EDTA-K2在血液分析仪血小板检测中的应用及阿米卡星对EDTA-K2相关的假性血小板减少症的纠正作用

目的 确认乙二胺四乙酸二钾(EDTA-K2)是全自动血液分析仪血小板检测的首选抗凝剂,研究EDTA-K2抗凝剂致假性血小板减少的原因,寻找纠正EDTA-K2相关的假性血小板减少症(EDTA-PTCP)的方法.方法 纳入2015年6月至2016年6月我院健康志愿者25例,采集的血标本分别用EDTA-K2、枸橼酸钠和肝素钠抗凝剂进行抗凝.纳入同期我院确诊的EDTA-PTCP患者10例,采集的血标本分别用EDTA-K2、EDTA-K2+阿米卡星抗凝.健康志愿者和EDTA-PTCP患者的血标本均同时用全自动血液分析仪及血小板手工计数.结果 健康志愿者EDTA-K2抗凝血标本的血小板计数和手工血小板计数在30 min内差异无统计学意义(P＞0.05);枸橼酸钠、肝素钠抗凝血标本的血小板计数和手工血小板计数在5、15、30、60 min时差异均有统计学意义(P＜0.01).EDTA-PTCP患者的EDTA-K2抗凝血标本在0、30、60、90 min时的血小板计数均低于手工血小板计数(P＜0.01).在EDTA-K2抗凝血标本中加入阿米卡星后,血小板计数随着时间延长而逐渐增加,90 min时与手工血小板计数相比差异无统计学意义(P＞0.05).结论 EDTA-K2的抗凝效果优于枸橼酸钠、肝素钠抗凝剂,是全自动血液分析仪血小板检测的首选抗凝剂.EDTA-PTCP患者的血标本在使用EDTA-K2作为抗凝剂时,可以用阿米卡星纠正.

Application of EDTA-K2 in detecting platelet and corrective effect of amikacin on patients with EDTA-K2-associated pseudothrombocytopenia

Objective: Confirm the EDTA - K2 is Automated Hematology Analyzer detecting platelet preferred anticoagulants.To study the cause of pseudothrombocytopenia caused by anticoagulant EDTA-K2and to investigate the correction methods of EDTA-dependent pseudothrombocytopenia. Methods: there were ten patients diagnosed with EDTA - PTCP from June 2015 to June 2016 in our hospital as the experimental group. Another 25 fit persons were chosen as the control group. The 25 fit persons used EDTA-K2, sodium citrate, sodium heparin as anticoagulants and the blood samples were drawn for examination.blood specimens of the 10 patients with EDTA-PTCP was managed with EDTA-K2, EDTA-K2 and amikacin, sodium citrate, sodium heparin anticoagulant. Blood specimens of the two groups were detected by automatic hematology analyzer and artificial microscopic counting. Results: The results of EDTA-K2 anticoagulation in the control group within 30 minutes showed no statistically difference. The results of sodium citrate and sodium heparin anticoagulation in the control group at every time showed statistically difference (P<0.001). In the experimental group, the platelet count of EDTA-K2 anticoagulant blood specimens was lower than sodium citrate, sodium heparin anticoagulant specimens and artificial microscopic counting (P < 0.001). In the experimental group, platelet count of EDTA-K2 and amikacin, anticoagulant blood specimens will increase gradually with the time going, 90 minutes of EDTA - K2 anticoagulant blood specimens and manual counting the platelet count no statistical difference(P>0.05). Conclusion: EDTA - K2 anticoagulant is the best choose of automatic hematology analyzer. The anticoagulant effect of EDTA-K2 is better than sodium citrate and sodium heparin anticoagulant. EDTA -K2 anticoagulants in certain blood specimens can cause low platelet count. Amikacin can correct EDTA-K2 associated thrombocytopenia.