特发性血小板减少性紫癜治疗前后巨核细胞的改变及其意义

Clinical value on changes of megalokaryocytes in patients with idiopathic thrombocytopenic purpura before and after treatment

目的探讨ITP治疗前后骨髓巨核细胞变化的临床意义。方法对ITP患者进行骨髓巨核细胞光镜与电镜检查,并作了治疗前后对比。结果巨核细胞数、颗粒型巨核细胞百分率,治疗后均明显低于治疗前(P<0.001);而产血小板型巨核细胞治疗后明显增加(P<0.001)。部分病例治疗前可见有程度不一的分隔膜系统(DMS)扩张,核周隙不规则扩张,质膜局部受损,未成熟型巨核细胞增多;治疗后,上述变化均有不同程度恢复。结论治疗前后骨髓巨核细胞的变化,对于ITP的诊断、疗效以及预后的判断均具有较重要的临床意义。

Objective: To study the clinical value on megalokaryocytes in the patients with ITP before and after the treatment. Methods: We observed the changes on bone marrow megalokaryocytes (microscope and electroscope) in 20 patients with ITP before and after the treatment. Results: After treatment the numbers of megalokaryocytes, granular megalokarycytes in bone marrow were significantly decreased (P <0.001, P <0.001), while mature megalokarycytes were obvriously increased (P <0.001). Some megalokarycytes showed alterations reflecting cell damage or dovelopmental defect. These were improved after the treatment. Conclusion: The changes of megalokaryocytes (microscope) before and after treatment have important clinical significances for pathogenesis, treatment and prognosis of ITP.