KX-21血细胞分析仪对血液病患者血小板的检测价值

目的　评价KX - 2 1血细胞分析仪对血小板低下标本的检测价值 .方法　分别用KX - 2 1和手工法对 6 0例儿科血液病患者的末梢血进行血小板计数 .结果　两种方法测定结果有显著性差异 (p <0 .0 5 ) ;当其中 37例患者血小板的直方图变得很不规则、呈锯齿状时 ,两种方法测定差异非常显著 (p<0 .0 1) .结论　对于血小板计数低下 (<10 0× 10 9/L)的血液病标本 ,应当复查     

细胞分析仪测定血小板的影响因素分析

目的 观察血细胞分析仪测定血小板的影响因素.方法 采用Abacus junior5CA-920血细胞分析仪及配套试剂,手工计数用草酸胺稀释液镜检血小板.末梢血标本采集后放置0.5分钟、5分钟、2小时分别在Abacus junior5CA-920血细胞分析仪上计数血小板,同时取静脉血手工计数.结果 有血小板聚集,MCV＜80fl时,血小板直方图异常;仪器法打印报告明显高于手工计数法时,血小板直方图向右呈逐渐升高趋势或"骆驼峰"样改变;手工法与仪器计数结果一致时,血小板直方图正常.结论 Abacus junior5CA-920血细胞分析仪计数血小板的准确性取决于多种因素,只有正确操作,排除各种因素干扰才能使血小板计数结果准确可靠.     

几种临床疾病的血小板相关抗体检测结果分析

目的 :探讨血小板相关抗体在血小板减少症中的临床应用。方法 :选择健康者、血小板低于正常的体检者、血小板减少性紫癜(ITP)、再障 (AA)、肝脏疾患、系统性红斑狼疮 (SLE)患者等采用ELISA法定量测定血小板抗体PAIgG、PAIgM、PAIgA ,并分析ITP患者治疗前后血小板相关抗体的变化。结果 :血小板低于正常的体检者血小板抗体的阳性率 14 .9% ,ITP、AA、SLE等患者血小板相关抗体阳性率与正常组比较有显著差异 ,分别为 78.9%、3 1.2 %、62 .5 % ,肝病者血小板相关抗体与正常组无差异。ITP患者治疗前后三种血小板抗体均有非常显著性变化 (P <0 .0 1)。结论 :血小板相关抗体测定在自身免疫性疾病引起的血小板减少的诊疗中有重要意义     

Pam3CSK4对血小板活化及其TLR2表达的影响

目的 探讨Toll样受体2(TLR2)在血小板激活及免疫方面的作用.方法 取健康人(n=5)全血6 ml,以密度梯度离心法制备洗涤血小板.用1、5、10μg/ml的TLR2激动剂Pam3CSK4(一种合成的细菌脂蛋白)刺激人洗涤血小板,然后测定血小板聚集率,血小板表面蛋白CD62p和TLR2表达的变化.结果 Pam3CSK4以浓度0、1、5和10μg/ml激活血小板:聚集率增加分别为(12.83±2.43)%、(28.32±5.67)%、(52.56±8.54)%、(76.24±11.23)%,P<0.01;血小板表面CD62p表达量增加分别为(11.20±1.67)%、(18.45±2.66)%、(22.45±2.04)%、(29.53±4.08)%,P<0.01.Pam3CSK4在1μg/ml时TLR2表达为(16.85±6.10)%,与对照组(10.81±3.99)%相比差异无统计学意义(P>0.05),在5 μg/ml、10μg/ml时TLR2表达量分别为(21.15±9.90)%和(22.52±9.26)%,与对照组比较差异有统计学意义(P<0.05).结论 细菌脂蛋白Pam3CSK4通过激活TLR2引起血小板聚集、活化,是血小板参与抑制革兰阳性细菌感染的免疫应答机制之一.     

KX-21血细胞分析仪对血液病患者血小板的检测价值

目的评价KX-21血细胞分析仪对血小板低下标本的检测价值.方法分别用KX-21和手工法对60例儿科血液病患者的末梢血进行血小板计数.结果两种方法测定结果有显著性差异(p<0.05);当其中37例患者血小板的直方图变得很不规则、呈锯齿状时,两种方法测定差异非常显著(p<0.01).结论对于血小板计数低下(<100×109/L)的血液病标本,应当复查.     

