10例EDTA依赖性假性血小板减少症血小板检测的动态分析

目的探讨EDTA依赖性假性血小板减少症(EDP)形成的原因及其血小板计数方法。方法选取EDP患者10例,采集2份样本,1份EDTA-K2抗凝,1份枸橼酸钠抗凝。EDTA抗凝血分别于0、15、30、60、120min上机检测。枸橼酸钠抗凝血在15min内检测。同时手工计数血小板。结果 EDTA抗凝血0min检测的血小板结果与手工计数及枸橼酸钠抗凝法的结果相比,差异均无统计学意义(P>0.05),15～120min的血小板计数与手工计数相比差异有统计学意义(P<0.05)。枸橼酸钠抗凝血计数与手工计数的结果亦无明显差别(P>0.05)。结论对EDP的动态分析支持EDTA依赖的血小板聚集是抗原抗体介导的免疫反应。确认EDP患者用EDTA抗凝采血后应立即检测,也可用枸橼酸钠抗凝检测或手工计数。

The Dynamic Analysis of PLT Count in EDTA-dependent Pseudothrombocyopenia

Objective To investigate the reason of Ethylenediamine tetra-aceticacid （EDTA）-dependent pseu- dothrombocytopenia （EDP） and the method of PLT count in EDP. Methods Blood samples of 10 EDP patients were treat- ed by EDTA-K2 and citrate sodium, respectively. The platelet in blood samples anticoagulated with EDTA were counted at different time points （0,15,30,60 and 120 min）. The same patients＇ blood samples anticoagulated with sodium citrate were tested within 15 min, and the manual counting method was used at the same time. Results No statistically signifi- cant difference was found among the results of counting platelets in blood samples anticoagulated with EDTA in 0 min, with sodium citrate,or with manual counting method （P〉0.05）. There were statistically significant differences between the results of counting platelets in blood samples anticoagulated with EDTA after 15 min and with manual counting method （P〈0.05）. No statistically significant difference was found between the results of counting platelets in blood samples anti- coagulated with sodium citrate and the results of manual counting method（P〉0. 05）. Conclusion The dynamic analysis of PLT count in EDP confirm that EDTA-dependent platelet aggregation is immunological reaction caused by antigen and an- tibody. The PLT samples of the EDP patients treated with EDTA should be tested immediately or treated with citrate sodi- um in 15 min or manual counting method.