目的:本文报道一例罕见的重症原发免疫性血小板减少症(ITP)患者治疗过程中合并EDTA、肝素钠、枸橼酸钠抗凝剂同时依赖性假性血小板减少的病例,分析与探讨其病因,为临床工作提供处理预案及经验指导。方法:通过静脉采血同时送EDTA-K2抗凝...目的:本文报道一例罕见的重症原发免疫性血小板减少症(ITP)患者治疗过程中合并EDTA、肝素钠、枸橼酸钠抗凝剂同时依赖性假性血小板减少的病例,分析与探讨其病因,为临床工作提供处理预案及经验指导。方法:通过静脉采血同时送EDTA-K2抗凝管、肝素钠抗凝管和枸橼酸钠(1:9)抗凝管至血细胞分析仪进行PLT计数,手指末梢血采血立即手工稀释计数法作为对比。回顾性分析该例临床资料,结合文献复习探讨其发生可能的原因。结果:该例ITP患者使用EDTA-K2抗凝管、肝素钠抗凝管、枸橼酸钠(1:9)抗凝管的PLT计数分别为6.00 × 109/L、9.00 × 109/L、7.00 × 109/L,手指末梢血校正手工稀释计数为PLT 32.00 × 109/L。患者ITP出血评分5分,重症ITP合并EDTA、肝素钠、枸橼酸钠抗凝剂同时依赖性假性血小板减少诊断明确,其原因可能与自身免疫性疾病及EDTA螯合、诱导血小板活化等机制相关,临床发生率极低,很容易误诊、漏诊,影响后续治疗,需要予以关注。结论:对于重症ITP患者治疗后血小板仍低的情况,除考虑治疗效果不理想外同时需要考虑合并EDTA、肝素钠、枸橼酸钠抗凝剂依赖性假性血小板减少的可能,需结合临床表现及时手工计数校正,可以减少临床误诊、漏诊。Objective: This article reports a rare case of severe primary immune thrombocytopenia (ITP) complicated with EDTA, sodium heparin, and sodium citrate anticoagulant-dependent pseudothrombocytopenia during treatment, shares and discusses its etiology, and provides treatment plans and experience guidance for clinical work. Methods: Venous blood was collected and sent to the blood cell analyzer for PLT counting in EDTA-K2 anticoagulant tubes, sodium heparin anticoagulant tubes, and sodium citrate (1:9) anticoagulant tubes. Finger-end blood sampling and immediate manual dilution counting were used as a comparison. The clinical data of this case were retrospectively analyzed, and展开更多
文摘目的:本文报道一例罕见的重症原发免疫性血小板减少症(ITP)患者治疗过程中合并EDTA、肝素钠、枸橼酸钠抗凝剂同时依赖性假性血小板减少的病例,分析与探讨其病因,为临床工作提供处理预案及经验指导。方法:通过静脉采血同时送EDTA-K2抗凝管、肝素钠抗凝管和枸橼酸钠(1:9)抗凝管至血细胞分析仪进行PLT计数,手指末梢血采血立即手工稀释计数法作为对比。回顾性分析该例临床资料,结合文献复习探讨其发生可能的原因。结果:该例ITP患者使用EDTA-K2抗凝管、肝素钠抗凝管、枸橼酸钠(1:9)抗凝管的PLT计数分别为6.00 × 109/L、9.00 × 109/L、7.00 × 109/L,手指末梢血校正手工稀释计数为PLT 32.00 × 109/L。患者ITP出血评分5分,重症ITP合并EDTA、肝素钠、枸橼酸钠抗凝剂同时依赖性假性血小板减少诊断明确,其原因可能与自身免疫性疾病及EDTA螯合、诱导血小板活化等机制相关,临床发生率极低,很容易误诊、漏诊,影响后续治疗,需要予以关注。结论:对于重症ITP患者治疗后血小板仍低的情况,除考虑治疗效果不理想外同时需要考虑合并EDTA、肝素钠、枸橼酸钠抗凝剂依赖性假性血小板减少的可能,需结合临床表现及时手工计数校正,可以减少临床误诊、漏诊。Objective: This article reports a rare case of severe primary immune thrombocytopenia (ITP) complicated with EDTA, sodium heparin, and sodium citrate anticoagulant-dependent pseudothrombocytopenia during treatment, shares and discusses its etiology, and provides treatment plans and experience guidance for clinical work. Methods: Venous blood was collected and sent to the blood cell analyzer for PLT counting in EDTA-K2 anticoagulant tubes, sodium heparin anticoagulant tubes, and sodium citrate (1:9) anticoagulant tubes. Finger-end blood sampling and immediate manual dilution counting were used as a comparison. The clinical data of this case were retrospectively analyzed, and
