多重抗凝剂引起PLT自身聚集检测1例分析  

Analysis of a platelet-induced autoagglutination case by multiple anticoagulants

作　　者：方美丹[1] 袁远[1] 吴春龙[1] 

机构地区：[1]浙江省台州医院检验科,浙江临海317000

出　　处：《中国卫生检验杂志》2014年第6期844-846,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨乙二胺四乙酸二钾(EDTA-K2)、枸橼酸钠和肝素引起1例血小板自凝的相关过程及解决方法。方法收集1例体外自发性凝集患者和1例健康体检者分别采用EDTA、枸橼酸钠和肝素进行抗凝,此外取1份自凝患者全血至EDTA抗凝管(加5 mg/ml阿米卡星),分别放置30 min,应用Sysmex 2100进行分析血小板。此外,采血后立即进行相关仪器法和手工法(草酸胺)相关检测。结果 EDTA、枸橼酸钠、肝素和EDTA(加阿米卡星)抗凝血放置30 min后血小板检测结果分别为22×109/L、25×109/L、31×109/L和171×109/L;0 min和30 min EDTA抗凝血均因自凝手工无法计数,而EDTA(加阿米卡星)手工计数为174×109/L。结论本例患者样本自发体外凝集,EDTA、枸橼酸钠和肝素均无法消除自凝现象,通过在EDTA加入5 mg/ml阿米卡星或采集后立即仪器检测可准确计数血小板。Objective To study the related process and solution of 1 case of platelet - induced autoagglutination by EDTA - K2, sodium citrate and heparin. Methods Fresh blood specimens were collected from 1 case of platelet - induced autoaggluti- nation and 1 healthy control, both were anticoagulated by EDTA, sodium citrate, heparin and EDTA （5 mg/ml amikaein） re- spectively. Platelet（PLT） counts were determined by Sysmex 2100 automated hematology analyzer and manual counting method after 30 mintues. Results The blood platelet counts were 22 × 109/L, 25 × 109/L, 31 × 109/L and 171 × 109/L in specimens with anticoagulant EDTA, sodium citrate, heparin and EDTA （5 mg/ml amikacin） respectively. The platelet counts of speci- mens with EDTA were all not available by manual counting method due to autoagglutination, but the plateIet counts of those with EDTA（5 mg/ml amikacin） were 174 × 109/L. Conclusion EDTA, sodium citrate and heparin were all not available to elimi- nate autoagglutination in the patient with spontaneous coagulation in vitro, while EDTA with 5 mg/ml amikacin or instrument de- tection immediately following blood collection were available for accurate platelet counting.

关 键 词：血小板假性减少 乙二胺四乙酸二钾 枸橼酸钠 肝素 阿米卡星 

分 类 号：R392.1[医药卫生—免疫学]