| 摘要: |
| 目的 确认乙二胺四乙酸二钾（EDTA-K2）是全自动血液分析仪血小板检测的首选抗凝剂，研究EDTA-K2抗凝剂致假性血小板减少的原因，寻找纠正EDTA-K2相关的假性血小板减少症（EDTA-PTCP）的方法。方法 纳入2015年6月至2016年6月我院健康志愿者25例，采集的血标本分别用EDTA-K2、枸橼酸钠和肝素钠抗凝剂进行抗凝。纳入同期我院确诊的EDTA-PTCP患者10例，采集的血标本分别用EDTA-K2、EDTA-K2+阿米卡星抗凝。健康志愿者和EDTA-PTCP患者的血标本均同时用全自动血液分析仪及血小板手工计数。结果 健康志愿者EDTA-K2抗凝血标本的血小板计数和手工血小板计数在30 min内差异无统计学意义（P>0.05）；枸橼酸钠、肝素钠抗凝血标本的血小板计数和手工血小板计数在5、15、30、60 min时差异均有统计学意义（P<0.01）。EDTA-PTCP患者的EDTA-K2抗凝血标本在0、30、60、90 min时的血小板计数均低于手工血小板计数（P <0.01）。在EDTA-K2抗凝血标本中加入阿米卡星后，血小板计数随着时间延长而逐渐增加，90 min时与手工血小板计数相比差异无统计学意义（P>0.05）。结论 EDTA-K2的抗凝效果优于枸橼酸钠、肝素钠抗凝剂，是全自动血液分析仪血小板检测的首选抗凝剂。EDTA-PTCP患者的血标本在使用EDTA-K2作为抗凝剂时，可以用阿米卡星纠正。 |
| 关键词: 假性血小板减少症 依地酸 柠檬酸纳 肝素钠 阿米卡星 |
| DOI：10.16781/j.0258-879x.2017.03.0389 |
| 投稿时间：2016-08-19修订日期：2016-09-18 |
| 基金项目: |
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| Application of EDTA-K2 in detecting platelet and corrective effect of amikacin on patients with EDTA-K2-associated pseudothrombocytopenia |
| LIANG Feng*,SUN Fen-yong |
(Department of Laboratory Medicine, the 10th People's Hospital of Shanghai, Tongji University, Shanghai 200072, China
*Corresponding author) |
| Abstract: |
| Objective To confirm the role of dipotassium ethylene diamine tetraacetate (EDTA-K2) as the preferred anticoagulant in platelet counting using automatic hematology analyzer, and to explore the cause of pseudothrombocytopenia (PTCP) induced by EDTA-K2 and the corrective measures for EDTA-K2-associated PTCP (EDTA-PTCP). Methods Blood specimens were collected from 25 healthy volunteers admitted to our hospital from Jun. 2015 to Jun. 2016 and were separately anticoagulated with the anticoagulant EDTA-K2, sodium citrate and heparin sodium; blood specimens were also collected from 10 patients with EDTA-PTCP in our hospital and were separately anticoagulated with EDTA-K2 or EDTA-K2+amikacin. Blood platelet in healthy volunteers and EDTA-PTCP patients was tested by automatic hematology analyzer and manual platelet counting. Results In healthy volunteers, there was no significant difference in the platelet counts between automatic hematology analyzer and the manual platelet counting with EDTA-K2 anticoagulation for 30 min (P>0.05); and a significant difference in the platelet count was noted between automatic hematology analyzer and the manual platelet counting in the blood specimens with sodium citrate or heparin sodium anticoagulation for 5, 15, 30 and 60 min (P<0.01). The platelet count by automatic hematology analyzer was significantly lower than that by manual platelet count in the blood specimens of EDTA-PTCP patients with anticoagulation for 0, 30, 60, 90 min (P<0.01); after adding amikacin, the platelet count increased with the prolongation of time in these patients with EDTA-K2 anticoagulation, and there was no significant difference between automatic hematology analyzer and manual platelet count at anticoagulation 90 min (P>0.05). Conclusion Anticoagulation effect of EDTA-K2 is superior to sodium citrate and heparin sodium, and EDTA-K2 can be used as the preferred anticoagulant in platelet detection using automatic hematology analyzer. Amikacin can correct EDTA-PTCP in the patients with anticoagulation of EDTA-K2. |
| Key words: pseudothrombocytopenia edetic acid sodium citrate heparin sodium amikacin |
