系统性红斑狼疮患者网织血小板和血小板生成素检测及其临床意义

The clinical significance of measuring reticulate platelets and thrombopoietin in the patients with systemic lupus erythematosus

目的探讨网织血小板(RPs)、血小板生成素(TPO)与系统性红斑狼疮(SLE)患者血小板减少的关系。方法48例SLE患者依据血小板计数(BPC)分为BPC正常组22例,BPC降低组26例和20例正常对照组,均通过流式细胞仪(FCM),放射免疫分析法(RIA),检测3组外周血网织血小板百分比(RP%)、TPO,并对部分患者进行骨髓巨核细胞(MK)直接计数。结果26例BPC降低组RP%(16.8±0.5)%、网织血小板绝对值RPC(3.7±0.6)×109/L与22例BPC正常组、正常对照组相比,均差异有显著性(P<0.01)。血小板减少或正常的SLE患者,其TPO水平分别为(47±6)、(49±6)pg/ml与正常对照组相比差异均有显著性(P<0.01)。SLE患者BPC降低组MK升高(15/26),SLE患者BPC正常组MK升高不明显(5/22)。结论①血小板减少的SLE患者RP%及RPC显著升高,提示外周血小板破坏可能是其主要原因。②SLE患者的TPO水平明显升高,提示SLE患者均存在巨核细胞的成熟障碍。

Objective To measure the percentage and absolute counts of reticulated plated (RPs), thrombopoietin (TPO) and megakaryocytes (MK) in bone marrow in the patients with systemic lupus erythematosus(SLE), and to explore the relationship between RPs and TPO levels in the patients with thrombombocytopenia of SLE. Methods Fortyeight patients with SLE were measured for RPs by flow cytometry(FCM) after thizole orange(TO) staining; serum TPO levels by radioimmunoassay (RIA). Results Forty-eight patients with SLE were grouped by blood platelets counts (BPC), 26 patients with thrombocytopenia and 22 patients with normal platelets. The reticulated platelets percentage (RP%) and reticulated platelets absolute counts (RPC) tended to be significantly higher in patients with thrombocytopenia of SLE than those in the other groups [(16.8±0.5)%, (3.7±0.6)×109/L, respectively, P<0.01]. But the serum levels of TPO in both groups with SLE were markedly higher than those in normal groups (47±6), (49±6) pg/ml, respectively, P<0.01]There were 15 patients with throm bocytopenia and 5 patients with norm al platelet counts,who increased M K num ber in bone m arrow (BM ).C onclusion The patients with throm bocy- topenia ofSLE increased dram atically R P%,R PC,TPO ,and M K .This dem onstrated thatthere were som e obstacles in m aturity of M K .The results also indicated that an excessive destruction of platelets w as the m ain reason for throm bocytopenia ofSLE.