41例EDTA依赖性血小板降低的原因及校正方法探讨

Discussion on the Causes and Correction Methods of EDTA Dependent Thrombocytopenia in 41 Cases

目的探讨EDTA依赖性血小板降低的原因及校正方法。方法回顾性分析2014年7月—2015年7月内江市市中区人民医院EDTA依赖性血小板降低的门诊及住院患者共41例。分别采用仪器全血法、仪器稀释法、枸橼酸钠抗凝剂法和手工法在不同时间点对患者血小板进行计数。结果 EDTA依赖性血小板降低现象发生的原因主要包括血小板聚集、血小板卫星现象、采血不通畅、抗凝剂不足和抗凝剂过量,发生率分别为51.2%、2.4%、22.0%、9.8%和14.6%。采血后0~5 min各种测定方法与手工法比较,血小板测定结果差异无统计学意义（P〉0.05）。而15 min后,KX-21仪器法与手工法比较,血小板测定结果差异具有统计学意义（P〈0.05）。稀释法在2 h内与手工法测定结果差异无统计学意义（P〉0.05）。枸橼酸盐抗凝法在1 h后与手工法比较,血小板测定结果差异具有统计学意义（P〈0.05）。结论稀释法是可作为EDTA依赖性血小板降低的校正方法。

Objective To investigate the causes and correction methods of EDTA dependent thrombocytopenia. Methods From July 2014 to July 2015, 41 patients with EDTA dependent thrombocytopenia in the People＇s Hospital of Shizhong Zone of Neijiang city were retrospectively analyzed. Instrument whole blood method, instrument dilution method, citric acid sodium anticoagulant method and manual method at different time points were used for platelet count. Results The phenomenon results of EDTA dependent thrombocytopenia from platelet aggregation, platelet satellitism, obstructed blood, anticoagulant deficiencies and anticoagulant overdose with the occurred rate of 51.2%, 2.4% and 22.0%, 9.8% and 14.6%, respectively. There was no significant difference in the results of PLT assay（P〉0.05） from 0 to 5 min after blood sampling.And after 15 min, PLT measured by instrument method and manual method has statistical significance（P〈0.05）. There was no significant difference（P〉0.05） between the dilution method and the manual method in the 2 hours. When citrate anticoagulation in one hour compared with manual method, the difference was statistically significant（P〈0.05）. Conclusion The Dilution method can be used as a calibration method for EDTA salt dependent thrombocytopenia.