCP持续时间≤2周的有35例.根据疗程长短分为2组,肿瘤切除与未治疗组（28例）和肿瘤化疗与介入治疗组（21例）,EDTA-PTCP持续时间≤2周的患者比例在两组间差异有统计学意义（89.3%比47.6%,x2=10.22,P＜0.01）.结论 肿瘤患者中EDTA-PTCP的发生与性别、合并常见病、肿瘤类型及治疗方式可能无关,与治疗用药可能有关;EDTA-PTCP持续时间与疗程长短可能有关.Objective To investigate the correlation factors of ethylenediaminetetraacetic aciddependent pseudothrombocytopenia （EDTA-PTCP） in cancer patients. Methods The potential correlation factors of EDTA-PTCP such as gender, age, case history, tumor types, therapeutic drugs and duration of EDTA-PTCP from cancer patients were analyzed based on the patient records from October 2007 to September 2009 at our cancer center. Results A total of 49 EDTA-PTCP cases from a pool of 55 000 cancer patients were collected. No correlation was found with gender（ male 49. 0%, female 51.0% ）, concurrent hypertension（20. 4% ）/diabetes（ 10. 2% ） or cancer types（ 1 - 11 cases each type）. EDTA-PTCP appeared at pre-therapy （ n = 13 ） and post-therapy （ n = 36）. Eleven cases（ 30. 6% ） were chemotherapy, 5 cases （ 13.9% ） were radiotherapy plus chemotherapy, 15 case（41.7% ）were tumor resection, 5 cases（ 13.9% ） were interventional therapy in 36 patients whose EDTA-PTCP appeared post-therapy. The mose frequence use in chemotherapy patients was dexamethasone（87. 5%, 14/16）, and in surgery patients was penicillin antibiotics（75.0%, 15/20）. And its frequency was once （ n = 18） and more than twice （ n = 31 ）. If the subjects were divided into 2 groups of non-treatment plus surgery and chemotherapy plus intervention on the basis of treatment course, there was a significant difference between two groups in proportion of patients whose duration of EDTA-PTCP ≤2 weeks （89. 3% vs 47. 6% ,x2 = 10. 22, P ＜0. 01）. Conclusions The incidence of EDTA-PTCP in cancer patients may be associated with therapeutic drugs, but not probably with gender,concurrent hypertension/diabetes, tumor types or therapeutic regimens. Duration of EDTA-PTCP may be associated with the treatment course.

关 键 词：血小板减少 肿瘤 依地酸 疾病特征 

分 类 号：R686[医药卫生—骨科学]