临床常见血小板减少的原因分析

Analysis of the causes of thrombocytopenia in clinic

目的总结分析4410例血小板减少的原因;总结分析临床检验工作中遇到的假性血小板减少的原因。方法通过回顾性分析4410例血小板减少和612假性血小板减低的患者的临床资料,对其减少原因进行汇总分析。结果 4410例血小板减少患者中,血液系统疾病占39%,药物性血小板减少占18%,脓毒症占13%,肝病、脾功能亢进占7%,心脑血管疾病占4%,妊娠占2%,风湿免疫性疾病占1%,糖尿病占1%;引起血小板假性减低的原因主要是血液凝集,另外还有EDTA依赖性血小板减少、大血小板、冷凝集等。结论引起血小板减少的原因主要是血液系统疾病,其次为药物因素和脓毒症;引起血小板计数假性减低的原因主要是血液凝集。

Objective： This study aimed to analyze and summarize the causes of thrombocytopenia and pseudothrombocytopenia in clinic. Methods： Clinical data from 4410 patients with thrombocytopenia and 612 patients with pseudothrombocytopenia were systematic reviewed and assessed through the retrospective analysis. Results： Hematological disease accounts for 39% of the total 4410 thrombocytopenic patients,whereas drug-induced thrombocytopenia and pyaemia contributed to a proportion of 18% and 13%,respectively. Other causes were hepatopathy / hypersplenism（ 7%）,cardiac-cerebral vascular disease（ 4%）,pregnancy（ 2%）,rheumatic autoimmune disease（ 1%） and diabetes（ 1%）. Blood agglutination is one of the major causes of pseudothrombocytopenia,and EDTA-depended thrombocytopenia,giant platelet,or cold agglutination also responses for the occurrence of thrombocytopenia. Conclusions： Hematological disease remains the leading cause of thrombocytopenia,and that drug-induced thrombocytopenia and pyaemia take the second place. Blood agglutination is one of the major reasons for pseudothrombocytopenia