两例EDTA依赖性假性血小板减少应用阿米卡星无效探讨

目的探讨2例乙二胺四乙酸(EDTA)依赖性假性血小板减少应用阿米卡星无效的机制。方法对2例EDTA依赖性假性血小板减少症患者的EDTA-K2抗凝血,在不同时间段分别加入阿米卡星,在血液分析仪检测,血涂片检查。结果该2名患者,加或不加阿米卡星,其血小板数均会随着时间的延长逐渐增加,其特征性的直方图也会随着时间的延长而消失,加入阿米卡星会获得更可靠的结果。结论阿米卡星并不能立即解离2例患者聚集的血小板,但随着时间延长,血小板缓慢解离,至4h达到相对稳定。1h内加入阿米卡星较为理想,相对普通EDTA抗凝可有效加速其解离过程,获得理想结果。

Investigation on two cases of amikacin application in validation for EDTA-dependent pseudo thrombocytopenia

Objective To investigate 2 cases of amikacin application in validation for ethylene diamine tetracetic acid （EDTA ）-dependent pseudo thrombocytopenia. Methods Two cases of EDTA-dependent pseudo thrombocytopenia were collected,and their EDTA-K2 anticoagulant blood were collected and added amikacin at different time periods.The blood samples were determined for hematology analysis and blood smears.Results For the 2 patients with or without amikacin,the platelet count increased gradually with time,and the histogram disappeared with time. Adding amikacin would obtain more reliable results.Conclusions Amikacin can not immediately dissociate the platelet aggregation in the 2 cases,however,with time,the slow dissociation of platelet achieves a relatively stable state for 4 h. Amikacin is added within 1 h is preferable.The relatively common EDTA anticoagulation can effectively accelerate the dissociation process,in order to obtain the desired results.