对比枸橼酸钠法、阿米卡星法、硫酸镁法和预稀释法对EDTA依赖性假性血小板减少症(Ethylene Diamine Tetraacetic Acid Dependent Pseudothrombocytopenia， EDTA-PTCP)血小板检测的应用效果。

重新采集EDTA-PTCP患者的EDTA-K₂、枸橼酸钠抗凝静脉血及末梢全血。吸取EDTA-K₂抗凝样本分别加入阿米卡星(6.5 mg/mL)和硫酸镁(25 mg/mL)。0、1、2、3、4 h分别检测EDTA-K₂抗凝、枸橼酸钠抗凝、阿米卡星法和硫酸镁法血小板数目，并分别取不同时间点的样本进行血涂片镜检，观察血小板解聚情况。末梢全血用于预稀释法和手工草酸铵法检测。

2019年7月至2020年1月就诊于广州医科大学附属第二医院的患者中，发生EDTA-PTCP者共33例。重新采集的20例枸橼酸钠抗凝样本中有3例血小板聚集消失，枸橼酸钠法与EDTA-K₂法以及手工草酸铵法比较，血小板计数结果均有统计学差异(P＜0.05，P＜0.01)；阿米卡星法中，32例患者有17例血小板聚集消失，检测结果与EDTA-K₂法和手工草酸铵法比较，均有统计学差异(P＜0.01，P＜0.05)；硫酸镁法样本4 h内血小板数目未见上升，与EDTA-K₂法比较，差异无统计学意义(P＞0.05)，与手工草酸铵法比较，结果有统计学差异(P＜0.01)；预稀释法与EDTA-K₂法相比，血小板计数结果有统计学差异(P＜0.01)，与手工草酸铵法比较，无统计学差异(P＞0.05)。

枸橼酸钠法和阿米卡星法仅适用于部分EDTA-PTCP患者，阿米卡星法解聚效果优于枸橼酸钠法。硫酸镁法解聚效果不佳。预稀释法是目前最准确的方法。解决EDTA-PTCP的首选方法是预稀释法，当患者不便采集末梢血，重抽静脉血时优先选择阿米卡星法。

To compared the effects of sodium citrate anticoagulation, amikacin supplement, magnesium sulfate supplement and predilution method on the determination of platelets in EDTA-PTCP (Ethylene Diamine Tetraacetic Acid Dependent pseudobocytopenia).

After confirming the patients with EDTA-PTCP, whole blood samples were collected simultaneously in EDTA-K₂ and sodium citrate anticoagulated tubes. Amikacin (6.5 mg/mL) and magnesium sulfate (25 mg/mL) were added after aspiration of EDTA-K₂ treated whole blood. Samples anticoagulated with EDTA-K₂ and sodium citrate, supplemented with amikacin and magnesium sulfate were tested for their platelet counts at 0 h, 1 h, 2 h, 3 h and 4 h, respectively. Platelet aggregations were also confirmed by microscopic examination at 0 h, 1 h, 2 h, 3 h and 4 h, respectively. In addition, we collected the peripheral blood of patients with EDTA-PTCP for pre dilution mode testing and manual counting.

Thirty-three patients with EDTA-PTCP were confirmed in The Second Affiliated Hospital of Guangzhou Medical University from July 2019 to January 2020. Platelet aggregations disappeared in 3 of 20 sodium citrate treated samples. The platelet counts of sodium citrate group were higher than that in EDTA-K₂ group (P＜0.05) but were lower than manual counting (P＜0.01). Platelet aggregations disappeared in 17 of 32 patients after adding amikacin into EDTA-K₂ treated whole blood. There were statistical differences between amikacin supplement group and EDTA-K₂ group (P＜0.01). There was statistical differences between amikacin supplement group and manual counting (P＜0.05). The platelet counts in magnesium sulfate supplement group did not show a significant increase within 4 hours. No significant differences were found between magnesium sulfate supplement group and EDTA-K₂group (P＞0.05). The platelet counts of magnesium sulfate supplement group were much lower than manual counting (P＜0.01). The platelet counts in pre-dilution group showed a remarkably increase compared to EDTA-K₂ group (P＜0.01). There were no significant differences in platelet counts between pre dilution and manual counting (P＞0.05).

Sodium citrate anticoagulation and amikacin supplement were not always effective for correcting platelet counts in vitro. Amikacin supplement had better dissociative effects on platelet aggregations than sodium citrate anticoagulation. Magnesium sulfate supplement had a poor dissociation effect on correcting platelet counts. Pre-dilution was the most accurate method. When it is inconvenient to collect peripheral blood from the patient, amikacin supplement is recommended for venous blood.