EDTA依赖的假性血小板减少的临床研究

发布时间：2018-03-05 14:24

本文选题：假性血小板减少　切入点：乙二胺四乙酸　出处：《浙江大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的本研究旨在探讨乙二胺四乙酸依赖的假性血小板减少(Ethylenediamine tetra-acetic Acid-Dependent Pseudothrombocytopenia, EDTA-PTCP)在一般健康人群中的发生率和可能的生化易感因素,并了解EDTA-PTCP伴随假性白细胞增多的发生率、动力学特点以及预防措施。方法我们对进行年度健康体检人群中EDTA-PTCP患者的实验室检查数据进行了一项单中心回顾性研究,对比84名患者和150名对照组的人口基本特征以及生化资料。随机选取25名EDTA-PTCP患者进一步研究假性白细胞增多的发生特点,在不同时间点分别测定用乙二胺四乙酸及柠檬酸钠抗凝处理后血标本的白细胞计数,白细胞分类和血小板计数。用光学显微镜观察血涂片是否存在血小板聚集。并评估全自动血细胞分析仪对假性白细胞增多的自动校正效果。结果EDTA-PTCP在我们的研究组中发生率为0.044%。年龄超过50岁的EDTA-PTCP患者明显多于50岁或以下人群,P0.05。年龄大于50岁的人群中,EDTA-PTCP男性患者明显多于女性患者,P0.05。与对照组比较,EDTA-PTCP组的谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、乳酸脱氢酶(LD)和尿酸(UA)水平明显增高,P0.05。在EDTA-PTCP患者中假性白细胞增多的发生率为92%,其中73.9%的假性白细胞增多患者白细胞计数值仍在正常参考范围内。假性白细胞增多的发展呈时间依赖性,中性粒细胞和淋巴细胞是发生假性增多的主要亚群。校正白细胞计数和未校正白细胞计数在EDTA抗凝血标本采集后15分钟以及更晚时间,分别计数均显著高于其基础计数值,P0.05。结论在大于50岁的男性健康人群中有更高的EDTA-PTCP发生率。生化资料可能有助于区分EDTA-PTCP高危人群。合理解释假性白细胞增多对预防诊断错误至关重要,假性白细胞增多的发展呈时间依赖性,Coulter LH750血细胞分析仪只在一定程度上减轻了假性白细胞增多程度,柠檬酸钠能够有效地防止SEWC.
[Abstract]:Objective to investigate the incidence of ethylenediamine tetra-acetic Acid-Dependent Pseudothrombocytopenia( EDTA-PTCP) in the general healthy population and the possible biochemical predisposing factors, and to investigate the incidence of EDTA-PTCP associated with pseudocytosis, in order to investigate the incidence of ethylenediamine tetra-acetic Acid-Dependent pseudothrombocytopenia (EDTA-PTCPA) in the general healthy population. Methods A single central retrospective study was conducted on laboratory data of EDTA-PTCP patients in the annual health checkup population. The basic demographic characteristics and biochemical data of 84 patients and 150 controls were compared. 25 patients with EDTA-PTCP were randomly selected to further study the characteristics of pseudocytosis. WBC count of blood samples treated with ethylenediamine tetraacetic acid and sodium citrate was measured at different time points. White blood cell classification and platelet count. Observation of platelet aggregation in blood smears by optical microscope. Automatic correction of pseudocytosis by automatic blood cell analyzer. Results EDTA-PTCP in our study. The incidence of EDTA-PTCP in the group was 0.044. The number of EDTA-PTCP patients over 50 years of age was significantly higher than that of the population under 50 years old (P0.05. the number of male patients with EDTA-PTCP was significantly higher than that of female patients P0.05.Compared with the control group, the patients with EDTA-PTCP had higher levels of alanine aminotransferase (alt) and alanine aminotransferase (alt). The levels of alt, ALP, LDD and UAA were significantly increased in patients with EDTA-PTCP. The incidence of pseudocytosis in EDTA-PTCP patients was 92. 73.9% of the patients with pseudocytosis were still in the normal reference. The development of pseudoleukopenia is time-dependent. Neutrophilic granulocytes and lymphocytes were the major subsets of pseudoproliferation. The corrected and uncorrected leukocyte counts were collected 15 minutes after EDTA anticoagulant samples were collected and later. Conclusion there is a higher incidence of EDTA-PTCP in healthy male population over 50 years old. Biochemical data may be helpful to distinguish the high risk population of EDTA-PTCP. It is important to prevent the diagnosis of errors. The development of pseudoleukopenia is time-dependent. Coulter LH750 hematology analyzer only alleviates pseudocytosis to a certain extent, and sodium citrate can effectively prevent SEWCs.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R446.11

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