EDTA-K_(2)抗凝剂诱发血小板聚集和卫星现象导致血小板假性降低分析  

Analysis on platelet aggregation induced by EDTA-K_(2) anticoagulant and false platelet reduction induced by satellite phenomenon

作　　者：瞿晓晓 陶洪群[1] 陈小剑[1] 余玲玲[1] QU Xiao-xiao;TAO Hong-qun;CHEN Xiao-jian;YU Ling-ling(Department of Laboratory Medicine,Second Affiliated Hospital of Wenzhou Medical University,Wenzhou,Zhejiang 325027,China)

机构地区：[1]温州医科大学附属第二医院检验医学科,浙江温州325027

出　　处：《中国卫生检验杂志》2021年第5期603-605,609,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的通过对乙二胺四乙酸二钾(EDTA-K_(2))抗凝剂诱发的血小板(PLT)聚集和卫星现象进行分析,进一步探讨其可能的发生机制及纠正措施。方法采用SYSMEX-XE5000全自动血细胞分析仪对同一患者EDTA-K_(2)和枸橼酸钠(1:9)抗凝的血常规标本进行PLT计数,并用预稀释管、EDTA-K_(2)抗凝剂管和枸橼酸钠(1:9)管同时采血后5min内检测所得平均PLT计数结果作为其参考值。分别于采血后不同时间段检测PLT,并进行血片制备(涂片时间从0 min开始)和瑞氏染色,动态观察其PLT计数结果及显微镜下PLT聚集和卫星现象。结果EDTA-K_(2)抗凝的PLT在0 min-10 min时血涂片没有聚集,10min时PLT开始轻微聚集,PLT计数开始下降,15 min出现卫星现象。20min开始并随着时间的延长,计数结果继续下降,PLT聚集成堆并伴有卫星现象。枸橼酸钠(1:9)抗凝的PLT计数结果经校正后也在10min开始下降并出现凝集但未出现卫星现象。10 min~20 min偏差仍在允许范围内。结论此类患者采用空白管、EDTA-K_(2)抗凝剂管或枸橼酸纳(1:9)管抗凝抽血后立即检测可获得准确结果;对于某些住院或行动不便患者,建议采用预稀释管、EDTA-K_(2)抗凝剂管或枸橼酸纳(1:9)管抽血后10 min内检测。若条件不允许,尽量在20min内进行检测。Objective To analyze the platelet aggregation induced by EDTA-K_(2) anticoagulant and the false platelet reduction induced by satellite phenomenon,and to further explore the possible mechanism and corrective measures.Methods A SYSMEX-XE5000 full-automatic blood cell analyzer was used to count PLT of EDTA-K_(2) and sodium citrate(1:9)anticoagulated blood samples of the same patient,and the mean PLT count obtained from the pre-diluted tube,EDTA-K_(2) anticoagulant tube and sodium citrate(1: 9)tube within 5 min of simultaneous blood collection was used as the reference value.PLT was detected at different periods after blood collection,and blood samples were prepared(smear time started from 0 min)and Wright staining was conducted.PLT count results,as well as PLT aggregation and satellite phenomena under the microscope,were observed dynamically.Results PLT of EDTA-K_(2) anticoagulant smear did not accumulate at 0 min-10 min,and the PLT began to accumulate slightly and the PLT count began to decrease at 10 min,and the satellite phenomenon appeared at 15 min.Starting at 20 min and extending with time,PLT counting results continued to decline,and PLT accumulation was accompanied by satellite phenomenon.The PLT count of sodium citrate(1:9)anticoagulant also began to decline and agglutinate at 10 min after correction,but no satellite phenomenon occurred.The 10 min-20 min deviation is still within the allowable range.Conclusion Accurate results can be obtained immediately after blood samples were taken by blank tube,EDTA-K2 anticoagulant tube or sodium citrate(1:9)tube.For some hospitalized or immobile patients,pre-diluted tubes,EDTA-K_(2) anticoagulant tubes,or sodium citrate(1:9)tubes are recommended for detection within 10 minutes after blood is drawn.If conditions do not allow,try to test within 20 minutes.

关 键 词：乙二胺四乙酸二钾 血小板聚集 卫星现象 血小板假性降低 

分 类 号：R446.11[医药卫生—诊断学]