单中心142例EDTA依赖的假性血小板减少症的实验室特征研究

A Single-center Laboratory Characteristics Study of 142 Patients with EDTA-dependent Pseudo-thrombocytopenia

目的研究EDTA依赖的假性血小板减少症(EDTA-PTCP)病人的实验室检测指标的特征,为研究其机制提供基础数据支持。方法收集2015年1月至2016年12月在我院诊治的门诊或住院的EDTA-PTCP病例,记录其基本信息以及实验室检测指标的数据,以异常率(增高或降低)分析EDTA-PTCP的检测数据特征,并采用Spearman相关分析血小板聚集程度与各指标的相关性。结果 EDTA-PTCP病人中,实验室指标异常率最高的为D-D和FDP,分别为78.57%和72.73%。此外,总异常率超过50%的实验室检测指标有HBDH、CREA、ALB、FIB、PA、CRP、WBC、LDH、UA和Fe。进一步分析发现,PLT的聚集程度与尿素氮(r=-0.27,P<0.01)、半胱氨酸蛋白抑制剂C(r=-0.26,P<0.05)、肌酐(r=-0.23,P<0.05)的含量呈反比。而与胆碱酯酶活性呈正比(r=0.36,P<0.05)。结论在EDTA-PTCP发生发展中,血浆中D-D、FDP、HBDH、CREA、ALB、FIB、PA、CRP、WBC、LDH、UA和Fe等异常率较高的物质可能具有一定作用。此外,BUN、CREA和Cystatin C可能具有抑制作用,而CHE具有促进作用,但其作用机制有待进一步研究。

Objective To investigate the laboratory testing characteristics of EDTA-dependent pseudothrombocytopenia（EDTA-PTCP） patients,and providing basic data for studying its mechanism. Methods The EDTA-PTCP cases were collected from outpatients or hospitalized patients who were treated in Guizhou Provincial People＇s Hospital from January 2015 to December 2016. The basic information and laboratory test data were recorded. The detection data characteristics of EDTA-PTCP were analyzed by abnormal rate（increase or decrease）. Spearman correlation was used to analyze the interrelation between platelet aggregation and each indexing. Results Among the EDTA-PTCP patients,the highest abnormal rate of laboratory indicators were D-D and FDP（78.57% and 72.73%,respectively）. In addition,the abnormal rate of HBRH,CREA,ALB,FIB,PA,CRP,WBC,LDH,UA and Fe had more than 50%. Further analysis showed that the degree of PLT was inversely proportional with BUN（r=-0.27,P〈0.01）,CREA（r =-0.23,P〈0.05） and Cystatin C（r =-0.26,P〈0.05）,and proportional with CHE（r =0.36,P〈0.05）. Conclusion In the development of EDTA-PTCP,plasma substances such as D-D,FDP,HBDH,CREA,ALB,FIB,PA,CRP,WBC,LDH,UA and Fe may have certain effects. BUN,CREA and Cystatin C may have inhibitory effect,while CHE has a promoting effect,but its mechanism remains to be further studied.