生物发光法检测血小板ATP、ADP及其初步应用

本 文用荧光素—荧光素酶 (Ｌｕｃｉｆｅｒｉｎ Ｌｕｃｉｆｅｒａｓｅ)与ＡＴＰ结合生物发光的原理 ,检测血小板ＡＴＰ、ＡＤＰ的释放功能 ,以诊断血小板释放功能障碍性疾病。1　资料与方法1.1　资料原发性血小板减少性紫癜 (ＩＴＰ)患者 16例 (男 3例、女 13例 ) ,年龄 11～ 2 6岁 ,均经我院血液科诊断。正常对照组 10例 (男 7例、女 3例 ) ,年龄 3 3～ 67岁 ,均无心、肝、肾、血液等疾病的健康献血员。试剂 :Ｅ Ｅ液 :96%乙醇 9份加 10 0ｍｍｏｌ/ＬＥＤＴＡ Ｎａ 1份 (ｐＨ=7.4)。ＰＥＰ ＰＫ液 :10ｍｍｏｌ/Ｌ磷酸烯醇丙酮酸 40 0 μｌ,…     

新型血小板功能分析仪PL-11监测血小板聚集功能的应用价值

目的 评价连续血小板计数法血小板功能检测仪PL-11监测血小板功能的价值.方法 分别应用SC-2000光学比浊法(LTA)与PL-11连续血小板计数法两种血小板功能检测仪,检测30例急性心肌梗死急诊入院患者,入院时、负荷剂量(600mg)服用氯吡格雷后的第8小时、PCI术后第三天晨起时的血小板聚集功能,分析两种仪器检测结果的相关性及PL-11在氯吡格雷抵抗(clopidogrel resistance,CR)的诊断准确性.结果 在测试人群中,LTA测得最大血小板聚集率(MAR)范围均较PL-11广;所有受试者在刚入院未服用氯吡格雷时,PL-11与LTA不相关(相关系数r=0.35,P=0.058＞0.05),在术前氯吡格雷大剂量冲击后及术后第三天两次检测的MAR存在相关性(r=0.500和0.571,P＜0.01);两种仪器三次检测结果均为第一次和第三次明显高于第二次,差异具有统计学意义(P ＜0.05);PL-11用于诊断CR的ROC曲线下面积为0.798(95％ CI:0.621～0.964).结论 PL-11连续血小板计数法与“金标准”的(LTA)浊法检测血小板聚集功能具有一定的相关性,其检测结果可供临床及实验室参考.     

儿童特发性血小板减少性紫癜与病毒感染关系探讨

目的　探讨儿童特发性血小板紫癜 (ITP)与病毒感染的关系 .方法　应用酶联免疫吸附法 (ELISA) ,对 5 2 7例学龄前患儿和 70例健康儿童进行巨细胞病毒 -IgM(CMV)、单纯疱疹病毒 -IgM(HSV)、风疹病毒 -IgM(RV)和EB病毒 -IgM血清学检查 .结果　 5 2 7例ITP患儿中 ,其中进行CMV检测的 175例 ,阳性 4 0例 (2 2 .86 % ) ,HSV116例 ,阳性 14例 (12 .0 7% ) ,风疹病毒 10 4例 ,阳性 10例 (9.6 % ) ,EB病毒 132例 ,阳性 7例 (5 .3% ) ,总阳性率为 13.4 7% .结论病毒感染是儿童特发性血小板减少性紫癜的一个重要原因 ,巨细胞病毒感染是主要病原 .     

血小板膜糖蛋白Ⅰa基因多态性与心肌梗塞的关系

目的　探讨汉族人群心肌梗塞发生与血小板糖蛋白 (glycoprotein,GP) a基因 80 7C/ T多态性的关系。方法　采用病例对照研究 ,应用聚合酶链反应 -序列特异性引物 (polymerase chain reaction-se-quence specific primers,PCR-SSP)方法检测 12 7例心肌梗塞患者 (急性或陈旧性 )和 175名正常对照血小板 GP a基因 80 7C/ T多态性。结果　心肌梗塞组和对照组 T和 C等位基因的分布差异有高度显著性(T:42 .70 %比 3 2 .0 0 % ,C:57.3 0 %比 68.0 0 % ,P<0 .0 1) ;无论在所有受试者还是在年龄≤ 60岁的受试者中 ,心肌梗塞组 (TT+ TC)基因型的频率均显著高于对照组 ,所有年龄受试者中 ,69.3 4 %比 51.43 % ,P<0 .0 0 5,比数比 =2 .14 ,95%可信区间为 1.3 4～ 3 .41;年龄≤ 60岁的受试者中 ;75.90 %比 51.52 % ,P<0 .0 0 5,比数比 =2 .96,95%可信区间为 1.58～ 5.55;L ogistic多因素回归分析显示血小板膜 GP a T等位基因为心肌梗塞的发生独立危险因素 (比数比 =4.96,95%可信区间为 2 .55～ 10 .90 )。结论　血小板膜 GP a T等位基因与心肌梗塞的发生相关联 ,可能为心肌梗塞发生的一种遗传易感性标志     

