飛行員EDTA依賴性假性血小板減少癥一例的診斷及文獻復習
摘要:目的 通過分析飛行員EDTA依賴性假性血小板減少癥,為準確診斷血小板減少癥提供依據. 方法 對1名用血細胞分析儀檢出血小板減少癥的飛行員,用手工法對血小板計數進行復查,將EDTA與枸櫞酸、肝素抗凝血進行對比,血涂片染色觀察血小板聚集情況. 結果 EDTA可誘發血小板聚集,導致假性血小板減少癥,可通過枸櫞酸、肝素抗凝血檢測進行鑒別.采血后即刻用儀器檢驗或手工檢驗,有助于避免假性診斷.經手工核查排除假性血小板減少癥后,該飛行員被認定飛行合格,飛行10h未發現出血現象和其他不適. 結論 對于飛行人員血小板減少癥,應考慮EDTA誘導的假性血小板減少癥的可能.建議在采血即刻即進行分析儀檢驗,或采用手工方法對血小板減少癥進行復核,以此來避免誤診、誤治及錯誤的飛行鑒定結論 . Abstract: Objective To provide evidence for accurately diagnosing thrombocytopenia in pilot by analyzing ethylene diamine tetreacetic acid (EDTA) dependent pseudothrombocytopenia.Methods A pilot was diagnosed as thrombocytopenia by EDTA count with hematology analyzer and his platelet was rechecked by manual test.The smears of citrate-and heparin-treated blood were taken for comparing the platelet aggregation. Results EDTA could induce platelet aggregation and cause pseudothrombocytopenia and that could be distinguished by the manual test of citrate-or heparin-treated blood.Testing of EDTA-treated blood by instrument shortly after sampling or manual test would be helpful to avoid such phenomenon. The pilot was qualified after re-examination by manual test of platelet.He was not found any hemorrhage and other discomfort in 10-hour flight. Conclusions EDTA dependent pseudo-thrombocytopenia may be resulted from instrument examination.Platelet counting immediately after blood sampling or rechecking by manual test for the flying personnel.who was diagnosed as thrombocytopenia by EDTA-treated blood counting,is suggested t
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