血小板聚集报警在真性和EDTA依赖性假性血小板减少鉴别中的应用

Clinical study of platelet clumps IP in differentiating EDTA-dependent from pseudothrom bocytopenia

目的探讨血小板聚集报警(PCIP)在EDTA依赖性假性血小板减少(EDTA-PTCP)与真性血小板减少鉴别中的意义。方法用Sysmex XE2100全自动血细胞分析仪检测70份健康人、57份真性血小板减少和26份EDTA-PTCP患者的EDTA-K2抗凝静脉血的PLT并记录血小板聚集报警信息(PCIP),比较PCIP在三组间的异同;检测26份EDTA-PTCP的枸橼酸盐抗凝静脉血的同上参数,并比较EDTA-PTCP组中两种抗凝标本PCIP的异同。血涂片镜检法复核57份真性血小板减少和26份EDTA-PTCP的EDTA-K2抗凝静脉血的血小板聚集情况,分析PCIP与血涂片镜检法在判断血小板聚集时的符合率。结果以血小板聚集指数(PCI,PLT Clumps Index)100为PCIP的cutoff值,70份健康人、57份真性血小板减少和26份EDTA-PTCP患者的EDTA-K2抗凝静脉血的PCIP阳性率分别为0%、1.75%和100%,前两组间PCIP无显著的统计学差异(P>0.05),EDTA-PTCP组PCIP阳性率显著高于健康人组、真性血小板减少组(P均<0.05);26份EDTA-PTCP的枸橼酸盐抗凝静脉血的PCIP阳性率为3.85%,显著低于本组EDTA-K2抗凝静脉血的结果 (t=8.649,P<0.05)。在判断血小板聚集时,PCIP与血涂片镜检法的符合率为98.8%(82/83)。结论 PCIP是监测血小板聚集的良好指标,可用于EDTA-PTCP和真性血小板减少的鉴别。

【Objective】 To study the clinical significance of platelet clumps IP（PCIP） provided by Sysmex XE2100 hematology analyzer in the identification of EDTA-dependent pseudo-thrombocytopenia.【Methods】 Vein bloods anticoagulant with EDTA-k2（including 70 healthy controls,57 true thrombocytopenia and 26 EDTA-PTCP） were analyzed using Sysmex XE2100 hematology analyzer,and the results of PCIP were recorded,and the positive rates of PCIP were mutually compared among the three groups.Samples from 26 EDTA-PTCP were also checked by replacing citric acid and using the same analyzer,and the positive rates of PCIP were compared with one from the same group＇s samples anticoagulant with EDTA-K2.83 blood films of vein bloods anticoagulant with EDTA-k2 were detected under microscope in 57 true thrombocytopenia and 26 EDTA-PTCP patients,and the rate of coincidence between PCIP and the results of microscopic platelet clumps in determining platelet aggregation was computed.【Resluts】 The cutoff value of PCIP was set to 100 and the positive rates of PCIP of samples anticoagulant with EDTA-K2 were respectively 0%,1.75% and 100% in healthy control,true thrombocytopenia and EDTA-PTCP groups,and no significant difference was found in PCIP between the first two groups（p0.05）,and the positive rates of PCIP in EDTA-PTCP group was significantly higher than in healthy control or true thrombocytopenia group respectively（p0.05 all）.The positive rates of PCIP of samples anticoagulant with citric acid was 3.85% in EDTA-PTCP group,and was significantly lower than with EDTA-k2 in the same group（t=8.649,p0.05）.In determining platelet aggregation,the rate of coincidence between PCIP and the results of microscopy was 98.8%（82/83）.【Conclusion】PCIP is a effective parameter for monitoring platelet aggregation and can be used to different from EDTA-PTCP and true thrombocytopenia.