EDTA-K_2抗凝剂诱发的血小板聚集与再解聚动态分析

Dynamic analysis of platelet aggregation and re-depolymerization induced by EDTA-K_2 anticoagulant

目的通过对EDTA-K_2抗凝剂诱发的血小板(PLT)聚集到再解聚现象进行动态分析,进一步探讨其可能的发生机制及纠正措施。方法采用SYSMEX-XE5000全自动血细胞分析仪对同一患者EDTA-K_2和枸橼酸钠(1∶9)抗凝的血常规标本进行PLT计数,并用空白管采血后立即检测所得PLT计数结果作为其参考值。分别于采血后不同时间段检测PLT,并进行涂片和瑞氏染色,动态观察其PLT计数结果及显微镜下PLT聚集情况。结果 EDTA-K_2抗凝的PLT在5 min^10 min时聚集最明显,计数结果最低;随着时间的延长,计数结果逐渐上升;在0 min以及30 min^60 min时,结果接近空白管PLT计数值。枸橼酸钠(1∶9)抗凝的PLT计数结果经校正后在各时间段均接近空白管PLT计数值。结论此类患者采用EDTA-K_2抗凝剂采血后应立即检测,也可将标本放置30 min后再检测;或者采用空白管抽血后立即检测以及改用枸橼酸钠(1∶9)抗凝检测。

Objective To investigate the possible mechanism and to take remedy measures of EDTA-K_2 anticoagulant-induced platelet aggregation（ PLT） by dynamic analysis of the phenomenon of PLT aggregation to re-depolymerization. Methods The SYSMEX-XE5000 automatic blood cell analyzer was used to count PLT of EDTA-K_2 and sodium citrate（ 1∶9） anticoagulated blood samples,and the results of PLT counting were detected immediately after collecting blood with blank tube were regarded as the reference. PLT was detected at different time points after blood collection,and smear and Wright＇s staining were performed in time. The PLT count and the PLT accumulation were observed under microscope dynamically. Results The PLT count of EDTA-K_2 anticoagulated blood aggregated the most obviously within 5 min-10 min,and the result was the lowest. The results gradually increased with the prolongation of time. At 0 min and within 30 min-60 min,the results were close to PLT count value of the blank tube. Results of sodium PLT count of blood anticoagulated by citrate（ 1∶9） were corrected for each time period and close to the blank tube PLT count. Conclusion Specimen anticoagulated by EDTA-K_2 should be tested immediately after the acquisition of blood samples,the specimen can also be placed 30 minutes after the test; or be tested immediately after the use of blank tube for blood,or use sodium citrate（ 1∶9） as coagulant for test.