孕周相关外周血血小板参数参考区间调查

Establishment of the reference interval of platelet parameters in pregnant women

目的:了解妊娠妇女不同孕期外周血血小板计数(PLT)、未成熟血小板分数(IPF)、未成熟血小板绝对值(IPF#)、高荧光强度未成熟血小板分数(H-IPF)和血小板平均侧向荧光强度(PLT-X)的变化,并调查各参数参考区间。方法:收集2016年10月至2018年10月不同孕期妇女(妊娠组)1 272例,分为早期妊娠组(≤12周)348例,中期妊娠组(13~27周)369例和晚期妊娠组(≥28周)555例,中晚期妊娠组共924例;收集健康未妊娠妇女(对照组)200例;同时收集同期重度子痫前期妇女(重度子痫前期组)88例和妊娠期糖尿病妇女(妊娠期糖尿病组)100例。应用SYSMEX XE-5000全自动血细胞分析仪定量检测各组的外周血PLT、IPF、IPF#、H-IPF和PLT-X,并采用95%CI建立孕周相关各参数的参考区间。结果:妊娠组的PLT低于对照组(P<0.05);而IPF、IPF#、H-IPF和PLT-X高于对照组(P<0.05)。早期、中期和晚期妊娠组的IPF、IPF#和PLT-X均随着孕周的增加而升高(P<0.05);早期和中期妊娠组的PLT、H-IPF比较差异无统计学意义(P>0.05),但与晚期妊娠组比较差异有统计学意义(P<0.05)。重度子痫前期组和妊娠期糖尿病组的PLT低于中晚期妊娠组(P<0.05);而IPF、IPF#、H-IPF和PLT-X高于中晚期妊娠组(P<0.05)。结论:血小板相关参数随妊娠妇女孕期的发展发生不同程度的变化,孕周相关外周血血小板参数参考区间的建立可以为评估妊娠期病理状态奠定基础。

Objective:To explore the variation of platelet count(PLT),immature platelet fraction(IPF),absolute value of immature fraction(IPF#),high-fluorescence intensity of immature platelet fraction(H-IPF),and mean side fluorescence intensity of platelet(PLT-X)in the pregnant women of different gestation,then to establish the reference intervals of these parameters.Methods:1 272 normal pregnant women(20 to 30 years old)from October 2016 to October 2018 were selected,and they were divided into three groups:348 cases of early trimester group(≤12 weeks),369 cases of second trimester group(13 to 27 weeks)and 555 cases of third trimester group(≥28 weeks),second and third trimester group included 924 cases.Also,200 cases of non-pregnant women of 20 to 30 years old were included as control group.At the same time,88 cases of pregnant women with pre-eclampsia and 100 cases of gestational diabetes were collected.The PLT,IPF,IPF#,H-IPF and PLT-X of peripheral vein blood were determined by Sysmex XE-5000 and the reference intervals were established by using 95%confidence interval.Results:The PLT of the pregnant women was lower than the control group(P<0.05),but the parameters of IPF,IPF#,H-IPF and PLT-X were higher than the latter.The IPF,IPF#,H-IPF and PLT-X increased with the increase of gestational weeks in the early,second and third trimester groups(P<0.05).There was no statistically significant difference in PLT and H-IPF between early and second trimeter groups(P>0.05),but there were significant differences in PLT and H-IPF between early and second trimeter groups with third trimeter one(P<0.05).The PLTs of the pregnant women with pre-eclampsia and gestational diabetes were lower than the second and third trimester group,but the parameters of IPF,IPF#,H-IPF and PLT-X were higher than the latter.Conclusion:Platelet related parameters varied with the development of pregnant women during pregnancy,and the platelet parameters reference intervals during different trimeters of pregnancy were the basis for assessing the pathological state of pregnancy.