本文選題：假性血小板減少　切入點(diǎn)：乙二胺四乙酸　出處：《浙江大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的本研究旨在探討乙二胺四乙酸依賴的假性血小板減少(Ethylenediamine tetra-acetic Acid-Dependent Pseudothrombocytopenia, EDTA-PTCP)在一般健康人群中的發(fā)生率和可能的生化易感因素,并了解EDTA-PTCP伴隨假性白細(xì)胞增多的發(fā)生率、動(dòng)力學(xué)特點(diǎn)以及預(yù)防措施。方法我們對(duì)進(jìn)行年度健康體檢人群中EDTA-PTCP患者的實(shí)驗(yàn)室檢查數(shù)據(jù)進(jìn)行了一項(xiàng)單中心回顧性研究,對(duì)比84名患者和150名對(duì)照組的人口基本特征以及生化資料。隨機(jī)選取25名EDTA-PTCP患者進(jìn)一步研究假性白細(xì)胞增多的發(fā)生特點(diǎn),在不同時(shí)間點(diǎn)分別測定用乙二胺四乙酸及檸檬酸鈉抗凝處理后血標(biāo)本的白細(xì)胞計(jì)數(shù),白細(xì)胞分類和血小板計(jì)數(shù)。用光學(xué)顯微鏡觀察血涂片是否存在血小板聚集。并評(píng)估全自動(dòng)血細(xì)胞分析儀對(duì)假性白細(xì)胞增多的自動(dòng)校正效果。結(jié)果EDTA-PTCP在我們的研究組中發(fā)生率為0.044%。年齡超過50歲的EDTA-PTCP患者明顯多于50歲或以下人群,P0.05。年齡大于50歲的人群中,EDTA-PTCP男性患者明顯多于女性患者,P0.05。與對(duì)照組比較,EDTA-PTCP組的谷丙轉(zhuǎn)氨酶(ALT)、谷草轉(zhuǎn)氨酶(AST)、堿性磷酸酶(ALP)、乳酸脫氫酶(LD)和尿酸(UA)水平明顯增高,P0.05。在EDTA-PTCP患者中假性白細(xì)胞增多的發(fā)生率為92%,其中73.9%的假性白細(xì)胞增多患者白細(xì)胞計(jì)數(shù)值仍在正常參考范圍內(nèi)。假性白細(xì)胞增多的發(fā)展呈時(shí)間依賴性,中性粒細(xì)胞和淋巴細(xì)胞是發(fā)生假性增多的主要亞群。校正白細(xì)胞計(jì)數(shù)和未校正白細(xì)胞計(jì)數(shù)在EDTA抗凝血標(biāo)本采集后15分鐘以及更晚時(shí)間,分別計(jì)數(shù)均顯著高于其基礎(chǔ)計(jì)數(shù)值,P0.05。結(jié)論在大于50歲的男性健康人群中有更高的EDTA-PTCP發(fā)生率。生化資料可能有助于區(qū)分EDTA-PTCP高危人群。合理解釋假性白細(xì)胞增多對(duì)預(yù)防診斷錯(cuò)誤至關(guān)重要,假性白細(xì)胞增多的發(fā)展呈時(shí)間依賴性,Coulter LH750血細(xì)胞分析儀只在一定程度上減輕了假性白細(xì)胞增多程度,檸檬酸鈉能夠有效地防止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.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R446.11

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