乙二胺四乙酸依赖性假性血小板减少症的处理措施

Countermeasures of Ethylenediaminetetraacetic Acid-Dependent Pseudothrombocytopenia

目的简述乙二胺四乙酸依赖性假性血小板减少症(EDTA-PTCP)的原因,并探讨相应的处理措施。方法选取2019年1月至2020年12月于医院门诊初诊血小板计数<100×10^(9)/L且无瘀点、瘀斑或其他出血表现的患者620例,涂片经瑞-姬氏染色筛选出显微镜镜下血小板聚集(EDTA-PTCP)的患者23例,分别采集其枸橼酸钠抗凝静脉血、未加抗凝剂末梢血各1管直接上机检测,统计血小板计数。结果 23例EDTA-PTCP患者枸橼酸钠抗凝静脉血的血小板计数为(158.65±53.97)×10^(9)/L,未加抗凝剂末梢血的血小板计数为(168.35±41.20)×10^(9)/L,与EDTA-K2抗凝静脉血的血小板计数结果(68.17±12.92)×10^(9)/L比较,差异有统计学意义(P<0.05)。结论对于血小板减少的患者,应先排除引起血小板减少的其他原因,确诊为EDTA-PTCP后,根据具体情况更换枸橼酸钠抗凝剂或采集未加抗凝剂末梢血立即进行血小板计数,以减少EDTA-PTCP的发生。

Objective The causes of ethylenediaminetetraacetic acid-dependent pseudo-thrombocytopenia(EDTA-PTCP) were briefly described and the countermeasures were discussed. Methods From January 2019 to December 2020, 620 patients with initial platelet counts <100×10^(9)/L and no petechiae, ecchymosis or other bleeding situations were selected from the Outpatient Department of the hospital, and 23 patients with EDTA-PTCP presented platelet aggregation by Wright Stain of the smears(observed by microscope) among them were screened out. The samples of sodium citrate anticoagulated venous blood and non-anticoagulated peripheral blood were collected from these subjects and the platelet counts were tested on the machine immediately and then the test results were counted. Results The platelet counts of the 23 EDTA-PTCP patients with sodium citrate anticoagulated venous blood were(158.65±53.97)×10^(9)/L and the platelet counts of the non-anticoagulant peripheral blood were(168.35±41.20)×10^(9)/L. The above mentioned two platelet counts values were both higher than that of EDTA-K2 anticoagulated venous blood, which was(68.17±12.92)×10^(9)/L, with a statistically significant difference(P<0.05). Conclusions In terms of patients with thrombocytopenia, other causes of thrombocytopenia should be excluded first, then followed the determination EDTA-PTCP. The platelet counts should be tested immediately by the samples with the sodium citrate anticoagulant or unanticoagulated peripheral blood as substitution according to the specific situation and thus reduce the occurrence of misdiagnosis.