EDTA依赖性血小板减少症血小板解聚方法在不同血细胞检测系统的效果评价  

Evaluation for effectiveness of EDTA dependent pseudothrombocytopenia platelets depolymerization methods in different blood cell analyzer

作　　者：钟阳 李颖能[1] 张伟红[1] ZHONG Yang;LI Yingneng;ZHANG Weihong(Department of Laboratory Medicine,Guangzhou First People's Hospital,Guangzhou 510180,Guangdong,China)

机构地区：[1]广州市第一人民医院检验科,广州510180

出　　处：《临床检验杂志》2023年第6期407-410,416,共5页Chinese Journal of Clinical Laboratory Science

摘　　要：目的通过比较不同方法对25例EDTA依赖性血小板减少症(EDTA-PTCP)标本中聚集血小板(platelets,PLT)的荧光染色法通道(PLT-O)解离效果,为实验室处理EDTA-PTCP标本提供参考。方法收集2020年1月至2021年4月在广州第一人民医院符合诊断为EDTA-PTCP的25例患者的EDTA-K_2抗凝静脉血。在血细胞分析仪旁采集静脉血于无抗凝剂管、枸橼酸钠抗凝管、肝素抗凝管各1管,EDTA-K_2抗凝管3管(A、B、C管)。无抗凝剂管即时检测所得值为患者PLT真值;肝素抗凝管、枸橼酸钠抗凝管及A管在不同时间段(即时、0.5 h、1.0 h、2.0 h、3.0 h)分别在2台血细胞分析仪上测定PLT数值;B、C管分别放置0.5 h、1.0 h后,加入丁胺卡那霉素1.0、2.0、3.0 h后测定PLT数值,比较各管各时间段的PLT解聚情况。结果用XE-5000的PLT-O通道检测EDTA-PTCP组25例样本的肝素、枸橼酸钠和EDTA-K_(2)抗凝剂管PLT数值均随着样本放置时间的延长而下降。BC-6800 Plus的PLT-O对EDTA-K_2抗凝剂管在各时间段的PLT解聚率均大于XE-5000。加入丁胺卡那霉素后,BC-6800 Plus的PLT-O对各管在各时间段PLT检测结果均比XE-5000更加接近准确值(即时检测值)。结论对于EDTA-PTCP血小板准确计数优先选用机旁抽血即时检测,在抽血1 h内用BC-6800 Plus的PLT-O模式检测或1 h内加入丁胺卡那霉素检测是EDTA-PTCP患者获得准确的PLT数值的最佳方案。Objective To compare the effects of dissociation for the aggregated platelets(PLT)in 25 samples with EDTA-dependent pseudothrombocytopenia(EDTA-PTCP)by different methods of fluorometric channels of platelet optical count(PLT-O)in order to provide a reference for clinical laboratories in processing such samples.Methods A total of 25 samples of EDTA-K,anticoagulated venous blood were collected from the patients eligible for the diagnosis of EDTA-PTCP in Guangzhou First People's Hospital from January 2020 to April 2021.The venous blood samples were collected close to the hematocrit analyzer and distributed into the tubes:non-anticoagulant,sodium citrate anticoagulation and heparin anticoagulation for each,and three tubes with EDTA-K_(2) anticoagulation tube(tubes A,B and C).The obtained values of PLT from the non-anticoagulant tubes were taken for the true values.The heparin anticoagulation tubes,sodium citrate anticoagulation tubes and EDTA-A tubes were determined to obtain the values of PLT counts on two blood cell analyzers at different time points(immediate,0.5,1.0,2.0 and 3.0 hours).The PLT counts in EDTA-B and C tubes were re-determined following placing for 0.5 and 1.0 hours,and subsequent addition of amikacin for 1.0,2.0 and 3.0 hours respectively.Results The PLT values of the 25 samples of EDTA-PTCP group in the heparin,sodium citrate and EDTA anticoagulant tubes were all decreased with the extension of placement time as determined by electrical impedance analysis in PLT-O channel of XE-5000.The PLT depolymerization rates of the samples with EDTA-PTCP in EDTA anticoagulant tubes determined by PLT-O in BC-6800 Plus were superior to those in XE-5000 at all time points.After the addition of amikacin,the PLT assay results determined in BC-6800 Plus for any anticoagulant tube at each time period were all closer to the accurate values compared to the assay values in XE-5000.Conclusion For accurate platelet count of EDTA-PTCP,immediate detection by machina sampling is preferred.In the face of EDTA-PTCP patients,th

关 键 词：假性血小板减少 血小板聚集 XE-5000 BC-6800 Plus 丁胺卡那霉素 解离 

分 类 号：R446[医药卫生—诊断学]