血小板聚集影响因素在血细胞计数中的临床应用

Clinical application of platelet aggregation for white blood cell count

目的分析血小板聚集影响因素,为降低血小板聚集所致血小板假性减低、实验室规避报告风险及减低误诊误治提供依据。方法对血小板小于80×10-9/L、小于125×10-9/L合并直方图提示血小板凝集标本进行推片、瑞氏-吉姆萨染色后显微镜下观察是否聚集,并采用统计软件SPSS 18.0进行统计分析。结果乙二胺四乙酸依赖性血小板减少症（EDTA-PTCP）共计184例,占0.444‰,其中门诊患者101例,占0.244‰,住院患者66例,占0.159‰,体检者17例,占0.041‰;多重抗凝剂依赖性血小板假性减少共计3例,占0.007‰,假性血小板聚集共计25例,占0.060‰。结论血小板聚集的发现依靠镜检,原因主要来源于EDTA-PTCP,假性聚集主要来源于采样因素,需加强业务技能培训。

Objective To analyze the cause of platelet aggregation in blood specimens,so as to provide basis for reducing platelet aggregation,and avoiding false positive of platelet count,false report,misdiagnosis and mistreatment.Methods The blood specimens which platelet was below 80×10-9/L,below 125×10-9/L with histogram hinted platelet aggregation,were smeared,stained with Wright-Giemsa,and observed by microscope for platelet morphological changes.The data between each groups were calculated and analyzed by statistical software SPSS version 18.0.Results A total of 184 cases of ethylenediaminetetraacetic acid dependent pseudothrombocytopenia（EDTA-PTCP）were found,accounted for 0.444‰totally,including 0.244‰ of out-patients（101cases）,0.159‰ of hospitalized patients（66cases）,and 0.041‰ of health examination personnel（17cases）.3cases of multi-dependent pseudothrombocytopenia and 25 cases of pseudo platelet aggregation were found,and accounted for 0.007‰ and 0.060‰ respectively.Conclusion The discovery of platelet aggregation which caused mainly by EDTA-PTCP,still relies on microscopy,and pseudo platelet aggregation comes mainly from sampling,so it needs to strengthen the skills training.