不同血小板计数方法的比较及对临床血小板输注的影响

目的比较手工法、自动血细胞分析仪法与免疫法计数血小板的结果，探讨低水平血小板准确计数能否减少临床血小板输注。方法采用手工法、自动血细胞分析仪法与免疫法同时计数血小板。以免疫血小板计数值（×10^9／L）将标本分为4组：≤5、6～10、11～20及〉20，对三种方法的计数结果进行比较。然后根据同一输注标准统一输注阈值（5×10^9／L），计算并比较以三种方法计数结果决定的血小板输注例数。结果免疫血小板计数（×10^9／L）≤5的标本，免疫血小板计数结果低于手工计数法，远低于仪器计数法；免疫血小板计数（×10^9／L）为6～10的标本，免疫血小板计数结果与手工计数的差异无统计学意义，低于仪器计数法结果；免疫血小板计数〉10×10^9／L的标本，三者计数结果的差异无统计学意义。根据同一输注标准统一输注阈值（5×10^9／L），与其他方法相比，采用免疫血小板计数结果决定的血小板输注例数有所增加。结论应使用免疫血小板计数法准确计数低水平血小板，尤其是低于10×10^9／L的标本；以5×10^9／L为输注阈值，采用免疫血小板计数可增加血小板输注例数。

Comparison of Platelet Count Results with Different Methods and Impact on Clinical Platelet Transfusion

Objective To compare the platelet count results with different methods and discuss whether accurate platelet count at low level could reduce clinical platelet transfusion. Methods The manual method, automatic instrumental method and flow cytometric immunological count were simultaneously used to count platelet. Based on the results of the immunological count, the samples were classified into 4 groups（×10^9/L）： ≤5,6-10,11-20 and 〉20. The count results of the three methods were compared. According to the same transfusion criteria and the same transfusion threshold, the count results of the three methods were respectively used to decide how to transfuse platelet. Results For samples with platelet counts ≤5×10^9/L with immunological count, the results of immunological count were significantly lower than the manual method,and much lower than the instrumental method. For platelet counts 〉5×10^9/L and ≤10×10^9/L, no significant difference existed between the results of the manual method and immunological count. And the latter were significantly lower than the instrumental method. For platelet counts 〉10×10^9/L,no significant difference existed among the results of three methods. According to the same transfusion criteria and the same transfusion threshold, the immunological count results decided the most transfusion frequency. Conclusion The immunological count should be used to accurately count platelet at low level, especially for platelet count ≤10 ×10^9/L;under the transfusion threshold of 5×10^9/L, the immunological count increased the transfusion.