震荡法在纠正EDTA依赖的假性血小板减少中的应用

Application of vortex mixing method in correcting platelet counts in EDTA-dependent pseudothrombocytopenia

目的:评估震荡法纠正EDTA依赖的假性血小板减少(EDTA-dependent pseudothrombocytopenia,EDTA-PTCP)的可行性。方法:收集140例EDTA-PTCP血标本,比较震荡前后全自动血细胞分析仪血小板计数检测结果,同时进行外周血涂片以观察血小板分布情况。结果:140例EDTA-PTCP血标本中,93例外周血涂片显示震荡后血小板聚集明显减少,血小板计数中位数为184×10~9/L,与震荡前(33×10~9/L)差异有统计学意义(P<0.05);另47例为未完全解聚标本血小板计数中位数为48×10~9/L,与震荡前(39×10~9/L)差异无统计学意义。140例EDTA-PTCP标本中,震荡前后其他参数差异均无统计学意义。20例正常抗凝血标本震荡前后各项参数差异均无统计学意义。结论:震荡法可纠正多数EDTA-PTCP,是一种简单、有效的方法,可以提高检测效率,减轻患者痛苦。

Objective:To explore the feasibility of vortex mixing method in correcting EDTA-dependent pseudothrombocytopenia(EDTA-PTCP).Methods:A total of 140 EDTA-PTCP samples were enrolled.By using automated hematology analyzer,the platelet counting was analyzed and compared before and after vortex mixing.Meanwhile,the blood smears were prepared for microscope review before and after vortex mixing.Results:Among 140 EDTA-PTCP specimens,93 samples were found obvious disaggregation of platelet clumps,with a significant increase of platelet counts after vortex compared with pre-vortex(median:184×10 9/L vs 33×10 9/L,P<0.05).The remaining 47 specimens showed no change in degree of platelet clumping(median of platelet counts:48×10 9/L vs 39×10 9/L).The other parameters of complete blood cell were not significantly affected by vortex mixing in all the 140 specimens.Furthermore,20 control anticoagulant specimens showed no significant changes of all parameters after vortex mixing.Conclusions:In most cases,vortex mixing is recommended as a simple and rapid method to correct the platelet counts in EDTA-PTCP,which can avoid misdiagnosis and unnecessary additional testing,relieve the pain of the patients.