三分群血细胞研究仪血小板计数结果影响因素研究［摘要］目的对影响三分群血细胞分析仪血小板检测结果的相关因素进行分析，寻求解决假性异常结果的途径和方法，避免临床误诊。方法随机选取门诊和住院患者100例,其中，末梢血50例，静脉血50例，均采用乙二胺四乙酸二钾(EDTA—K2)进行抗凝后30min内上机检测，异常结果行手工计数和血涂片染色观察。结果100例原始标本中共有异常结果11例，包括减低8例，增高3例；通过更换抗凝剂、手工计数、涂片染色观察，6例减低结果被纠正，2例为EDTA抗凝剂依赖引起的假性血小板减少症(EDTA—PTCP),3例属反应性增高。结论当仪器出现与临床诊断严重不符的血小板异常结果时，应及时分析原因，通过更换抗凝剂种类、适当控制标本放置时间，同时辅以手工计数和血涂片染色观察可有效区分真性与假性计数结果异常，提高检测结果的准确性。［关键词］血细胞分析仪；血小板计数；抗凝剂；影响因素［中图分类号］R446.11+1［文献标识码］A［文章编号］1674—4721(2012)09(c)—0086—02Analysisofinfluencefactorsofplateletcountresultsofthree一clusterbloodcellanalyzerLIUJuDepartmentofLaboratory,MaternalandChildCareServiceCenterofYunCountyinShiyanCityinHubeiProvince,YunCounty442500,China[Abstract]ObjectiveToanalyzetherelatedinfluencefactorsofplateletcountresuItsofthree一clusterbloodcellanalyzer,andseekwaysandmeansofsolvingpseudoexceptionresults,soastoavoidclinicalmisdiagnosis.MethodsOnehundredcasesofout一patientsandin一patientswerechosenrandomly,with50casesofperipheralbloodand50casesofvenousblood.Allpatientsweremadethetestbythemachinewithin30minutesafteranticoagulantbyethylenediaminetetraaceticaciddipotassium（EDTA一K2）.Theabnormalresultswerecountedbyhandandobservedbybloodsmearstaining.ResuItsIntheoriginalsamplesof100cases,therewere11casesofabnormalresults,including8casesofdecreasedand3casesofincreased・Throughtheexchangeofanticoagulant,manualcountandobservationofsmearstaining,6casesofdecreasedwerecorrected,2caseswerepseudo一thrombocytopenia(EDTA一PTCP)causedbyEDTAanticoagulantresistance，3caseswereincreasedreactivity・ConclusionWhentheequipmentsshowthatabnormalplateletresuItsdon'tcomplywithclinicaldiagnosisseriously,itisnecessarytoanalyzethereasonsintime・Throughexchangingthetypesofanticoagulant，controllingstoragetimeofsamplesappropriatelyandsuppplementedbymanualcountandobservationofbloodsmearstaining,thetrueandfalsecountabnormalresultscanbedistinguishedeffectively,andtheaccuracyoftestresuItscanbeimproved・[Keywords]Bloodcellanalyzer；Plateletcount；Anticoagulant；Influencefactor三分群血细胞分析仪以其准确、快速、经济适用广泛应用于各级医院，由于其采用电阻抗法进行血小板计数，加之血小板自身具有的易于黏附、聚集、变形和破坏[1]等特性,极易导致计数结果出现异常。同时血小板计数作为止凝血检验中最基本、最常用的项目之一，其准确性显得尤为重要，因此对影响其计数准确性的因素进行探讨并找出切实可行的解决方法进行纠正，则更具现实意义。1资料与方法1.1一般资料随机选取本院2012年1〜4月100例门诊和住院患者，末梢血50例，静脉血50例。其中，男58例，女42例，年龄3〜52岁；单位体检人员12例，孕产妇38例，儿童50例。