新生儿血小板抗体阳性结果分析

目的 :探讨新生婴儿的血小板抗体阳性是否与临床患者有关系。方法 :用简易致敏红细胞血小板血清学检测技术(SEPSA)对 2 6 6例住院的年龄为 1- 2 0 d的新生儿进行了血小板抗体检测 ,并与同期的 2 782例围产孕妇血小板抗体检测结果进行了对比研究。结果 :显示患病新生儿的血小板抗体阳性率为 11.3% ,显著高于同期围产孕妇的阳性率 (2 .6 % ) ,进而推测高于正常新生儿。新生儿血小板抗体免疫球蛋白类型为 Ig G型。抗体阳性率分布为 :黄疸儿10 .3% ,感染等 16 .7% ,有出血症状的 30 % ,而早产儿是 5 .4 %。结论 :调查的新生婴儿血小板抗体的发生率高与患病有关系孕妇产期作血小板检测具有优生意义 ,能有效地帮助产前诊治 ,减少引发新生儿血小板减少性紫癜及新生儿患病率。     

Platelet counting by the coulter LH 750, sysmex XE 2100, and advia 120: a comparative analysis using the RBC/platelet ratio reference method

We compared the accuracy and precision of the impedance platelet counts generated by the Beckman Coulter LH 750 and the Sysmex XE 2100 and the optical platelet counts produced by the Advia 120 and the Sysmex XE 2100 withflow cytometric reference platelet counts. Samples analyzed had platelet counts less than 150 x 10(3)/microL (150 x 10(9)/L) with a platelet flag or less than 75 x 10(3)/microL (75 x 10(9)/L) on the Sysmex SE 9500. The 105 samples were run sequentially through each analyzer. Anti-CD41 and anti-CD61 monoclonal antibodies were used for flow cytometric determination of the reference platelet count by the RBC/platelet ratio method. The Beckman Coulter and the Sysmex impedance platelet counts showed better correlation with the reference method than the optical platelet counts by the Advia and the Sysmex. At platelet transfusion thresholds of 10 and 20 x 10(3)/microL (10 and 20 x 10(9)/L), the precision of the impedance methods was somewhat better than that of the optical methods. Current methods of optical platelet counting may not be superior to impedance platelet counts for all patient populations.     

Platelet counts in capillary blood.

Samples of venous and capillary blood were collected simultaneously from healthy adults to assess the accuracy of platelet counts in capillary blood as determined by an automated particle counter. The difference between the mean venous blood platelet count (248,300) and the mean capillary blood count (215,500) was highly significant (P less than .001). For 24% (7/29) of the subjects, the capillary blood platelet count underestimated the venous blood count by greater than or equal to 25%, with three subjects erroneously classified as thrombocytopenic. A heterogeneous group of thrombocytopenic patients showed a similar difference in mean platelet counts (venous blood: 72,500/microliter; capillary blood: 65,400/microliter; P = 0.01). In most clinical situations, capillary blood platelet counts were adequate for patient evaluation; however, when an accurate platelet count is necessary, venous blood should be used.     

Platelet measurements in rat, dog and mouse blood samples using the Sysmex XT-2000iV

In this study, blood platelet measurements were evaluated for three laboratory species—rat, dog and mouse—using the Sysmex XT-2000iV haematology analyser, which offers two alternative methods for counting platelets—electrical impedance and a combination of light scattering and fluorescence. The analytical performance was satisfactory in terms of imprecision, carry-over between samples and linearity. The rat platelet counts were stable for at least 24 h at 4 °C, but not at room temperature: There were marked reductions at 24 and 48 h for dogs at both 4 °C and room temperature. Mean platelet volumes increased with time for both rats and dogs. Using the XT-2000iV, results were obtained for platelet counts (×10⁹/L) together with the mean platelet volume (femtolitres), platelet distribution width (femtolitres), platelet large cell ratio (percent) and plateletcrit (percent), and these were compared with results obtained with the Siemens Advia 120? with its multispecies software. Differences were observed for platelet counts and other platelet measurements made with the two analysers and between counts made by light scattering vs. fluorimetry. Some of these differences are due to the technologies employed in gating the cell populations and expressions used to describe the platelet populations.     

