临床实验室对EDTA依赖性假性血小板减少的解决方法

Solution method of clinical laboratory for EDTA-dependent pseudothrombocytopenia

目的了解临床常见乙二胺四乙酸二钾(EDTA-2K)依赖性假性血小板减少(EDTA-PTCP)发生率,并探讨常规临床实验室针对其的解决方法。方法选取2015年4月至2016年4月成都大学附属医院收治的住院患者38 291例作为研究对象,对其中、高度疑似EDTA-PTCP的15例患者再次采用枸橼酸钠抗凝剂和血小板稀释液手工法分别采样检测血小板计数(Plt)。结果 EDTA-PTCP发生率为0.04%(15/38 291),15例患者采用EDTA-2K、枸橼酸钠抗凝剂和血小板稀释液手工法检测Plt分别为(57±17)、(119±53)、(112±54)×109 L-1,三组Plt比较,差异有统计学意义(F=8.387,P=0.001);采用EDTA-2K检测Plt明显低于采用枸橼酸钠抗凝剂、血小板稀释液手工法,差异均有统计学意义(P<0.05);采用枸橼酸钠抗凝剂检测Plt与血小板稀释液手工法比较,差异无统计学意义(P=0.391)。结论 EDTA-PTCP发生率为0.04%,疑似EDTA-PTCP标本建议更换枸橼酸钠抗凝剂或血小板稀释液手工法重新检测Plt。

Objective To understand the incidence of clinically common ethylenediaminetetraacetic acid dipotassium （EDTA-2K） dependent pseudothrombocytopenia （EDTA-PTCP） and to investigate its solution method of routine clinical laborato- ry. Methods A total of 38 291 inpatients in our hospital from April 2015 to April 2016 were selected as the research subjects. Among them, 15 cases of highly suspected EDTA-PTCP were performed the re-sampling for detecting platelet count （Plt） by adopting sodium citrate anti-coagulant and PLT diluting agent manual method respectively. Results The incidence of EDTA- PTCP was 0.04% （15/38 291 ）. Pit counts in 15 cases detected by adopting EDTA-2K,sodium citrate anti-coagulant and PLT di- luting agent manual method were （57~17）, （119~53 ）, （112~54）~109 L-1 respectively. The difference among 3 groups was statistically significant （F=8.387 ,P=0.001 ）. Pit count detected by adopting EDTA-2K was significantly lower than that by adopting sodium citrate anti-coagulant and PLT diluting agent manual method ,and the difference was statistically significant （P〈0.05）. However, Plt count had no statistical difference between by adopting sodium citrate anti-coagulant and PLT diluting agent manu- al method （P=0.391）. Conclusion The incidence of EDTA-PTCP is 0.04%. The sample of suspected EDTA-PTCP is rec- ommended that Pit count be detected again by replacing as sodium citrate anti-coagulant or PLT diluting agent manual method.