特发性血小板减少性紫癜血小板参数变化及其临床意义

The clinical significance of platelet parameter changes in idiopathic thrombocytopenic purpura

目的探讨特发性血小板减少性紫癜(ITP)时血小板参数的变化及其临床意义。方法对确诊为急性型特发性血小板减少性紫癜患儿67例分别测定其治疗前后的血小板数(PLT)、平均血小板体积(MPV)及血小板分布宽度(PDW)及大血小板比率(P-LCR),同时测定50例健康儿童以上血小板参数作为对照组。治疗前与对照组及与治疗后分别进行比较。并对血小板与血小板参数进行相关性分析。结果(1)ITP患儿治疗前PLT明显低于对照组,而PDW、MPV、P-LCR明显高于对照组,差异均具有极显著性(P<0·001),治疗后PLT上升,PDW、MPV、P-LCR下降,与治疗前比较差异具有极显著性(P<0·001)。(2)ITP轻、中、重度患儿随病情加重PLT进行性下降,而PDW、MPV、P-LCR进行性增大,但极重度患儿MPV反而变小。(3)PLT与MPV呈负相关(P<0·001)。MPV与PDW、PDW、MPV与P-LCR、PDW与P-LCR呈正相关(P<0·05)。结论血小板参数的动态观察有助于ITIP的鉴别诊断、病情判断及疗效观察。

Objective To explore the clinical significance of platelet parameter changes in idiopathic thrombocytopenic purpura （ITP）. Methods The platelet total （PLT）, mean platelet volume （MPV） and platelet distribution width （PDW） and platelet larger cell ratio （ P - LCR） were detected in 67 cases of idiopathic thrombocytopenic purpura （ITP） before and after treatment. It was compared with 50 cases of normal children. Results （ 1 ） Before the treatment PLT in ITP was obviously decreased than that of the normal children （P 〈0. 001 ）. MPV, PDW and P- LCR were obviously increased than those of the normal children （P 〈 0. 001 ）. After the treatment PLT was significantly increased, MPV, PDW and P- LCR were reduced significantly （P 〈 0. 001 ）. （2） The abnormalities of the platelet parameter became significant with the procession of ITP stages. But MPV was reduced in extreme severe form. （3） MPV was negatively correlated with PLT （P 〈 0. 001 ）. MPV positively correlated with PDW, MPV positively correlated with P - LCR, PDW positively correlated with P - LCR （P 〈 0. 05 ）. Conclusion Dynamical observation of the platelet parameter helps for the differential diagnosis, telling the degrees of the states of the patients and observing the effectiveness of therapy of ITP.