枸橼酸钠干粉抗凝管在消除EDTA依赖性假性血小板减少症中的应用研究  

Study on Applying Sodium Citrate Powder Inanticoagulant Tube to Eliminating EDTA Dependency Pseudo Thrombocytopenia

作　　者：黄江浩[1] 何维娜[1] 华建江[1] 常帅[1] 刘平[1] 汪奇云[1] 徐志康[1] 

机构地区：[1]广州医科大学附属深圳沙井医院检验科,广东深圳518104

出　　处：《四川医学》2014年第12期1530-1534,共5页Sichuan Medical Journal

基　　金：2013年深圳市宝安区科技计划--社会公益(医疗卫生类)立项项目(编号:2013143)

摘　　要：目的研究一种能消除EDTA依赖性假性血小板减少症(PTCT)的枸橼酸钠干粉抗凝管,以便准确计数此类患者血液中的血小板。方法 1通过观察枸橼酸钠干粉的不同抗凝浓度、不同抗凝血量对PLT值的影响,选出枸橼酸钠干粉的最佳抗凝浓度和最佳抗凝血量。2选取对照人群130例,用EDTA-K2、枸橼酸钠干粉和枸橼酸钠水剂三种方式抗凝,用仪器法测血常规各值。3选PTCT患者28例,各采集3份静脉血和一份末稍血样本,1份静脉血(2m L)用EDTA-K2抗凝、1份静脉血(2m L)用109mmol/L枸橼酸钠水剂抗凝管抗凝,另1份静脉血(2m L)用枸橼酸钠干粉抗凝管抗凝,末稍血用许汝氏稀释液稀释作血小板手工计数用。三种抗凝血分别于0min、5min、15min、30min、1h、2h、4h、8h用日本希森美康公司XE-1000仪器进行血小板计数检测并同时用玻片在显微镜下镜检血小板有无凝集现象。结果 1枸橼酸钠干粉抗凝管的最佳抗凝浓度为12.8mg/管,最佳抗凝血量为200~800μL。2经枸橼酸钠干粉抗凝管对130例对照组人群的血常规仪器检测结果与EDTA-K2、枸橼酸钠水剂二种方式抗凝的血常规检测结果比较,各种检测(WBC、RBC、HGB、PLT)值与前者比较差异均无统计学意义(P>0.05),与后者比较差异均有统计学意义(P<0.05),EDTA-K2与枸橼酸钠水剂二法检测值间比较差异亦有统计学意义(P<0.05)。328例PTCT患者的枸橼酸钠干粉抗凝管血放置0min^8h和EDTA-K2抗凝血在放置0min用玻片在显微镜下镜检血小板无凝集现象,枸橼酸钠水剂抗凝管血放置60min内未见明显凝集现象,EDTA-K2抗凝血放置5min^8h、枸橼酸钠水剂抗凝管血放置60min后用玻片在显微镜下镜检血小板有不同程度的凝集现象。枸橼酸钠干粉抗凝管血0min^8h仪器血小板计数值与末稍血手工计数值比较,差异均无统计学意义(P>0.05),EDTA-K2抗凝血放置0min仪器检测的血小板计数值与末稍血手工计数值及枸橼�Objective Research on a kind of anticoagulant tube containing sodium citrate powder to eliminate EDTA de-pendency pseudo thrombocytopenia（PTCT）,aiming at counting the platelets in blood accurately. Methods ①Effects of different concentration by sodium citrateanticoagulation,observation of different anticoagulantpowder amount on PLT value,the best anticoagu-lantconcentration and the best amount of sodium citrateanticoagulation for dry powder. ②Select control group 130 cases,using ED-TA-K2,sodium citrate powder and sodium citrate agent to anticoagulation those blood samples respectively,then count CBC by in-strumemt. ③Select 28 cases of patients with PTCT,collect 3 venous blood and 1 peripheral blood sample from each one case,2mL ve-nous blood anticoagulation with EDTA-K2,2mL venous blood anticoagulation with 109mmol/ L sodium citrate agent,2mL venous blood anticoagulation with sodium citrate powder,peripheral blood diluted by Xu Ru＆#39;s dilution leaving for platelet manual counting. Three kinds of anticoagulant will be detected the platelet by XE - 1000 meter made by SYSMEX in 0min,5min,15min,30min,1h,2h,4h, 8h. And at the same time we will observe whether the platelets on slides agglutinate under microscope. Results ① The optimal con-centration of sodium powder anticoagulantanticoagulant tube citric 12. 8mg/ tube,the best anti coagulation is 200 ~ 800μL. ② The 130 cases in the controlgroup routine testing results and EDTA-K2,sodium citrateanticoagulation agent two ways of blood testing re-sults bysodium citrate powder anticoagulant tubes,all kinds of detection（WBC,RBC,HGB,PLT） value and the former was no signifi-cant difference（P 〉 0. 05）,and the latter difference there were statistically significant（P 〈 0. 05）,the detection of EDTA-K2 and so-dium citrate agent two method alsohad statistical significance value difference（P 〈 0. 05）. ③From 28 cases of patients with PTCT, samples those mixed with EDTA-K2 anticoagulant in 0min,sodium citrate powder in 0min ~ 8hhas no aggluti

关 键 词：枸橼酸钠 血小板计数 

分 类 号：R446.111[医药卫生—诊断学]