16例EDTA依赖性假性血小板减少的临床分析

Clinical Analysis of 16 Cases of EDTA-Dependent Pseudo-Thrombocytopenia

目的 探讨乙二胺四乙酸（EDTA）依赖性假性血小板减少（EDTA-PTCP）的发病原因及防范措施,以减少临床误诊误治.方法 对2015年6月至12月我院门诊及住院患者发现的16例EDTA-PTCP的临床资料进行回顾性分析.结果 患者行血常规检查均发现血小板减少（〈60±109/L）,均重新采血并于1 h内送检,EDTA-K2抗凝管机检血小板结果仍明显降低（18~52）±109/L,血小板直方图存在曲皱、尾部上翘、拖尾、无拟合曲线等异常;枸橼酸钠抗凝管机检及草酸铵稀释液手工计数血小板均接近正常,且枸橼酸钠抗凝管机检血小板直方图正常,16例均明确为EDTA-PTCP.结论 应用EDTA-K2抗凝管机检血小板计数减低而患者并无出血倾向、血栓形成等相关血小板减少症表现时,应采取手工计数、更换抗凝剂等方法复检,以减少或避免临床误诊误治.

Objective To investigate the ethylene diamine tetra-acetic acid （EDTA）dependent pseudo-thrombocytopenia （EDTA-PTCP）the cause and preventive measures to reduce clinical misdiagnosis.Methods June 2015-EDTA-PTCP clinical data of 16 cases in December 2015 in our hospital outpatient and inpatient found were retrospectively analyzed.Results The patients underwent outpatient or inpatient blood tests were thrombocytopenia （〈60× 109/L）,were re-bled and censorship within 1 h, EDTA- K2 anticoagulant tube machine inspection results are still significantly lower platelet （18-52）×109/L, platelet histogram exists curled tail upturned tail, no other abnormal curve fitting; sodium citrate anticoagulation tube machine inspection and ammonium oxalate manual dilutions were close to normal platelet count,and sodium citrate tube machine subject to normal platelet histogram, 16 cases were clear of EDTA-PTCP.Conclusion EDTA-K2 anticoagulant tube machine inspection and reduce platelet count in patients with no bleeding tendency,thrombosis and other related thrombocytopenia performance, should be taken manually count, anticoagu- lants and other methods to replace the re-examination, in order to reduce or avoid misdiagnosis mistreatment.