乙二胺四乙酸三钾导致血小板假性减少症的认识与分析  

The analysis and study pseudothrombocy topenia caused by EDTA-K_3

作　　者：张静[1] 韩志梅[1] 

机构地区：[1]辽宁省大连市友谊医院检验科,116000

出　　处：《国际检验医学杂志》2011年第7期776-777,共2页International Journal of Laboratory Medicine

摘　　要：目的探讨乙二胺四乙酸三钾(EDTA-K3)引起血小板(PLT)聚集原因以及采取的相应措施。方法对3例典型EDTA依赖性血小板假性减少(PTCP)患者采用XE-2100血液分析仪,观察不同抗凝剂(EDTA-K3、枸橼酸钠及肝素锂)在不同时间段测定血小板的变化。结果 (1)3例典型EDTA-PTCP患者均显示在仪器旁,即刻检测血小板3种抗凝剂均可,且结果相近,超过30 min后,EDTA-K3抗凝下降明显,而枸橼酸钠与肝素锂抗凝血对血小板也有不同程度的影响。(2)仪器异常直方图和散点图提示血小板的异常凝集。(3)新鲜血涂片与EDTA-K3抗凝血对比显示血小板的大片聚集。结论 EDTA-PTCP患者采取机前即刻检测结果比较可靠,更换枸橼酸钠与肝素锂抗凝剂的方法不作首选。结合临床症状、血常规直方图与散点图及周围血涂片,避免对EDTA-PTCP患者的误诊误治。Objective Explore EDTA K3 cause PLT aggregation causes and take appropriate measures and correction measures. Methods Three cases of typical pseudo-reduction of EDTA-dependent thrombocytopenia in patients with XE-2100 hematology analyzer,observation the effects of different anticoagulants（EDTA-K3, sodium citrate and heparin）in different time periods measured changes in platelet. Results （1）The 3 typical model EDTA-PTCP sufferer all show at the side of the instrument,instant examination blood platelets three kinds of anticoagulants all can,and result close by,over 30min after, the EDTA-K3 anticoagulants descend obvious,but the sodium citrate and lithium heparin anticoagulant on platelet also have different degrees of impact. （2）Instrument abnormality spread some diagram hint blood platelets of abnormality solidify. （3）Fresh blood smear with anticoagulant EDTA-K3 comparison showed large platelet aggregation. Conclusion EDTA PTCP patients with immediate test results before taking machine more reliable,replacement lithium heparin anticoagulant citrate method, difficult choice, combined with clinical symptoms and routine blood test scatter and peripheral blood smear,to avoid patients with EDTA PTCP of misdiagnosis and mistreatment.

关 键 词：依地酸 血小板计数 血液分析仪 假性血小板减少症 

分 类 号：R595.3[医药卫生—内科学]