Risk of underestimating platelet count because of the increase of mean platelet volume at the end of pregnancy

We report the case of a pregnant woman for whom the platelet count (77 x 10(9)/L) was underestimated by Coulter STKS analyzer during the third trimester because of large platelets. The microscopic counting of platelets revealed an isolated thrombocytopenia (120 x 10(9)/L). When not pregnant, the patient has low but normal platelet count (155 x 10(9)/L) with high mean platelet volume (MPV > 12 fL). This case report recalls that concomitantly to the decrease in platelet count, the MPV significantly increases at the end of pregnancy. This poorly known phenomenon does not impair platelet count by blood cell analyzers in as much as the platelet volume is in the range of measurement but may be responsible for underestimation of the platelet count if the MPV is already high before pregnancy. We describe how to detect this anomaly and propose simple guidelines for thrombocytopenia in normal pregnancy.     

Evaluation of a new automatic hematological system: the Advia 70 (Bayer-Diagnostics)

The Advia 70 hematology system is a new automated analyser manufactured in Texas (USA) by MWI-DANAM and marketed by Bayer- Diagnostics in France. The throughput is 70 complete blood counts (CBC) with leukocyte differential counts (diff) per hour. Three sample modes are proposed: normal mode (180 muL of whole blood), sample saver mode (90 muL) or automatic sampler (180 muL). The principles used on Advia 70 are: 1) electrical impedance for cell counting (WBC, RBC, platelets, MCV) and RBC/plt sizing; 2) multi-dimensional optical system and absorbance for white cell differential. The Advia 70 has been evaluated in our laboratory over a three-week period. Within-run variations of blood counting (CBC & diff) were determined on normal and abnormal patient specimens whereas between run-variations were determined on normal controls. Linearity and detection limits were also tested. The Advia 70 system results were reproducible and reliable. The correlations between the various sample modes were very good. Contamination and store assays were performed. Thirty normal and abnormal samples were successively analysed on the Advia 70 system and on the Advia 120 system which methodologies are different (myeloperoxidase staining coupled with flow cytometry-nuclear lobularity analysis for WBC/Diff, flow cytometry and laser diffraction for RBC/platelets), and the results were compared: despite the different technologies used on both analysers, the correlations were very good (CBC and diff parameters). Finally, we evaluated the leukocyte differential flags on 72 patients samples with abnormal cells, using the blood smear examination as the reference method. In conclusion, the Advia 70 can be used in private and hospital laboratories.     

Platelet indices in SGA newborns

PurposeThe current study objective was to compare blood platelet indices in full-term small-for-gestational-age newborns (SGA) and full-term appropriate-for-gestational-age newborns (AGA).Materials/MethodsWe introduced to our study 61 SGA newborns (31 females and 30 males) and 70 eutrophic infants (32 females and 38 males). The SGA newborns were divided into two groups: those weighing less than the 5th centile: 35 infants (16 females and 19 males) and those between the 5th and 10th centiles: 26 infants (15 females and 11 males). Platelet indices were estimated in blood samples collected from the umbilical artery.ResultsSGA demonstrated a decreased count of blood platelets (238×103/μ) as compared with AGA (286×103/µL), p=0.0001. Platelet hematocrit (PTC) also showed differences in both groups (SGA=0.19% vs. AGA=0.22%; p=0.0005). Mean platelet volume (MPV) was higher in SGA (8.25fl) as compared with AGA (7.84fl); p=0.008. Large platelet count (LPLT) was higher in AGA 6.26% vs. SGA=4.75%; p=0.01. Platelet distribution width (PDW) was found to be nearly the same (SGA=47%, AGA=46%). PDW was higher in SGA newborns < 5th centile (43%) as compared with SGA infants between the 5th and 10th centiles (52%); p=0.008.ConclusionsA decreased blood platelet count, platelet hematocrit and large metabolically active platelet count, which in addition to reduced synthesis and excessive consumption of coagulation factors in states of hiperclotting is characteristic of IUGR, enhances the possibility of bleeding complications and increases the risk of infections. From a clinical point of view, it is important to take into consideration the degree of intrauterine hypotrophy during the evaluation of hemostatic disorders.     

Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Platelet Count and Plateletcrit (PCT) as predictors of in-hospital paediatric mortality: a case-control Study

BackgroundThrombocytopenia has been shown to predict mortality. We hypothesize that platelet indices may be more useful prognostic indicators. Our study subjects were children one month to 14 years old admitted to our hospital.AimTo determine whether platelet count, plateletcrit (PCT), mean platelet volume (MPV) and platelet distribution width (PDW) and their ratios can predict mortality in hospitalised children.MethodsChildren who died during hospital stay were the cases. Controls were age matched children admitted contemporaneously. The first blood sample after admission was used for analysis. Receiver operating characteristic (ROC) curve was used to identify the best threshold for measured variables and the ratios studied. Multiple regression analysis was done to identify independent predictors of mortality.ResultsForty cases and forty controls were studied. Platelet count, PCT and the ratios of MPV/Platelet count, MPV/PCT, PDW/Platelet count, PDW/PCT and MPV × PDW/Platelet count × PCT were significantly different among children who survived compared to those who died. On multiple regression analysis the ratio of MPV/PCT, PDW/Platelet count and MPV/Platelet count were risk factors for mortality with an odds ratio of 4.31(95% CI, 1.69–10.99), 3.86 (95% CI, 1.53–9.75), 3.45 (95% CI, 1.38–8.64) respectively. In 67% of the patients who died MPV/PCT ratio was above 41.8 and PDW/Platelet count was above 3.86. In 65% of patients who died MPV/Platelet count was above 3.45.ConclusionThe MPV/PCT, PDW/Platelet count and MPV/Platelet count, in the first sample after admission in this case control study were predictors of mortality and could predict 65% to 67% of deaths accurately.     

Evaluation of the Sysmex XT-2000iV haematology analyser for rat,dog and mouse whole blood samples

The Sysmex XT-2000iV is a dedicated haematology analyser with full blood count, reticulocyte and five-population differential leucocyte capabilities for several laboratory animal species. The laboratory animal species chosen for this study were rat, dog and mouse. Results from dipotassium ethylenediamine tetraacetic acid (K₂EDTA) samples from these species were compared with the laboratory’s established haematology analyser, the Bayer (now Siemens) Advia 120™ with multispecies software (Siemens Medical Solutions Diagnostics Europe Limited, Frimley, UK). Imprecision, carry-over between samples, linearity and stability data were also studied. In addition, results obtained for leucocyte differential counts were compared with standard manual 100-cell counts. Throughout this study, the Sysmex XT-2000iV proved to be robust, reliable and dependable. In summary, the Sysmex XT-2000iV has proved capable of accurately and precisely producing haematology results for animal species used within the pharmaceutical industry.     

血小板凝胶的制备方法及其影响因素

背景：血小板凝胶制备方法繁多,分类标准不统一。 目的：总结血小板凝胶制备方法,并讨论影响因素。 方法：由第一作者检索1990至2011年 PubMed数据库及万方数据库。英文检索词为“Platelet gel,Classification,Parameters”,中文检索词为“血小板凝胶,分类,影响因素”。 结果与结论：依据凝胶产量与成分、凝胶中纤维蛋白结构两个主要影响因素可将血小板凝胶制备方法分为4大类,即纯富血小板血浆凝胶、富白细胞-血小板血浆凝胶、纯富血小板纤维蛋白凝胶和富白细胞-血小板纤维蛋白凝胶;根据制备流程不同,血小板凝胶的每一种制备方法还可以再分为手工制备方法和全自动制备方法,但各种分类方法均存在不足之处。     

白细胞介素-6基因-572C/G基因型与外周血血小板数量的相关性研究

目的 :观察IL 6基因 -5 72C/G多态性对健康人群外周血血小板数量的影响。方法 :采用聚合酶链反应 限制性片段长度多态性分析方法测定我院门诊体检的 2 0 3例健康人群的IL 6基因 -5 72C/G多态性 ,分析其与外周血血小板数量的关系。结果 :-5 72C/G多态性与人群中外周血血小板数量相关 ,G等位基因携带者血小板数量明显高于CC基因型者 ( 188.2 3± 5 2 .5 6× 10 9·L- 1 vs 181.3 0± 5 0 .10× 10 9·L- 1 ,P <0 .0 5 ) ,而两组间年龄、性别、体重指数、血压、血糖、胆固醇、甘油三脂、白细胞数量及分类等一般临床和生化特征均无差别 (P均 >0 .0 5 )。结论 :IL 6基因 -5 72C/G多态性可以影响健康人群外周血血小板数量水平 ,G等位基因携带者血小板水平较高 ,这在血栓性疾病的一级预防中具有一定意义