标题：乙二胺四乙酸依赖性假性血小板减少症检测方法探讨

      作者：陈爱莲，马小宏
    （如皋市人民医院检验科，江苏 如皋 226500）

      卷次： 2015年26卷21期

      【摘要】 目的 探讨乙二胺四乙酸依赖性假性血小板减少症(EDTA-PTCP)几种检测方法的可靠性。
方法 对5例EDTA-PTCP患者和20位健康体检者同时用经乙二胺四乙酸二钾(EDTA-K2)、枸橼酸钠和肝素锂三
种抗凝管及末梢血稀释的方式采集标本，分别用血液分析仪在三种抗凝管采集标本后5 min、30 min、60 min测定
血小板计数，采集末梢血用显微镜手工计数血小板，对所有标本涂片染色观察血小板形态。结果 5例
EDTA-PTCP患者EDTA-K2采血管采血后30 min和60 min血小板计数(PLT)比5 min时测定结果显著偏低，差异具
有统计学意义(P<0.05)。DTA-PTCP患者EDTA-K2采血后30 min和60 min抗凝血涂片染色均见明显的血小板聚
集现象，而健康体检者EDTA-K2抗凝血涂片及未抗凝血直接涂片染色见血小板散在分布。在采血 30 min后测
定，EDTA-K2采血管PLT明显低于枸橼酸钠、肝素锂及手工计数结果，差异均具有统计学意义(P<0.05)；20例健康体
检者在采血后5 min、30 min、60 min时EDTA-K2采血管PLT与枸橼酸钠、肝素锂、手工计数的结果比较差异均无统
计学意义(P>0.05）。结论 对疑似EDTA-PTCP患者可以用EDTA-K2采血管重新采血立即测定，或不使用抗凝剂直
接抽血立即测定，也可以使用枸橼酸钠或肝素锂抗凝管初步确认，同时涂片染色并手工计数得到正确的结果。

      【关键词】 乙二胺四乙酸；枸橼酸钠；肝素锂；假性血小板减少症；血小板计数

      【中图分类号】 R558+.2 【文献标识码】 A 【文章编号】 1003—6350（2015）21—3170—03


Investigation on the detection method for EDTA-dependent pseudothrombocytopenia.
CHEN Ai-lian, MA
Xiao-hong. Department of Clinical Laboratory, Rugao People' Hospital, Rugao 226500, Jiangsu, CHINA

【Abstract】 Objective To investigate the reliability of the methods for detecting EDTA-dependent pseudo-
thrombocytopenia (EDTA-PTCP). Methods Blood samples were collected from 5 patients of EDTA-PTCP and 20
healthy subjects by three anticoagulant tubes (EDTA-K2, sodium citrate and heparin lithium) and peripheral blood dilu-
tion. Platelets were determined by haematology analyzer 5 min, 30 min, 60 min after the samples were collected by an-
ticoagulant tubes, as well as determined manually under the microscope for peripheral blood samples collected. Smear
staining was performed to observe platelet morphology. Results In the five DTA-PTCP patients, the platelet count
of EDTA-K2 anticoagulant tube was significantly lower at 30 min and 60 min after sample collection than at 5 min
(P<0.05). Platelet of EDTA-K2 anticoagulant tube from the 5 patients showed significant aggregation during smear
staining, while the platelet of EDTA-K2 anticoagulant tube from the 20 healthy subjects and the peripheral blood (man-
ual counting) showed scattered distribution. 30 min after blood collection, the platelet count of EDTA-K2 anticoagu-
lant tube was significantly lower than that of sodium citrate anticoagulant tube, heparin lithium anticoagulant tube,
manual counting (P<0.05). In 20 healthy subjects, no significant difference exist in the results between EDTA-K2 anti-
coagulant tube and sodium citrate anticoagulant tube, heparin lithium anticoagulant tube, manual counting (P>0.05).
Conclusion For suspected patients of EDTA-PTCP, blood samples can be collected by EDTA-K2 anticoagulant tube
or draw directly without anticoagulant for immediate platelet determination. Samples can also be collected by using so-
dium citrate or lithium heparin anticoagulant tube for initial identification. Smear staining and manual counting should
be performed to obtain correct results.

      【Key words】 Ethylene diamine tetraacetic acid (EDTA); Sodium citrate; Heparin lithium; Pseudothrombocyto-
penia; Platelet count