血小板假性减低的原因及其校正分析

Reasons of platelet pseudo reducing and its correction

目的分析乙二胺四乙酸二钾（EDTA—K2）和枸橼酸钠导致血小板假性减低的原因及实验室常用的校正方法。方法按照《临床检验操作规程》规定的镜检规则选择血小板减少患者末梢血涂片1056份，涂片镜检发现镜检65例与机器结果不符，重抽构橼酸钠抗凝血检测，同时采末梢血手工计数血小板和抗凝血涂片镜检，同时分组血小板对EDTA—K2发生聚集者为一组，血小板对EDTA-K2和枸橼酸钠均发生聚集者为二组。结果第一组血小板检测结果远低于枸橼酸钠抗凝血、新鲜末梢血、手工显微镜计数检测的血小板，而后三者方法检测的血小板值非常接近；第二组EDTA抗凝血和枸橼酸钠抗凝血检测结果相近且其均低于新鲜末梢血和手工显微镜计数检测的血小板，而后两者检测的血小板结果非常相近。结论EDTA和枸橼酸钠均可出现凝集导致血小板假性减低．必须采末梢血涂片镜检进行复查，避免血小板假性减少的发生，为临床提供可靠的数据。

Objective To analyze the causes of ethylenediamine tetraacetic acid dipotassium（EDTA - K2） and sodium citrate induced pseudo platelet reducing and laboratory calibration methods. Methods To choose 1056 patients with thrombocytopenia according to the regulations of the journal of clinical inspection procedures of microscopy rules, smear microscopy results found 65 cases of microscopy and machine, heavy smoke sodium citrate anticoagulant detection, at the same time in peripheral blood platelet and manual counting of anticoagulant blood smear microscopy, at the same time grouping platelets for EDTA - raiser for a group of K2, platelets for EDTA - K2 and sodium citrate raiser for the two groups. Results The first group of the platelet test results was far lower than the sodium citrate anticoagulant, manual microscope count test, fresh peripheral blood platelets, and then the three methods of platelet values very close. The second group of EDTA anticoagulant and sodium citrate and its similar anticoagulant were lower than fresh peripheral blood platelet count detection, and manual microscope which both detection of platelet resuhs were very similar. Conclusions EDTA and sodium citrate can appear agglutination platelet pseudo, must carry on the review in peripheral blood smear microscopy, avoid the happening of alkaline reduce platelet, provide reliable data for clinic.