不同采血管中血液电解质浓度与血小板数量的相关性分析  

Correlation Analysis between Electrolytes and Platelet in Different Blood Collection Tubes

作　　者：刘永娥[1] 杨连军 梁华[3] 安月[1] 

机构地区：[1]大连医科大学附属第二医院检验科,辽宁大连116023 [2]大连市结核病医院,辽宁大连116033 [3]辽宁国际旅行卫生保健中心,辽宁大连116001

出　　处：《现代检验医学杂志》2013年第1期100-102,105,共4页Journal of Modern Laboratory Medicine

摘　　要：目的 探讨不同血样采集管中电解质（K＋,Na＋,Cl-,Ca2＋）浓度与血小板数量的相互关系,为临床判断离子假性升高或是降低提供指导.方法 分别用真空肝素锂抗凝管、真空促凝剂管及普通塑料管对103例患者标本测定血浆、血清中电解质,并用真空血常规管测定相应血小板总数.按血小板数PLT≤100×109/L,100×109/L1000×109/L分成5组进行比较.结果 当PLT≤600×109/L时,血浆、血清中K＋浓度比较差异无统计学意义（P〉0.05）;当600×109/L1 000×109/L时,血浆中K＋浓度（3.42±0.34）mmol/L与血清中K＋浓度（5.17±1.90）mmol/L比较差异有统计学意义（t=3.51,P=0.001）;且两者K＋浓度差值随着血小板总数的升高而增大.Na＋,Cl-,Ca2＋在上述各组别之间差异均无统计学意义（P〉0.05）.结论 当PLT〉600×109/L时,血小板能影响血清中K＋,提示临床应用促凝剂的真空采血管进行电解质检测时,若出现高血钾的情况,应该考虑血小板导致假性高血钾症的可能.Objective To study the relationship between the electrolytes（K^＋ , Na^＋ , Cl^- , Ca^2＋ ） and platelet in the different tubes for blood samples and provide guidance for clinic to estimate whether the electrolytes increase or decrease is true. Methods 103 blood samples of patients were separately poured into vacuum heparin-lithium anticoagulant tube,vacuum coagulant tube and plastic tube to test the electrolytes in plasma and serum. The number of platelet was tested in vacuum blood tube. The samples were divided into 5 groups by the number of platelet, which included PLT≤100 ×10^9/L, 100 ×10^9/L〈 PLT≤300 ×10^9/L,300 ×10^9/L〈 PLT≤ 600 × 10^9/L, 600 ×10^9/L〈 PLT≤ 1 000 ×10^9/L, and PLT≤ 1 000 ×10^9/L. Resuits When the platelet count was less than 600 ×10^9/L,the difference of K^＋ concentration between plasma and serum was not statistically significant （P〉0.05）. When 600 ×10^9/L〈PLT≤ 1 000 × 10^9/L and PLT〉1 000 × 10^9/L, the K^＋ concentration in plasma （3.93±0.52,3.42±0.34） mmol/L was statistically significant （t=3.06,3.51,P=0. 002,0. 001） ,compared with which in serum （4. 45±0. 50,5.17±1.90） mmol/L. When the platelet count was over 600 ×10^9/L, the difference of K＋ concentration between plasma and serum had statistical significance （P〉0.01）, and the more the platelet, the bigger the difference of K＋ concentration of the two groups. The differences of Na^＋ , Cl^- and Ca^2＋ among the above different groups did not have statistical significance （P〈0.05）. Conclusion When the platelet count was over 600×10^9/L,the platelet could influence the K^＋ concentration in serum, which suggests that if there is hyperkalemia phenomenon when test the electrolytes using vacuum coagulant tubes,should consider the possibility of pseudohyperkalemia that platelet leads to.

关 键 词：电解质 血小板 血浆 血清 

分 类 号：R446.11[医药卫生—诊断学]